BACKGROUND: Gestational diabetes mellitus (GDM) represents a risk factor for both mother and her offspring in a short-term (perinatal morbidity) and long-term horizon (postpartum diabetes or foetal programming). Several studies focused at peri/postnatal outcomes of GDM mother´s offspring, however relatively few (and none in Czech population) were designed as prospective. The aim of the study was to ascertain eventual anthropometric and developmental abnormalities and/or morbidity in offspring of GDM mothers compare to controls in a 5-year follow-up using a parent-reported parameters related to psychomotor development and common paediatric morbidities including a sub-study of offspring of GDM mothers experiencing adverse perinatal outcomes. METHODS: A 5 year follow up study of offspring of GDM mothers (n = 26) vs those with a normal pregnancy (n = 63). An electronic questionnaire was used to obtain the parameters (such as growth, psychomotor development, vaccination, morbidity history etc.) available to parents from the parent-held infant health record. Data on pregnancy and delivery were available from the previous study. RESULTS: Offspring of GDM mothers had delayed psychomotor development in early childhood, but in 5 years of age they seemed to gradually achieve results of a control group. Children with macrosomia had a higher percentile of weight-for-height and were significantly more frequently ill than those with a normal birth weight. Offspring of obese mothers had worse verbal language skills in early childhood and a higher percentile of weight-for-height. CONCLUSION: Maternal gestational diabetes and obesity can be considered an important determinant of postnatal offspring development and health status, which further advocates for broader implementation of preventive strategies.

Department of Obstetrics and Gynaecology University Hospital Brno Jihlavská 20 625 00 Brno Czech Republic

Department of Pathophysiology Faculty of Medicine Masaryk University Kamenice 5 Brno 625 00 Czech Republic

Department of Pediatrics University Hospital Brno Černopolní 9 Brno Czech Republic

Zobrazit více v PubMed

Reece EA, Leguizamón G, Wiznitzer A. Gestational diabetes: the need for a common ground. Lancet. 2009;373(9677):1789–1797. doi: 10.1016/S0140-6736(09)60515-8. PubMed DOI

Association AD. 2.Classification and Diagnosis of Diabetes:. Diabetes Care. 2019;42(1):S13–S28. doi: 10.2337/dc19-S002. PubMed

Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773–1779. doi: 10.1016/S0140-6736(09)60731-5. PubMed DOI

Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care. 2002;25(10):1862–1868. doi: 10.2337/diacare.25.10.1862. PubMed DOI

Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–682. doi: 10.2337/dc09-1848. PubMed DOI PMC

Nolan CJ, Damm P, Prentki M. Type 2 diabetes across generations: from pathophysiology to prevention and management. Lancet. 2011;378(9786):169–181. doi: 10.1016/S0140-6736(11)60614-4. PubMed DOI

Dabelea D, Pettitt DJ. Intrauterine diabetic environment confers risks for type 2 diabetes mellitus and obesity in the offspring, in addition to genetic susceptibility. J Pediatr Endocrinol Metab. 2001;14(8):1085–1091. doi: 10.1515/jpem-2001-0803. PubMed DOI

Sanchez CE, Barry C, Sabhlok A, Russell K, Majors A, Kollins SH, et al. Maternal pre-pregnancy obesity and child neurodevelopmental outcomes: a meta-analysis. Obes Rev. 2018;19(4):464–484. doi: 10.1111/obr.12643. PubMed DOI PMC

Hildén K, Hanson U, Persson M, Magnuson A, Simmons D, Fadl H. Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden. Diabet Med. 2019;36(2):151–157. doi: 10.1111/dme.13843. PubMed DOI PMC

Wang J, Pan L, Liu E, Liu H, Liu J, Wang S, et al. Gestational diabetes and offspring's growth from birth to 6 years old. Int J Obes (Lond) 2019;43(4):663–672. doi: 10.1038/s41366-018-0193-z. PubMed DOI PMC

Parnell AS, Correa A, Reece EA. Pre-pregnancy Obesity as a Modifier of Gestational Diabetes and Birth Defects Associations: A Systematic Review. Matern Child Health J. 2017;21(5):1105–1120. doi: 10.1007/s10995-016-2209-4. PubMed DOI

Lowe WL, Scholtens DM, Kuang A, Linder B, Lawrence JM, Lebenthal Y, et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Gestational Diabetes Mellitus and Childhood Glucose Metabolism. Diabetes Care. 2019;42(3):372–380. doi: 10.2337/dc18-1646. PubMed DOI PMC

Lowe WL, Lowe LP, Kuang A, Catalano PM, Nodzenski M, Talbot O, et al. Maternal glucose levels during pregnancy and childhood adiposity in the Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study. Diabetologia. 2019;62(4):598–610. doi: 10.1007/s00125-018-4809-6. PubMed DOI PMC

