Is maternal diabetes a risk factor for childhood obesity?

Abstract

Objective: Our objective is to determine if there is a relationship between diabetes during pregnancy and childhood obesity, in our inner-city, African–American population. Methods: Pertinent child, neonatal and maternal pregnancy and delivery data were collected from mothers of children age 2–5 years old. Outcome variable definition was based on children’s body mass index (BMI) subgroups; independent variable definition on birthweight subgroups based on customized growth percentiles. Covariates included pre and postnatal factors. Those covariates marginally related to diabetes (p < 0.2) by bivariate analyses, were allowed to compete in logistic regression, with p < 0.05 significant. Results: Four hundred and ninety-three patients were enrolled, of which 35 (7.1%) had diabetes during pregnancy. Children of diabetic mothers were more likely to be obese at age 2–5 years than those of non-diabetics (p = 0.004). Five of 20 covariates had p < 0.2 in bivariate setting. Following stepwise logistic regression, diabetes and maternal prepregnancy BMI were significant determinants of childhood obesity. When large-for-gestational age (LGA) was added into the model, diabetes was no longer significant (p = 0.105); only LGA (p = 0.008) and maternal prepregnancy BMI (p = 0.032) were significantly associated with childhood obesity. Conclusions: In our inner-city, primarily African–American population, diabetes in pregnancy is significantly related to childhood obesity at age 2–5 years. Well-controlled diabetes during pregnancy that avoids macrosomia may lead to prevention of future childhood obesity as well.

Keywords::

• Customized growth percentiles fetal origins of adult disease
• large-for-gestational age infants

Declaration of interest:Supported in part by Grant #K12 HD-01254 (S.H.M.) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.