Credit: CC0 Public DomainNew research published in Diabetology (Journal of the European Association for Study of Diabetes [EASD]) shows that…
Credit: CC0 Public Domain
New research published in Diabetology (Journal of the European Association for Study of Diabetes [EASD]) shows that children who are larger than the average at birth (Great for Pregnancy Age or LGA) and born to mothers with Pregnancy diabetes is almost three times as likely to be overweight as children were born a normal size to diabetic mothers. The study is by Dr. Padma Kaul (Department of Medicine, University of Alberta, Edmonton, AB, Canada) and co-authors.
There are several reasons to be overweight or obese in childhood. Research has shown that children who are born large are more likely to be greater in childhood. Maternal weight, pre-pregnancy and pregnancy and maternal diabetes during pregnancy are established risk factors for getting LGA infants. However, little is known about the relative effect of LGA and mother’s diabetes during pregnancy to be overweight / overweight in early childhood.
The study analyzed 81
,226 children born between January 2005 and August 2013. Almost all mothers lived in the Calgary zone in the province of Alberta, Canada, with a smaller proportion than elsewhere in the state. Data on height and weight at the time of the offspring preschool (4-6 years) immunization visit between January 2009 and August 2017, as well as breastfeeding in the first 5 months of life, were related to the mother’s hospital stay
Children were grouped into six categories based on maternal diabetes status during pregnancy (no diabetes, pregnancy diabetes or existing diabetes) and birth weight (suitable for pregnancy age [AGA] or LGA). The WHO criteria were used to identify children who were overweight or overweight. There were 69 506 children in the non-diabetes / AGA group (control group), 5926 in no diabetes / LGA group, 4563 in gestational diabetes / AGA group, 573 in gestational diabetes / LGA group, 480 in the existing diabetes / AGA group group and 178 in the existing diabetes / LGA group.
Overweight / obesity at pre-school age ranged from 21% in the control group to 43% in the gestational diabetes / LGA group. Obesity / obesity was also high in LGA / existing diabetes group (36%) and no diabetes / LGA group (35%). Statistical calculations showed that a child’s risk of obesity / obesity was close to threefold (2.79 times increased risk) if they were in the pregnancy / LGA group compared to the control without diabetes / AGA group. In the existing diabetes / LGA group and the non-diabetes / LGA group, the risk doubled compared with controls, which clearly indicates LGA as an independent risk factor for obesity / obesity in the child.
Further analysis showed that LGA alone contributed 39% to the risk of obesity in the child, much higher than that found for single pregnancy disease (16%) or only existing diabetes (15%); The risk contribution for combinations of Pregnancy / LGA and existing diabetes / LGA were 50% and 39% respectively.
When the former existing diabetes group was further stratified to type 1 and type 2 subgroups, the authors found that the prevalence of obesity / obesity was 21% in the type 1 / AGA group, 31% in the type 1 / LGA group (similar those in the no diabetes groups), 27% in the type 2 / AGA group and 42% in the type 2 / LGA group.
The authors explain that the LGA at birth is a potentially modifiable factor and this study highlights the need to better understand the factors associated with its occurrence for developing strategies to reduce overweight childhood / obesity. The authors believe that LGA may be a surrogate marker for two variables not measured in the study: the weight of the mammal (either excess before pregnancy or pregnancy) or glycemic control during pregnancy.
They say: “Our study shows that a greater proportion of childhood obesity can be attributed to LGA than mammalian diabetes during pregnancy. We hope these results will strengthen public health campaigns that advise women who are planning to get pregnant like, like smoking, alcohol consumption and other lifestyle choices, their weight before pregnancy and weight gain and blood sugar control during pregnancy can have a significant impact on their children’s future health. “
Breastfeeding during the first five months of life was associated with an approximately 25% lower probability of overweight / childhood obesity, overall and in all groups besides pregnancy diabetes / LGA and existing diabetes / LGA (both Type 1 and Type 2).
The authors say, “The protection offered by breast milk did not extend to pregnancy diabetes / LGA and existing diabetes / LGA groups – not in total or in the types 1 / LGA and type 2 / LGA subgroups. About LGA, as we think, Is a marker of poor blood sugar control during pregnancy, additional research is required to investigate whether glucose and insulin levels in breast milk in mothers with diabetes can increase, rather than protect against, the risk of obesity in childhood. “
CDC: Prevalence of Pregnancy Diabetes 6.0 percent in 2016
Padma Kaul et al., Compound of Mammal’s Diabetes, Great for Pregnancy, and Overweight or Obesity in Childhood Diabetology (2018). DOI: 10.1007 / s00125-018-4758-0