Gestational diabetes is a
fairly common pregnancy complication. A new study looks into how it can impact
a child’s future health.
Children born to mothers
with gestational diabetes mellitus (GDM) are at increased risk of developing
asthma and wheeze, according to a study involving more than 1000 mother-child
pairs. The participants, who were in the second trimester when the investigation
began, were drawn from an existing, predominantly Black study group in
Tennessee. Participants responded to questionnaires and provided biospecimens
through the remainder of their pregnancies. In addition, birth records provided
information about pregnancy complications and labor and delivery. Postnatally,
1100 pairs participated in annual in-person clinic visits through the child’s
third year and again at about age 4 years. At the 4-year visit (which also
included children up to 6.5 years), investigators administered parental
questionnaires to assess each child’s history of wheeze and asthma.
Investigators documented
GDM for 62 (5.6%) of pregnant participants. Compared with other women in the
study, those with GDM were older and had a higher socioeconomic status and
prepregnancy body mass index. Women with GDM also gained less weight during
pregnancy and were more likely to experience preeclampsia/gestational
hypertension. In addition, children born to mothers with GDM were larger at
birth. GDM status was not affected by maternal history of asthma.
At follow-up, wheeze and
asthma were more common among children born to women with GDM than among those
born to women without the condition. Overall, reported prevalence of current
wheeze and asthma was 19% versus 15.7%, respectively. Among children of women
with GDM, 30.6% had current wheeze compared with 18.3% of children of women
without GDM; 27.4% versus 15.9%, respectively, had current asthma; and 25.8%
versus 13.4% had diagnosed asthma. The differences held even after adjusting
for multiple potential confounding factors. Investigators therefore concluded
that GDM may be a risk factor for childhood asthma.
Here is another instance
where we need to look to our adult medicine colleagues to help optimize health
for babies yet to be born. However, the rate of GDM is rising because of
increasing obesity/overweight, so if we can support our current patients in
establishing and maintaining their recommended weight, we will help keep the
next generation of children healthy.
Source: Contemporary Pediatrics