Children of Mothers With Diabetes During Pregnancy

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Birth weight and parental BMI predict overweight in children from mothers with gestational diabetes, by U.M. Schaefer-Graf and colleagues. Diabetes Care 28:1745–1750, 2005

What is the problem and what is known about it so far?

Some women who have never had diabetes develop high blood glucose during pregnancy. This is called gestational diabetes. Gestational diabetes often results in the baby growing more than usual while in the womb and mothers having larger-than-usual newborns.

Why did the researchers do this particular study?

Past studies have shown that problems that arise from pregnant mothers having high blood glucose can have long-term effects on children. These children can be more likely to be obese (seriously overweight) or to have a problem with blood glucose and diabetes. The researchers did this study to see how high blood glucose during pregnancy affects the health of the children.

Who was studied?

Researchers studied 324 children from white women who had diabetes during pregnancy.

How was the study done?

In all of the pregnancies, doctors recorded the mothers' height and weight before pregnancy, the mothers' blood glucose levels, and the size of the babies' bellies while they were in their mothers' womb. The weight and height of children were measured at birth and, on average, 5 years later. Researchers also looked at data about the children's weight and height from their routine doctor's visits when the babies were 6, 12, and 24 months old, as well as the height and weight of the parents during these visits.

What did the researchers find?

About 37% of children who were larger than normal at birth were overweight 5 years later; only 25% who were around normal size at birth were overweight 5 years later. In addition, 69% of the children who had obese parents were also overweight 5 years later, whereas only 20% of the children who had normal-weight or overweight parents were overweight. The children of mothers with high blood glucose during pregnancy have a high chance of being overweight, and the researchers believe that this is related to their rapid growth in the womb and the higher-than-normal weight levels of their parents.

What were the limitations of the study?

The results of the study were based on a group that only represented 40% of the eligible group of patients. That could mean that the study's findings cannot be widely applied to any group. However, birth weight and the weight levels of the mothers were the same in both groups, so it is unlikely that the children in the study group were more likely to be overweight than in any other group.

What are the implications of the study?

This study shows that prevention has to start as early as possible. Mothers should try to manage their diabetes during pregnancy, and families with children of mothers who had high blood glucose during pregnancy should try to promote a healthy lifestyle and keep a close eye on the weight of their children. Even though there is a connection between diabetes during pregnancy and obesity, if parents encourage their children to eat healthy and exercise, obesity and diabetes can in many cases be prevented.

Visit the American Diabetes Association's recommendations for treating gestational diabetes.

FOR MORE INFORMATION

Gestational Diabetes 

Gestational Diabetes: What to Expect, 4th Edition, by the American Diabetes Association (Alexandria, Va., ADA, 2001)

A randomized trial evaluating a predominately fetal growth-based strategy to guide management of gestational diabetes in Caucasian women, by U. Schaefer-Graf and colleagues. Diabetes Care 27:297–302, 2004