Gestational diabetes can have lasting effects on child health

Children born to mothers with gestational diabetes mellitus (GDM) are at increased risk of developing asthma and wheeze, according to a study involving more than 1000 mother-child pairs. The participants, who were in the second trimester when the investigation began, were drawn from an existing, predominantly Black study group in Tennessee. Participants responded to questionnaires and provided biospecimens through the remainder of their pregnancies. In addition, birth records provided information about pregnancy complications and labor and delivery. Postnatally, 1100 pairs participated in annual in-person clinic visits through the child’s third year and again at about age 4 years. At the 4-year visit (which also included children up to 6.5 years), investigators administered parental questionnaires to assess each child’s history of wheeze and asthma.

Investigators documented GDM for 62 (5.6%) of pregnant participants. Compared with other women in the study, those with GDM were older and had a higher socioeconomic status and prepregnancy body mass index. Women with GDM also gained less weight during pregnancy and were more likely to experience preeclampsia/gestational hypertension. In addition, children born to mothers with GDM were larger at birth. GDM status was not affected by maternal history of asthma.

At follow-up, wheeze and asthma were more common among children born to women with GDM than among those born to women without the condition. Overall, reported prevalence of current wheeze and asthma was 19% versus 15.7%, respectively. Among children of women with GDM, 30.6% had current wheeze compared with 18.3% of children of women without GDM; 27.4% versus 15.9%, respectively, had current asthma; and 25.8% versus 13.4% had diagnosed asthma. The differences held even after adjusting for multiple potential confounding factors. Investigators therefore concluded that GDM may be a risk factor for childhood asthma.

Thoughts from Dr. Farber

Here is another instance where we need to look to our adult medicine colleagues to help optimize health for babies yet to be born. However, the rate of GDM is rising because of increasing obesity/overweight, so if we can support our current patients in establishing and maintaining their recommended weight, we will help keep the next generation of children healthy.

Reference

1. Adgent MA, Gebretsadik T, Reedus J, et al. Gestational diabetes and childhood asthma in a racially diverse US pregnancy cohort. Pediatr Allergy Immunol. 2021;32(6):1190-1196. doi:10.1111/pai.13523