Camprubi Robles M, Campoy C, Garcia Fernandez L, Lopez-Pedrosa JM, Rueda R, Martin MJ. Maternal Diabetes and Cognitive Performance in the Offspring: A Systematic Review and Meta-Analysis. PLoS ONE. 2015;10(11):e0142583. doi: 10.1371/journal.pone.0142583. PubMed DOI PMC

Kowalczyk M, Ircha G, Zawodniak-Szałapska M, Cypryk K, Wilczyński J. Psychomotor development in the children of mothers with type 1 diabetes mellitus or gestational diabetes mellitus. J Pediatr Endocrinol Metab. 2002;15(3):277–281. doi: 10.1515/jpem.2002.15.3.277. PubMed DOI

Rizzo TA, Dooley SL, Metzger BE, Cho NH, Ogata ES, Silverman BL. Prenatal and perinatal influences on long-term psychomotor development in offspring of diabetic mothers. Am J Obstet Gynecol. 1995;173(6):1753–1758. doi: 10.1016/0002-9378(95)90422-0. PubMed DOI

Bartáková V, Ťápalová V, Wágnerová K, Janků P, Bělobrádková J, Kaňková K. Pregnancy outcomes in women with gestational diabetes: specific subgroups might require increased attention. Ceska Gynekol. 2017;82(1):16–23. PubMed

Bartáková V, Barátová B, Pácal L, Ťápalová V, Šebestová S, Janků P, Kaňková K. Development of a New Risk Score for Stratification of Women with Gestational Diabetes Mellitus at High Risk of Persisting Postpartum Glucose Intolerance Using Routinely Assessed Parameters. Life (Basel) 2021;11(6):464. PubMed PMC

Group WMGRS. WHO Motor Development Study: windows of achievement for six gross motor development milestones. Acta Paediatr Suppl. 2006;450:86–95. doi: 10.1111/j.1651-2227.2006.tb02379.x. PubMed

de Onis M, Garza C, Victora CG, Onyango AW, Frongillo EA, Martines J. The WHO Multicentre Growth Reference Study: planning, study design, and methodology. Food Nutr Bull. 2004;25(1 Suppl):S15–26. doi: 10.1177/15648265040251S103. PubMed DOI

Bednářová J, Šmardová V. Školní zralost: Co by mělo umět dítě před vstupem do školy. Computer press; 2011.

Group WMGRS WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr. Suppl. 2006;450:76–85. doi: 10.1111/j.1651-2227.2006.tb02378.x.. PubMed DOI

Zhang S, Liu H, Zhang C, Wang L, Li N, Leng J, et al. Maternal glucose during pregnancy and after delivery in women with gestational diabetes mellitus on overweight status of their children. Biomed Res Int. 2015;2015:543038. doi: 10.1155/2015/543038. PubMed DOI PMC

Cabizuca CA, Rocha PS, Marques JV, Costa TFLR, Santos ASN, Schröder AL, et al. Postpartum follow up of gestational diabetes in a Tertiary Care Center. Diabetol Metab Syndr. 2018;10:2. doi: 10.1186/s13098-017-0303-4. PubMed DOI PMC

Catalano PM, McIntyre HD, Cruickshank JK, McCance DR, Dyer AR, Metzger BE, et al. The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care. 2012;35(4):780–786. doi: 10.2337/dc11-1790. PubMed DOI PMC

Ethridge JK, Catalano PM, Waters TP. Perinatal outcomes associated with the diagnosis of gestational diabetes made by the international association of the diabetes and pregnancy study groups criteria. Obstet Gynecol. 2014;124(3):571–578. doi: 10.1097/AOG.0000000000000412. PubMed DOI PMC

Nayak PK, Mitra S, Sahoo JP, Daniel M, Mathew A, Padma A. Feto-maternal outcomes in women with and without gestational diabetes mellitus according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Diabetes Metab Syndr. 2013;7(4):206–209. doi: 10.1016/j.dsx.2013.10.017. PubMed DOI

Laafira A, White SW, Griffin CJ, Graham D. Impact of the new IADPSG gestational diabetes diagnostic criteria on pregnancy outcomes in Western Australia. Aust N Z J Obstet Gynaecol. 2016;56(1):36–41. doi: 10.1111/ajo.12394. PubMed DOI

Nguyen PTH, Pham NM, Chu KT, Van Duong D, Van Do D. Gestational Diabetes and Breastfeeding Outcomes: A Systematic Review. Asia Pac J Public Health. 2019:1010539519833497. doi: 10.1177/1010539519833497. PubMed

Peters LL, Thornton C, de Jonge A, Khashan A, Tracy M, Downe S, et al. The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population-based cohort study. Birth. 2018;45(4):347–357. doi: 10.1111/birt.12348. PubMed DOI PMC

Quinn PD, Rickert ME, Weibull CE, Johansson ALV, Lichtenstein P, Almqvist C, et al. Association Between Maternal Smoking During Pregnancy and Severe Mental Illness in Offspring. JAMA Psychiat. 2017;74(6):589–596. doi: 10.1001/jamapsychiatry.2017.0456. PubMed DOI PMC

