Anthropometric profile of children and adolescents from diabetic pregnancies
Keywords:
Children, adolescent, diabetes, obesity, pregnancyAbstract
SUMMARYBackground: Exposure in utero to maternal diabetes is a risk factor for obesity and type 2 diabetes. It may contribute to the current epidemic outbreak of these diseases.
Aim: to evaluate the impact of the exposure to maternal diabetes on the anthropometric profile of the offspring.
Methods: This cross-sectional study was conducted in the department "A" of the National Institute of Nutrition. It involved 120 children and adolescents who were from 5 to 19 years old and recruited between October 2008 and November 2009. They were divided into two groups :
• A first group of 80 children from diabetic mothers ;
• A second control group of 40 children from non-diabetic pregnancies. They have had a clinical examination. Data about diabetic pregnancies were collected from the mothers'medical records.
Results : body mass index and waist circumference of children from both groups were comparable. In both groups, two thirds of children had a normal weight (62.5 % in the first group versus 65% in the control group). Obesity is more common in children exposed to maternal hyperglycemia (31.3% versus 25% in the control group), but the difference is not statistically significant. The majority of obese children (88%) are those from diabetic mothers with type 2 or gestational diabetes.
Conclusion: our results underline the need for early screening for gestational diabetes and an optimal management of diabetic pregnancy to reduce the metabolic risk in the offspring.
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References
Pettitt DJ, Baird HR, Aleck KA, Bennett PH, Knowler WC. Excessive obesity in offspring of Pima Indian women with diabetes during pregnancy. N Engl J Med 1983; 308:242-45
Williams CL, Hayman LL, Daniels SR et al. Cardiovascular Health in Childhood: A Statement for Health Professionals From the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American HeartAssociation. Circulation 2002;106:143-160
Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child 1970; 45:13-23.
Gautier JF, Fetita LS, Sobngwi E. Exposition foetale au diabète maternel et diabétogenèse. Médecine de la reproduction 2005 ; 7:276-85.
Gillman M, Rifas-Shiman S, Berkey S, Field AE, Colditz A. Maternal gestational diabetes, birth weight, and adolescent obesity. PEDIATRICS 2003; 111:e221-26
Seidman DS, Laor A, Stevenson DK, Sivan E. Macrosomia does not predict overweight in late adolescence in infants of diabetic mothers. Acta Obstet Gynecol Scand 1998; 77:58-62
Whitaker RC, Pepe MS, Seidel KD, Wright JA, Knoop R. Gestational diabetes and the risk of offspring obesity. Pediatrics 1998; 101:e9-15.
Pettitt DJ, Knowler WC. Long-term effects of the intrauterine environment, birth weight, and breast-feeding in Pima Indians. Diabetes Care 1998; 21 (Suppl 2):B138-41.
Simmons D, Breier B. Fetal overnutrition in Polynesian pregnancies and in gestational diabetes may lead to dysregulation of the adipoinsular axis in offspring. Diabetes Care 2002; 25:1539-44.
Pettitt DJ, Knowler WC, Bennett PH, Aleck KA, Baird HR. Obesity in offspring of diabetic Pima Indian women despite normal birth weight. Diabetes Care 1987; 10:76-80.
Wolf HJ, Ebenbichler CF, Huter O et al. Fetal leptin and insulin levels only correlate in large-for-gestational age infants. Eur J Endocrinol 2000; 142:623-29
Dabelea D. The predisposition to obesity and diabetes in offspring of diabetic mothers. Diabetes Care 2007; 30 (Suppl 2):s169-74.
ohr B, McGarvey, Tucker R. Effects of maternal gestational diabetes on offspring adiposity at 4-7 years of age. Diabetes Care 1999; 22:1284-91.
Silverman BL, Rizzo T, Green OC et al. Long-term prospective evaluation of offspring of diabetic mothers. Diabetes 1991; 40 (Suppl 2):121-25.
Hillier T, Pedula KL, Schmidt MM, Mullen JA, Charles MA, Pettitt DJ. Childhood obesity and metabolic imprinting: the ongoing effects of maternal hyperglycemia. Diabetes Care 2007; 30:2287-92.
Franks P, Looker H, Kobes S et al. Gestational glucose tolerance and risk of type 2 diabetes in young Pima Indian offspring. Diabetes 2006; 55:460-65.
Pettitt DJ, Bennett PH, Knowler WC, Baird HR, Aleck KA. Gestational diabetes mellitus and impaired glucose tolerance during pregnancy: long-term effects on obesity and glucose tolerance in the offspring. Diabetes 1985; 34 (Suppl 2):119-22.
Weiss P, Scholz H, Haas J, Tamussino K, Seissler J, Borkenstein M. Long term follow-up of infants of mothers with type 1 diabetes. Diabetes Care 2000; 23:905-11.
