Mothers With Gestational Diabetes Have Fatter Babies at 2 Months

Veronica Hackethal, MD

May 19, 2016

Women who have gestational diabetes — even if it is well controlled and babies are breastfed — may still have babies that are 16% fatter at 2 to 3 months of age than those born to healthy mothers, according to a new study published online on May 12, 2016 in Diabetes Care.

No differences in fat volume existed at birth. The research is the first to find that babies born to mothers with gestational diabetes laid down more fat in the first few months of life, compared with babies born to healthy mothers.

"This study demonstrates babies born to mothers with gestational diabetes have greater adipose tissue in early infancy, which may be a harbinger for longer-term health problems," first author Karen Logan, MD, of Imperial College London, United Kingdom, wrote in an email to Medscape Medical News .

"It is important that these offspring are encouraged to exercise and maintain a healthy weight [as they grow up]," she added.

Study Assessed Fat Tissue With Whole-Body MRI

Past studies have suggested a link between gestational diabetes and overweight and obesity in offspring.

A recently published study found that gestational diabetes and/or excessive weight gain during pregnancy increases the risk of obesity in the offspring during the first 10 years of life, even when babies have a normal birth weight.

And the large Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study found that babies were fatter at birth when their mothers had gestational diabetes (Diabetes. 2009;58:453–459).

The HAPO study, though, used indirect techniques to measure fat mass.

This new study used whole-body MRI to directly measure fat tissue, Dr Logan pointed out.

It included 86 infants (diabetes group: n=42; control group: n=44) born at Chelsea and Westminster Hospital in London, United Kingdom, between October 2011 and October 2014. Babies were scanned shortly after birth and at 8 to 12 weeks of age. Scans quantified whole-body and regional fat-tissue volumes, as well as fat content within the liver (which correlates strongly to internal abdominal fat and metabolic disease).

Mothers with gestational diabetes had well-controlled blood glucose levels with a mean third-trimester HbA1c of 5.3%. Most infants were breastfed up to 8 to 12 months (diabetes group 71%, control 74%).

At about age 11 days, the gestational-diabetes group and control group had similar total fat volumes (P = .55). By 10 weeks, though, the babies born to mothers with gestational diabetes had significantly higher total fat volumes than babies in the control group (P = .01).

Even after adjustment for infant size, the gestational-diabetes group still had significantly more total fat volume at 10 weeks than the control group (16.0%, P = .002).

No significant between-group differences in the distribution of fat tissue and fat content in the liver existed at either time point, however.

While development of obesity in childhood may be due to environmental factors that promote weight gain, the study suggests something else might be going on, because differences in fatness occurred very early in infancy.

Does Gestational Diabetes Have Independent Effects on Fat Mass?

Results remained about the same after adjustment for infant sex and maternal prepregnancy body mass index (BMI). That suggests gestational diabetes could have an independent effect on infant fat mass, according to the authors.

Possible mechanisms that might explain these results include "programming" in the womb, changes in breast-milk content, and differences in infant appetite, Dr Logan hypothesized.

"It is now important to establish the possible effects of increased adiposity on the future health of these infants and whether treatment to reduce adiposity will improve long-term metabolic health in offspring of mothers with gestational diabetes," she concluded.

The researchers of this study do not have official plans to follow this group of infants over time. The HAPO researchers, however, plan to follow children up at age 10 to evaluate later effects of gestational diabetes and infant fatness on obesity and metabolic health, according to Dr Logan.

The study was funded by Action Medical Research Clinical Research Fellowship. The authors report no relevant financial relationships.

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Diabetes Care. Published online May 12, 2016. Abstract

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