Joint Associations of Maternal Gestational Diabetes and Hypertensive Disorders of Pregnancy With Overweight in Offspring

Yuying Gu, Jun Lu, Weiqin Li, Huikun Liu, Leishen Wang, Junhong Leng, Wei Li, Shuang Zhang, Shuting Wang, Jaakko Tuomilehto, Zhijie Yu, Xilin Yang, Andrea A. Baccarelli, Lifang Hou, Gang Hu*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objectives: Either maternal gestational diabetes mellitus (GDM) or hypertensive disorder of pregnancy (HDP) is associated with an increased risk of obesity in the offspring. However, their joint associations with obesity in offspring remain unclear. We investigated the joint associations of maternal GDM and HDP with childhood overweight in offspring. Methods: We performed a large study in 1967 mother-child pairs. Maternal GDM was diagnosed according to the 1999 World Health Organization (WHO) criteria. HDP was defined as self-reported doctor-diagnosed hypertension or treatment of hypertension (including gestational hypertension, preeclampsia, sever preeclampsia or eclampsia) after 20 weeks of gestation on the questionnaire. Body mass index (BMI) for age Z-score and childhood overweight were evaluated according to WHO growth reference. We used the general linear models to compare children's Z score for BMI and logistic regression models to estimate odds ratios of childhood overweight according to maternal different status of GDM and HDP. Results: Offspring of mothers with both GDM and HDP had a higher BMI for age Z-score (0.63 vs. 0.03, P < 0.001) than children born to normotensive and normoglycemic pregnancy. After adjustment for maternal and children's major confounding factors, joint GDM and HDP were associated with increased odds ratios of offspring's overweight compared with normotensive and normoglycemic pregnancy (2.97, 95% confidence intervals [CIs] 1.65–5.34) and GDM alone (2.06, 95% CIs 1.20–3.54), respectively. After additional adjustment for maternal pre-pregnancy BMI and gestational weight gain, joint maternal GDM, and HDP was still associated with an increased risk of offspring's overweight compared with the maternal normotensive, and normoglycemic group but became to have a borderline increased risk compared with the maternal GDM alone group. Conclusions: Maternal GDM alone or joint GDM and HDP were associated with increased ratios of offspring's overweight.

Original languageEnglish (US)
Article number645
JournalFrontiers in Endocrinology
Volume10
DOIs
StatePublished - Sep 20 2019

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Gestational Diabetes
Mothers
Pregnancy
Body Mass Index
Joints
Pre-Eclampsia
Obesity
Logistic Models
Odds Ratio
Confidence Intervals
Hypertension
Pregnancy Induced Hypertension
Eclampsia
Weight Gain
Linear Models

Keywords

  • childhood
  • gestational diabetes mellitus
  • hypertensive disorders of pregnancy
  • obesity
  • overweight

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Gu, Yuying ; Lu, Jun ; Li, Weiqin ; Liu, Huikun ; Wang, Leishen ; Leng, Junhong ; Li, Wei ; Zhang, Shuang ; Wang, Shuting ; Tuomilehto, Jaakko ; Yu, Zhijie ; Yang, Xilin ; Baccarelli, Andrea A. ; Hou, Lifang ; Hu, Gang. / Joint Associations of Maternal Gestational Diabetes and Hypertensive Disorders of Pregnancy With Overweight in Offspring. In: Frontiers in Endocrinology. 2019 ; Vol. 10.
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title = "Joint Associations of Maternal Gestational Diabetes and Hypertensive Disorders of Pregnancy With Overweight in Offspring",
abstract = "Objectives: Either maternal gestational diabetes mellitus (GDM) or hypertensive disorder of pregnancy (HDP) is associated with an increased risk of obesity in the offspring. However, their joint associations with obesity in offspring remain unclear. We investigated the joint associations of maternal GDM and HDP with childhood overweight in offspring. Methods: We performed a large study in 1967 mother-child pairs. Maternal GDM was diagnosed according to the 1999 World Health Organization (WHO) criteria. HDP was defined as self-reported doctor-diagnosed hypertension or treatment of hypertension (including gestational hypertension, preeclampsia, sever preeclampsia or eclampsia) after 20 weeks of gestation on the questionnaire. Body mass index (BMI) for age Z-score and childhood overweight were evaluated according to WHO growth reference. We used the general linear models to compare children's Z score for BMI and logistic regression models to estimate odds ratios of childhood overweight according to maternal different status of GDM and HDP. Results: Offspring of mothers with both GDM and HDP had a higher BMI for age Z-score (0.63 vs. 0.03, P < 0.001) than children born to normotensive and normoglycemic pregnancy. After adjustment for maternal and children's major confounding factors, joint GDM and HDP were associated with increased odds ratios of offspring's overweight compared with normotensive and normoglycemic pregnancy (2.97, 95{\%} confidence intervals [CIs] 1.65–5.34) and GDM alone (2.06, 95{\%} CIs 1.20–3.54), respectively. After additional adjustment for maternal pre-pregnancy BMI and gestational weight gain, joint maternal GDM, and HDP was still associated with an increased risk of offspring's overweight compared with the maternal normotensive, and normoglycemic group but became to have a borderline increased risk compared with the maternal GDM alone group. Conclusions: Maternal GDM alone or joint GDM and HDP were associated with increased ratios of offspring's overweight.",
keywords = "childhood, gestational diabetes mellitus, hypertensive disorders of pregnancy, obesity, overweight",
author = "Yuying Gu and Jun Lu and Weiqin Li and Huikun Liu and Leishen Wang and Junhong Leng and Wei Li and Shuang Zhang and Shuting Wang and Jaakko Tuomilehto and Zhijie Yu and Xilin Yang and Baccarelli, {Andrea A.} and Lifang Hou and Gang Hu",
year = "2019",
month = "9",
day = "20",
doi = "10.3389/fendo.2019.00645",
language = "English (US)",
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journal = "Frontiers in Endocrinology",
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Gu, Y, Lu, J, Li, W, Liu, H, Wang, L, Leng, J, Li, W, Zhang, S, Wang, S, Tuomilehto, J, Yu, Z, Yang, X, Baccarelli, AA, Hou, L & Hu, G 2019, 'Joint Associations of Maternal Gestational Diabetes and Hypertensive Disorders of Pregnancy With Overweight in Offspring', Frontiers in Endocrinology, vol. 10, 645. https://doi.org/10.3389/fendo.2019.00645

