Prenatal Exposure to High Glucose Levels Increases Lean as well as Fat Mass in Offspring

Compared to nondiabetic women, women with diabetes and high glucose levels during pregnancy tend to have babies with high birth weights. Moreover, it is thought that these offspring are at greater risk for obesity than those children born to women without diabetes. But is the larger body size due to greater lean mass in addition to greater fat mass?

To better understand the relationship between body composition of children born to women with higher than normal levels of glucose during pregnancy, Dr Paula C Chandler-Laney, Department of Nutrition Sciences, University of Alabama–Birmingham, and colleagues analyzed data from 27 mother-child pairs. Pairs were eligible for inclusion if the child was a singleton and born on or after 37 weeks. At study time, children ranged between 5 and 10 years of age (average age = 7.3 ± 1.5 years); children were excluded if they had diabetes, showed growth restriction in utero, or had congenital defects.

At delivery, the average maternal age was 25.7 ± 6.5 years. According to their medical records, the average 1-hour glucose concentration was 130.5 ± 34.5. Eight of the women (30%) had received a diagnosis of gestational diabetes. Four of these women received insulin treatment to control the diabetes; the remaining four used nutritional strategies.

For their analysis, the researchers procured resting energy expenditure measures and body composition information for the children. They also tracked physical activity and conducted interviews to ascertain daily energy intake for three 24-hour periods.

Based on their calculations, the researchers found that maternal glucose concentration during pregnancy was independently and positively associated with children’s fat mass and lean mass. In addition, maternal glucose remained positively associated with children’s fat mass regardless of the child’s lean mass, energy intake, and time spent engaged in physical activity.

“Although the mechanism is not clear, prenatal exposure to relatively high maternal glucose may program children to store rather than use energy,” Chandler-Laney and colleagues explained. “Future research is warranted to examine synthesis, action, and target tissue responsiveness to endocrine/neuroendocrine factors affecting anabolic growth, such as growth hormone, insulin-like growth factor-1, and insulin in children differing with respect to the prenatal environment.”

More Information

• OBGYN.net’s Gestational Diabetes Resource Center