In Utero Exposure to Gestational Diabetes and Child Health at Age Three to Seven: A Cohort Study

Abstract

Objective: To determine if, after adjusting for potential confounders, child health outcomes differ between children exposed to maternal gestational diabetes mellitus (GDM) and their unexposed peers.

Study design: Prospective cohort study. Recruitment took place between June 2022 and May 2024. The primary outcome was overweight or obesity. The secondary outcomes were other measures of size, eating behavior, behavioral and emotional problems, neurodevelopmental disorders, atopic disorders, and diabetes. Between-group differences were determined with generalized linear mixed models adjusted for gestational weight gain and socioeconomic status.

Results: Of the 699 children who participated at a mean age of 5.6 years, 295 (42.2%) were exposed to GDM. There was no difference in the risk of being overweight or obese in children exposed to GDM compared with those unexposed (adjusted relative risk [95% CI]: 0.69 [0.44, 1.08]). Children exposed to GDM had lower body mass index z scores (adjusted relative risk [95% CI]: -0.30 [-0.53, -0.60]), enjoyment of food scores (adjusted relative risk [95% CI]: -0.17 [-0.31, -.04]), and risk of abnormal hyperactivity scores (adjusted relative risk [95% CI]: 0.23 [0.06, 0.87])] Other outcomes were similar between exposure groups.

Conclusions: After accounting for confounders, children exposed to treated GDM had a risk of being overweight or obese comparable with their unexposed peers. Our findings are reassuring for parents and health practitioners caring for women who experience GDM and their children.

Keywords: birth cohort; child health; diabetes in pregnancy; long-term effects; offspring.