Treatment of Gestational Diabetes Mellitus and Offspring Early Childhood Growth

Autor: Diane M. Comer, Steve N. Caritis, Kaleab Z. Abebe, Christina M. Scifres, Maisa Feghali, Jacqueline Atlass, Janet M. Catov, Silva A. Arslanian
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Offspring
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Clinical Biochemistry
Weight Gain
Biochemistry
Cohort Studies
Young Adult
03 medical and health sciences
Child Development
0302 clinical medicine
Endocrinology
Pregnancy
Internal medicine
Diet
Diabetic
Glyburide
medicine
Birth Weight
Humans
Insulin
030212 general & internal medicine
Medical nutrition therapy
Online Only Articles
Prenatal Nutritional Physiological Phenomena
Retrospective Studies
030219 obstetrics & reproductive medicine
business.industry
Obstetrics
Medical record
Biochemistry (medical)
Infant
Newborn
Infant
Pennsylvania
medicine.disease
Gestational diabetes
Diabetes
Gestational
Child
Preschool
Prenatal Exposure Delayed Effects
Female
medicine.symptom
business
Weight gain
Body mass index
Cohort study
Zdroj: J Clin Endocrinol Metab
ISSN: 1945-7197
0021-972X
Popis: Background Gestational diabetes mellitus (GDM) is associated with fetal overgrowth, and certain treatments are associated with an increased risk of macrosomia. However, there are limited data about the long-term effect of GDM treatment on childhood growth. Methods Cohort study of 816 women with GDM and their offspring delivered between 2009 and 2012. Childhood height and weight through age 3 were collected from the medical record and z-scores and body mass index (BMI) were calculated. We assessed the association between GDM treatment and childhood growth using linear mixed modeling. Results Treatment was divided into medical nutritional therapy (MNT) (n = 293), glyburide (n = 421), and insulin (n = 102). At delivery, birthweight, z-score, and BMI were higher in the offspring of women treated with either glyburide or insulin compared to MNT. However, weight, z-score, and BMI were similar among all offspring at 6 months and 1, 2, and 3 years of age. After controlling for covariates, there were differences in the weight z-score (P = 0.01) over the 3-year period by treatment group, but no differences in weight (P = 0.06) or change in BMI (P = 0.28). Pairwise comparisons indicated that insulin was associated with more weight gain compared with MNT (0.69 kg; 95% CI, 0.10-1.28; P = 0.02) and glyburide was associated with a trend toward lower weight z-score compared with MNT (−0.24; 95% CI, −0.47 to 0.003; P = 0.05). Conclusion Despite growth differences detected at birth, we observed no meaningful differences in childhood growth from 6 months to 3 years among treatment groups, including in the offspring of women with GDM treated with glyburide.
Databáze: OpenAIRE
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