Micalizzi L, Knopik VS. Maternal smoking during pregnancy and offspring executive function: What do we know and what are the next steps? Dev Psychopathol. 2018;30(4):1333–1354. doi: 10.1017/S0954579417001687. PubMed DOI PMC

Hohlweg-Majert P, Goyert A, Schmitt A. Psychomotor development of children born operatively by Caesarian section, vacuum or forceps in the period between 3 and 7 years (author's transl) Z Geburtshilfe Perinatol. 1979;183(5):375–383. PubMed

Kumar R, Ouyang F, Story RE, Pongracic JA, Hong X, Wang G, et al. Gestational diabetes, atopic dermatitis, and allergen sensitization in early childhood. J Allergy Clin Immunol. 2009;124(5):1031–8.e1–4. doi: 10.1016/j.jaci.2009.06.052.. PubMed DOI PMC

Shore SA. Obesity and asthma: possible mechanisms. J Allergy Clin Immunol. 2008;121(5):1087–93; quiz 94–5. doi: 10.1016/j.jaci.2008.03.004. PubMed

Curhan GC, Chertow GM, Willett WC, Spiegelman D, Colditz GA, Manson JE, et al. Birth weight and adult hypertension and obesity in women. Circulation. 1996;94(6):1310–1315. doi: 10.1161/01.cir.94.6.1310. PubMed DOI

Whincup PH, Kaye SJ, Owen CG, Huxley R, Cook DG, Anazawa S, et al. Birth weight and risk of type 2 diabetes: a systematic review. JAMA. 2008;300(24):2886–2897. doi: 10.1001/jama.2008.886. PubMed DOI

Grissom NM, Reyes TM. Gestational overgrowth and undergrowth affect neurodevelopment: similarities and differences from behavior to epigenetics. Int J Dev Neurosci. 2013;31(6):406–414. doi: 10.1016/j.ijdevneu.2012.11.006. PubMed DOI PMC

Leddy MA, Power ML, Schulkin J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol. 2008;1(4):170–178. PubMed PMC

Marchi J, Berg M, Dencker A, Olander EK, Begley C. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev. 2015;16(8):621–638. doi: 10.1111/obr.12288. PubMed DOI

Casas M, Forns J, Martínez D, Guxens M, Fernandez-Somoano A, Ibarluzea J, et al. Maternal pre-pregnancy obesity and neuropsychological development in pre-school children: a prospective cohort study. Pediatr Res. 2017;82(4):596–606. doi: 10.1038/pr.2017.118. PubMed DOI

Adane AA, Mishra GD, Tooth LR. Maternal pre-pregnancy obesity and childhood physical and cognitive development of children: a systematic review. Int J Obes (Lond) 2016;40(11):1608–1618. doi: 10.1038/ijo.2016.140. PubMed DOI

Catalano PM, Farrell K, Thomas A, Huston-Presley L, Mencin P, de Mouzon SH, et al. Perinatal risk factors for childhood obesity and metabolic dysregulation. Am J Clin Nutr. 2009;90(5):1303–1313. doi: 10.3945/ajcn.2008.27416. PubMed DOI PMC

Kaar JL, Crume T, Brinton JT, Bischoff KJ, McDuffie R, Dabelea D. Maternal obesity, gestational weight gain, and offspring adiposity: the exploring perinatal outcomes among children study. J Pediatr. 2014;165(3):509–515. doi: 10.1016/j.jpeds.2014.05.050. PubMed DOI PMC

Tozuka Y, Kumon M, Wada E, Onodera M, Mochizuki H, Wada K. Maternal obesity impairs hippocampal BDNF production and spatial learning performance in young mouse offspring. Neurochem Int. 2010;57(3):235–247. doi: 10.1016/j.neuint.2010.05.015. PubMed DOI

Rodriguez A, Miettunen J, Henriksen TB, Olsen J, Obel C, Taanila A, et al. Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts. Int J Obes (Lond) 2008;32(3):550–557. doi: 10.1038/sj.ijo.0803741. PubMed DOI

Craig L, Sims R, Glasziou P, Thomas R. Women's experiences of a diagnosis of gestational diabetes mellitus: a systematic review. BMC Pregnancy Childbirth. 2020;20(1):76. doi: 10.1186/s12884-020-2745-1. PubMed DOI PMC

Kilgour C, Bogossian FE, Callaway L, Gallois C. Postnatal gestational diabetes mellitus follow-up: Australian women's experiences. Women Birth. 2015;28(4):285–292. doi: 10.1016/j.wombi.2015.06.004. PubMed DOI

Scholtens DM, Kuang A, Lowe LP, Hamilton J, Lawrence JM, Lebenthal Y, et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism. Diabetes Care. 2019;42(3):381–392. doi: 10.2337/dc18-2021. PubMed DOI PMC