OAKLAND, Calif., October 23, 2014 – Women who developed gestational diabetes and were overweight before pregnancy were at a higher risk of having daughters who were obese later in childhood, according to new research published today in Diabetes Care.
Based on long-term research that included a multi-ethnic cohort of 421 girls and their mothers (all members of Kaiser Permanente Northern California), the study is among the first to directly link maternal hyperglycemia (high blood glucose) to offspring being overweight later.
"Glucose levels during pregnancy, particularly gestational diabetes, were associated with the girls being overweight, and this association was much stronger if the mother was also overweight before pregnancy," said Ai Kubo, PhD, the study's lead author and an epidemiologist at the Kaiser Permanente Division of Research in Oakland, California.
The girls were part of the Cohort study of Young Girls' Nutrition, Environment, and Transitions (CYGNET), part of a National Institutes of Health-funded consortium examining early determinants of puberty.
"This research builds on our long-term study of pubertal development in girls, which has been underway since the girls were between 6 and 8 years old," said Lawrence H. Kushi, ScD, a study co-author and CYGNET Study principal investigator at the Division of Research.
The girls were followed from 2005 to 2011, with annual clinic visits to measure each girl's height, weight, body fat, abdominal obesity, and other parameters. Pregnant women in the Kaiser Permanente system take glucose tolerance tests during gestational weeks 24 to 28. Kaiser Permanente's comprehensive electronic medical records allowed researchers to link data collected on the girls to information about their mothers.
Twenty-seven mothers in the study had gestational diabetes. If a girl's mother had gestational diabetes, her risk of having a body mass index at or above the 85th percentile was 3.5 times higher than that of girls whose mothers did not have gestational diabetes. This association was independent of other important factors that influence girl's obesity, such as race/ethnicity, maternal obesity, and girl's pubertal stage.
Furthermore, the study found that if the girl's mother was also overweight and had gestational diabetes, her subsequent risk of being overweight was about 5.5 times higher. Similar associations were observed for a girl's increased body fat and likelihood of having abdominal obesity.
Kubo said the study suggests that behavior modifications in women to reduce weight gain and improve lifestyle before and during pregnancy may also help reduce the risk of obesity in their offspring.
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Funding support for the study came from the National Institute of Environmental Health Sciences, the National Cancer Institute, and the National Center for Research Resources.
In addition to Kubo and Kushi, co-authors of the study were Assiamira Ferrara, MD, PhD, Charles P. Quesenberry, Jr., PhD, Cecile A. Laurent, and Anousheh S. Mirabedi, of the Kaiser Permanente Division of Research; Gayle C. Windham, PhD, California Department of Public Health; Louise C. Greenspan, MD, Kaiser Permanente San Francisco Medical Center; Julianna Deardorff, PhD, University of California, Berkeley; and Robert A. Hiatt, MD, PhD, University of California, San Francisco.
About Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR's 500-plus staff is working on more than 250 epidemiological and health services research projects. For more information, visit http://www.dor.kaiser.org or follow us @KPDOR.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve approximately 9.5 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to kp.org/share.
Journal
Diabetes Care