Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Clinic of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Acta Obstet Gynecol Scand. 2023 Sep;102(9):1193-1202. doi: 10.1111/aogs.14593. Epub 2023 Jul 19.
Children born to mothers with gestational diabetes mellitus (GDM) are at risk of metabolic disturbances such as diabetes mellitus and overweight. However, few have examined the outcome of children whose mothers were at risk of GDM. The aim of the study was to investigate how mothers' risk of developing GDM affects physical health and neurodevelopment of the children at 7 years of age.
This is a secondary analysis of a follow-up study of a multicenter randomized controlled trial including 855 pregnant women, carried out at St. Olavs Hospital, Trondheim University Hospital, and Stavanger University Hospital in Norway from 2007 to 2009. Risk factors for developing GDM included age >40 years, diabetes in near family, previous child with birthweight ≥4500 g and pre-pregnancy body mass index (BMI) ≥25 kg/m . Data on GDM risk factors were available for 750 women, who were divided into a risk group if they had one or more risk factors for developing GDM (n = 238) and a no risk (n = 512) group. At 7 years of age, 72 children born to mothers in the risk group and 194 children born to mothers in the no risk group participated. The children's height, weight and physical activity were reported by their parents. Neurodevelopmental outcomes were assessed by using the Five-to-Fifteen questionnaire, which includes motor skills, executive functions, perception, memory, language, social skills, and emotional/behavioral problems.
Most women had only one risk factor for GDM, and pre-pregnancy overweight was the most prevalent risk factor. Children of mothers in the risk group had higher birthweight and length. At the 7-year follow-up, they had a higher weight and BMI, and the odds ratio of being overweight was 3.0 (95% confidence interval 1.1-8.3). There was no group difference in the children's physical activity and their neurodevelopmental outcomes were similar.
We found higher BMI and increased risk of overweight in children born to mothers with one or more risk factors for developing GDM. A focus on preventing pre-pregnancy overweight should be encouraged.
患有妊娠糖尿病（GDM）的母亲所生的孩子存在发生糖尿病和超重等代谢紊乱的风险。然而，很少有研究关注那些母亲存在 GDM 风险的孩子的结局。本研究旨在探讨母亲发生 GDM 的风险如何影响孩子在 7 岁时的身体健康和神经发育。
这是对一项多中心随机对照试验的随访研究的二次分析，该研究于 2007 年至 2009 年在挪威的特隆赫姆大学医院和斯塔万格大学医院进行，共纳入 855 名孕妇。GDM 发生的危险因素包括年龄>40 岁、近亲中有糖尿病、既往分娩的孩子体重≥4500g 和孕前体重指数（BMI）≥25kg/m²。共有 750 名妇女的 GDM 危险因素数据可用，其中有一个或多个 GDM 危险因素的妇女被分为风险组（n=238），无危险因素的妇女被分为无风险组（n=512）。在 7 岁时，风险组的 72 名儿童和无风险组的 194 名儿童参与了研究。儿童的身高、体重和体力活动由其父母报告。神经发育结果通过使用 Five-to-Fifteen 问卷进行评估，该问卷包括运动技能、执行功能、感知、记忆、语言、社交技能和情绪/行为问题。
大多数妇女只有一个 GDM 危险因素，且孕前超重是最常见的危险因素。母亲为风险组的儿童出生体重和身长较高。在 7 岁随访时，他们的体重和 BMI 较高，超重的比值比为 3.0（95%置信区间 1.1-8.3）。两组儿童的体力活动无差异，神经发育结果相似。
我们发现，母亲有一个或多个 GDM 危险因素的儿童 BMI 较高，超重风险增加。应鼓励关注预防孕前超重。
