Obesity and abnormal glucose tolerance in offspring of diabetic mothers: A systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 29329330 · doi:10.1371/journal.pone.0190676
What was done
Researchers conducted a systematic review and meta-analysis searching MEDLINE and EMBASE for observational studies evaluating obesity and abnormal glucose tolerance in offspring of mothers with gestational diabetes (GDM), type 1 diabetes (T1DM), or type 2 diabetes (T2DM) compared to offspring of non-diabetic mothers. Fixed-effect meta-analysis was used unless heterogeneity was present, and study quality was evaluated using the RoBANS tool.
What was found
The analysis included 20 observational studies with 26,509 children. Offspring of GDM mothers had higher childhood BMI z-scores (pooled mean difference [MD] 0.14, 95% CI 0.04 to 0.24, 7 studies, 21,691 children), which disappeared after adjusting for maternal pre-pregnancy BMI, and higher 2-hour plasma glucose from prepuberty to early adulthood (MD 0.43 mmol/L, 95% CI 0.18 to 0.69, 5 studies, 890 children). Offspring of T1DM mothers had higher BMI z-scores from prepuberty to adolescence (MD 0.35, 95% CI 0.13 to 0.58, 3 studies, 844 children), which persisted after adjusting for maternal pre-pregnancy BMI, and higher rates of T2DM from ages 2 to 5 years to early adulthood (pooled OR 6.10, 95% CI 1.23 to 30.37, 2 studies, 448 children). Only one study evaluated offspring of T2DM mothers.
Why it matters
The findings indicate that offspring of diabetic mothers face increased risks of obesity and impaired glucose tolerance, with the BMI risk in GDM offspring being largely confounded by maternal pre-pregnancy weight.
Limits
All included studies were observational, and the evidence quality was rated low to very low. Few studies adequately adjusted for key confounders such as maternal pre-pregnancy BMI, only one study evaluated T2DM mothers, and several analyses relied on very small numbers of studies and participants.
Cited by
- supports Studies show that babies born to mothers with high glucose levels during pregnancy are more likely to develop obesity in childhood, adolescence, and adulthood.