ESPEYB16 15 Editorsߣ Choice (1) (18 abstracts)
15.6. Late-pregnancy dysglycemia in obese pregnancies after negative testing for gestational diabetes and risk of future childhood overweight: An interim analysis from a longitudinal mother-child cohort study
Gomes D , von Kries R , Delius M , Mansmann U , Nast M , Stubert M , Langhammer L , Haas NA , Netz H , Obermeier V , Kuhle S , Holdt LM , Teupser D , Hasbargen U , Roscher AA & Ensenauer R
Department of General Pediatrics, Neonatology and Pediatric Cardiology, Division of Experimental Pediatrics and Metabolism, University Children’s Hospital, Faculty of Medicine, Heinrich Heine University Dusseldorf, Dusseldorf, Germany
To read the full abstract: PLoS Med 2018;15:e1002681.
These authors highlight a novel pregnancy risk factor, ‘late-pregnancy dysglycaemia’ in women who are obese but had normal glucose tolerance when they were tested for gestational diabetes mellitus (GDM) earlier in pregnancy. In a prospective cohort study of obese women without GDM (n=448), high maternal glycated haemoglobin at delivery (HbA1c >=5.7% [39 mmol/mol]) was associated with high third-trimester gestational weight gain and large-for-gestational-age birth weight, and was a major risk factor for higher childhood BMI and later diabetes or prediabetes in the mothers.
The detection and management of GDM has deservedly received much attention in recent years. However, most of us assume that those pregnant women who test negative for GDM are ‘in the clear’. However, the current paper clearly shows that this is not the case. Here, the authors report a unique prospective cohort study with data on trimester-specific glucose levels. Among obese mothers who tested negative testing for GDM at the end of the 2nd trimester, compared to those with normal HbA1c at delivery, those with ‘late-pregnancy dysglycemia’ (30.1%) had higher risks of total and third-trimester excessive gestational weight gain and a 4-fold (RR 4.01, 95% CI 1.97–8.17) higher risk of future prediabetes or diabetes. Their offspring had higher risk for large-for-gestational-age birth weight, and had greater weight gain during early childhood (Delta BMI z-score per year 0.18, 95% CI 0.06–0.30) and higher BMI z-score at 4 years (Delta 0.58, 95% CI 0.18–0.99). Late-pregnancy dysglycemia in GDM-negative mothers accounted for about one-quarter of the association of maternal obesity with offspring BMI at age 4 years. Importantly, the authors conclude that negative GDM testing in obese pregnancies is not an ‘all-clear signal’. Instead attention is needed to monitor and control weight gain and glucose levels in obese women in the third-trimester.
Article tools
My recent searches
My recently viewed abstracts
Authors
ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more