TY - JOUR
T1 - Glucose Intolerance in Pregnancy and Offspring Obesity in Late Adolescence
AU - Bendor, Cole D.
AU - Bardugo, Aya
AU - Rotem, Ran Shmuel
AU - Derazne, Estela
AU - Gerstein, Hertzel C.
AU - Tzur, Dorit
AU - Pinhas-Hamiel, Orit
AU - Tsur, Avishai M.
AU - Cukierman-Yaffe, Tali
AU - Lebenthal, Yael
AU - Afek, Arnon
AU - Chodick, Gabriel
AU - Twig, Gilad
N1 - Publisher Copyright:
© 2022 by the American Diabetes Association.
PY - 2022/7
Y1 - 2022/7
N2 - OBJECTIVE Gestational hyperglycemia is associated with deleterious neonatal outcomes, but long-term risks for offspring obesity are less clear. We estimated the odds for offspring adolescent overweight and obesity among mothers with gestational glucose intolerance. RESEARCH DESIGN AND METHODS In a mother-offspring historical cohort, the Israel military conscription data set was linked to a large health maintenance organization. Included were women who were evaluated at adolescence and underwent two-step gestational diabetes screening (mean age, 31 years) with a 50-g glucose challenge test (GCT), fol-lowed by a 100-g oral glucose tolerance test (OGTT) if the result was abnormal. Glucose tolerance categories included gestational normoglycemia, abnormal GCT with normal OGTT, impaired glucose tolerance (IGT; one abnormal OGTT value), and gestational diabetes. The primary outcome was offspring overweight/obesity (BMI ‡85th percentile) at adolescence, measured prior to military conscription. Logistic regression models were applied. RESULTS Of 33,482 mother-offspring pairs, overweight and obesity were observed in 6,516 offspring. Across increasing categories of pregnancy glycemia, the propor-tions of offspring with adolescent overweight/obesity increased: normoglycemia, 19%; abnormal GCT with normal OGTT, 22%; gestational IGT, 24%; and gesta-tional diabetes, 25% (P < 0.0001). Corresponding odds ratios after adjustment for the mother’s late adolescent characteristics (sociodemographic confounders and BMI) and pregnancy age were 1.2 (95% CI 1.1–1.4), 1.3 (1.2–1.5), and 1.4 (1.3–1.6), respectively. Further adjustment for offspring birth weight percentile and sociodemographic variables did not materially change results. Associations were more pronounced with increasing obesity severity. CONCLUSIONS Gestational glucose intolerance, including categories not meeting the gestational diabetes threshold, was associated with increased odds for offspring over-weight/obesity at late adolescence.
AB - OBJECTIVE Gestational hyperglycemia is associated with deleterious neonatal outcomes, but long-term risks for offspring obesity are less clear. We estimated the odds for offspring adolescent overweight and obesity among mothers with gestational glucose intolerance. RESEARCH DESIGN AND METHODS In a mother-offspring historical cohort, the Israel military conscription data set was linked to a large health maintenance organization. Included were women who were evaluated at adolescence and underwent two-step gestational diabetes screening (mean age, 31 years) with a 50-g glucose challenge test (GCT), fol-lowed by a 100-g oral glucose tolerance test (OGTT) if the result was abnormal. Glucose tolerance categories included gestational normoglycemia, abnormal GCT with normal OGTT, impaired glucose tolerance (IGT; one abnormal OGTT value), and gestational diabetes. The primary outcome was offspring overweight/obesity (BMI ‡85th percentile) at adolescence, measured prior to military conscription. Logistic regression models were applied. RESULTS Of 33,482 mother-offspring pairs, overweight and obesity were observed in 6,516 offspring. Across increasing categories of pregnancy glycemia, the propor-tions of offspring with adolescent overweight/obesity increased: normoglycemia, 19%; abnormal GCT with normal OGTT, 22%; gestational IGT, 24%; and gesta-tional diabetes, 25% (P < 0.0001). Corresponding odds ratios after adjustment for the mother’s late adolescent characteristics (sociodemographic confounders and BMI) and pregnancy age were 1.2 (95% CI 1.1–1.4), 1.3 (1.2–1.5), and 1.4 (1.3–1.6), respectively. Further adjustment for offspring birth weight percentile and sociodemographic variables did not materially change results. Associations were more pronounced with increasing obesity severity. CONCLUSIONS Gestational glucose intolerance, including categories not meeting the gestational diabetes threshold, was associated with increased odds for offspring over-weight/obesity at late adolescence.
UR - http://www.scopus.com/inward/record.url?scp=85134361348&partnerID=8YFLogxK
U2 - 10.2337/dc21-2634
DO - 10.2337/dc21-2634
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C2 - 35670776
AN - SCOPUS:85134361348
SN - 0149-5992
VL - 45
SP - 1540
EP - 1548
JO - Diabetes Care
JF - Diabetes Care
IS - 7
ER -