Joint Associations of Maternal Gestational Diabetes and Hypertensive Disorders of Pregnancy With Overweight in Offspring. / Gu, Yuying; Lu, Jun; Li, Weiqin; Liu, Huikun; Wang, Leishen; Leng, Junhong; Li, Wei; Zhang, Shuang; Wang, Shuting; Tuomilehto, Jaakko; Yu, Zhijie; Yang, Xilin; Baccarelli, Andrea A.; Hou, Lifang; Hu, Gang.

In: Frontiers in Endocrinology, Vol. 10, 645, 20.09.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Joint Associations of Maternal Gestational Diabetes and Hypertensive Disorders of Pregnancy With Overweight in Offspring

AU - Gu, Yuying

AU - Lu, Jun

AU - Li, Weiqin

AU - Liu, Huikun

AU - Wang, Leishen

AU - Leng, Junhong

AU - Li, Wei

AU - Zhang, Shuang

AU - Wang, Shuting

AU - Tuomilehto, Jaakko

AU - Yu, Zhijie

AU - Yang, Xilin

AU - Baccarelli, Andrea A.

AU - Hou, Lifang

AU - Hu, Gang

PY - 2019/9/20

Y1 - 2019/9/20

N2 - Objectives: Either maternal gestational diabetes mellitus (GDM) or hypertensive disorder of pregnancy (HDP) is associated with an increased risk of obesity in the offspring. However, their joint associations with obesity in offspring remain unclear. We investigated the joint associations of maternal GDM and HDP with childhood overweight in offspring. Methods: We performed a large study in 1967 mother-child pairs. Maternal GDM was diagnosed according to the 1999 World Health Organization (WHO) criteria. HDP was defined as self-reported doctor-diagnosed hypertension or treatment of hypertension (including gestational hypertension, preeclampsia, sever preeclampsia or eclampsia) after 20 weeks of gestation on the questionnaire. Body mass index (BMI) for age Z-score and childhood overweight were evaluated according to WHO growth reference. We used the general linear models to compare children's Z score for BMI and logistic regression models to estimate odds ratios of childhood overweight according to maternal different status of GDM and HDP. Results: Offspring of mothers with both GDM and HDP had a higher BMI for age Z-score (0.63 vs. 0.03, P < 0.001) than children born to normotensive and normoglycemic pregnancy. After adjustment for maternal and children's major confounding factors, joint GDM and HDP were associated with increased odds ratios of offspring's overweight compared with normotensive and normoglycemic pregnancy (2.97, 95% confidence intervals [CIs] 1.65–5.34) and GDM alone (2.06, 95% CIs 1.20–3.54), respectively. After additional adjustment for maternal pre-pregnancy BMI and gestational weight gain, joint maternal GDM, and HDP was still associated with an increased risk of offspring's overweight compared with the maternal normotensive, and normoglycemic group but became to have a borderline increased risk compared with the maternal GDM alone group. Conclusions: Maternal GDM alone or joint GDM and HDP were associated with increased ratios of offspring's overweight.

AB - Objectives: Either maternal gestational diabetes mellitus (GDM) or hypertensive disorder of pregnancy (HDP) is associated with an increased risk of obesity in the offspring. However, their joint associations with obesity in offspring remain unclear. We investigated the joint associations of maternal GDM and HDP with childhood overweight in offspring. Methods: We performed a large study in 1967 mother-child pairs. Maternal GDM was diagnosed according to the 1999 World Health Organization (WHO) criteria. HDP was defined as self-reported doctor-diagnosed hypertension or treatment of hypertension (including gestational hypertension, preeclampsia, sever preeclampsia or eclampsia) after 20 weeks of gestation on the questionnaire. Body mass index (BMI) for age Z-score and childhood overweight were evaluated according to WHO growth reference. We used the general linear models to compare children's Z score for BMI and logistic regression models to estimate odds ratios of childhood overweight according to maternal different status of GDM and HDP. Results: Offspring of mothers with both GDM and HDP had a higher BMI for age Z-score (0.63 vs. 0.03, P < 0.001) than children born to normotensive and normoglycemic pregnancy. After adjustment for maternal and children's major confounding factors, joint GDM and HDP were associated with increased odds ratios of offspring's overweight compared with normotensive and normoglycemic pregnancy (2.97, 95% confidence intervals [CIs] 1.65–5.34) and GDM alone (2.06, 95% CIs 1.20–3.54), respectively. After additional adjustment for maternal pre-pregnancy BMI and gestational weight gain, joint maternal GDM, and HDP was still associated with an increased risk of offspring's overweight compared with the maternal normotensive, and normoglycemic group but became to have a borderline increased risk compared with the maternal GDM alone group. Conclusions: Maternal GDM alone or joint GDM and HDP were associated with increased ratios of offspring's overweight.

KW - childhood

KW - gestational diabetes mellitus

KW - hypertensive disorders of pregnancy

KW - obesity

KW - overweight

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