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A study published in the journal Diabetes, Obesity & Metabolism found that children born to mothers with gestational diabetes have an increased risk of being overweight as they grow up. The study also found that intensive treatment of gestational diabetes during pregnancy improved outcomes for both mother and baby, but did not reduce the risk of childhood obesity. The researchers suggest that prevention and intensive management of gestational diabetes are important in reducing the risk of childhood obesity. They also recommend that children from gestational diabetes pregnancies adopt a healthy lifestyle from an early age to reduce the risk of future health problems. Further research is needed to better understand these relationships and develop effective health management strategies for women with gestational diabetes and their children. [Extracted from the article]

Aims: This study tests whether cut‐off points of the International Association of Diabetes and Pregnancy Study Group's (IADPSG) criteria had threshold effects on post‐partum prediabetes and diabetes among Chinese pregnant women with gestational diabetes mellitus (GDM). Materials and Methods: A total of 507 out of 1000 women with GDM (948 of them enrolled in a lifestyle trial during pregnancy) turned up for the follow‐up study and underwent a 75‐g 2‐h oral glucose tolerance test. GDM was diagnosed based on the IADPSG's criteria while post‐partum diabetes and prediabetes were defined by the World Health Organization's. Generalized logit model was used to obtain odds ratios (OR) and 95% confidence interval (CI) of fasting, 1‐h and 2‐h plasma glucoses (PGs) for post‐partum diabetes and prediabetes. Restricted cubic spline was used to identify any threshold effects. Results: At a median of 9.1 weeks post‐partum, 3.7% (n = 19) women developed post‐partum diabetes and 35.1% (n = 178) developed post‐partum prediabetes. Fasting PG ≥ 5.1 mmol/L was associated with markedly increased risk of post‐partum diabetes without a discernible threshold (adjusted OR: 3.87, 95% CI: 1.03–14.52) while 2‐h PG ≥ 8.5 and ≥ 9.0 mmol/L had threshold effects on post‐partum prediabetes (2.10, 1.33–3.30) and diabetes (4.02, 1.04–15.56). The 1‐h PG also had a threshold at ≥10.0 mmol/L for prediabetes (1.67, 1.06–2.64), but it was not significant for post‐partum diabetes. Conclusions: Among Chinese women with GDM, fasting PG ≥ 5.1 mmol/L was associated with post‐partum diabetes without any discernible threshold effects while 2‐h PG ≥ 8.5 and ≥ 9.0 mmol/L respectively identified women at high risk of post‐partum prediabetes and diabetes. [ABSTRACT FROM AUTHOR]

This study assessed within-trial cost-effectiveness of a shared care program (SC, n = 339) for pregnancy outcomes compared to usual care (UC, n = 361), as implemented in a randomized trial of Chinese women with gestational diabetes (GDM). SC consisted of an individualized dietary advice and physical activity counseling program. The UC was a one-time group education program. The effectiveness was measured by number needed to treat (NNT) to prevent one macrosomia/large for gestational age (LGA) infant. The cost-effectiveness was measured by incremental cost-effectiveness ratio in terms of cost (2012 Chinese Yuan/US dollar) per case of macrosomia and LGA prevented. The study took both a health care system and a societal perspective. This study found that the NNT was 16/14 for macrosomia/LGA. The incremental cost for treating a pregnant woman was ¥1,877 ($298) from a health care system perspective and ¥2,056 ($327) from a societal perspective. The cost of preventing a case of macrosomia/LGA from the two corresponding perspectives were ¥30,032/¥26,278 ($4,775/$4,178) and ¥32,896/¥28,784 ($5,230/$4,577), respectively. Considering the potential severe adverse health and economic consequences of a macrosomia/LGA infant, our findings suggest that implementing this lifestyle intervention for women with GDM is an efficient use of health care resources. [ABSTRACT FROM AUTHOR]

OBJECTIVE Several studies assessed maternal gestational diabetes mellitus (GDM) with the risk of childhood high blood pressure, and the results were inconsistent. We investigated the association between maternal GDM and hypertension risk in offspring during early childhood. METHODS We performed a large study in 1,156 mother–child pairs (578 GDM and 578 non-GDM matched by their offspring's age and sex). Maternal GDM was diagnosed according to the World Health Organization criteria. Childhood height, weight, and blood pressure were measured using standardized methods. Age-, sex-, and height-specific blood pressure Z score, childhood hypertension, and high blood pressure were evaluated according to the reference range of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. RESULTS After adjustment for maternal and children's characteristics, children born to mothers with GDM during pregnancy had higher mean values of systolic blood pressure Z score (0.09 vs. −0.17), and higher prevalence of hypertension (6.4% vs. 3.5%) and high blood pressure (15.6% vs. 9.3%) in comparison with their counterparts born to mothers without GDM during pregnancy (all P values <0.05). Multivariable-adjusted odds ratios among children of mothers with GDM compared with children of mothers without GDM were 2.32 (95% confidence intervals [CI] 1.16–4.62) for hypertension and 1.89 (95% CI 1.24–2.86) for high blood pressure, respectively. CONCLUSIONS Maternal GDM was associated with an increased risk of hypertension in the offspring. Controlling maternal GDM may be important for preventing childhood hypertension in the affected offspring. [ABSTRACT FROM AUTHOR]

In the article, the authors present their study which examined the effects of lifestyle intervention in maternal gestational diabetes mellitus (GDM) on the growth pattern of newborns before two years of age. In the research, a population-based randomized controlled trial (RCT) was carried out in Tianjin, China. The study compared the effectiveness of intensive care (IC) against usual care (UC) on adverse pregnancy results in patients with GDM.

Background: Short height is associated with gestational diabetes mellitus (GDM) but the underlying mechanism remains unknown. This study aims to explore whether short height has a synergistic effect with pre-pregnancy overweight/obesity and undue weight gain on the risk of GDM. Methods: We recruited 19,962 singleton pregnant women from their first antenatal care visit in urban Tianjin, China, between October 2010 to August 2012. At 24–28 weeks of gestation, women underwent a 50-g 1-h glucose challenge test (GCT) followed by a 75-g 2-h oral glucose tolerance test (OGTT) if the GCT result was ≥7.8 mmol/L. GDM was defined by the International Association of Diabetes and Pregnancy Study Group's cut-points. Univariable and multivariable logistic regression analyses were performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) analysis nested in the logistic regression analysis was used to identify a cutoff point of height for GDM. Additive interaction was used to test interactions between short height, pregnancy overweight/obesity and undue weight gain. Results: A total of 1,517 (or 7.6%) women developed GDM. The risk of GDM increased rapidly with a decreasing height from 158 cm and downwards. Using height ≥158 cm as the reference group, women with < 158 cm of height were at increased GDM risk (adjusted OR: 1.44, 95%CI: 1.18–1.75). Maternal overweight/obesity at the first antenatal care visit greatly enhanced the OR of short height for GDM (adjusted OR: 3.78, 95%CI: 2.84–5.03) with significant additive interaction (P < 0.05). However, the interaction between short height and undue weight gain was non-significant (P > 0.05). Conclusions: In Chinese pregnant women in urban Tianjin, height < 158 cm had a synergistic effect with pre-pregnancy overweight/obesity on the risk of GDM. [ABSTRACT FROM AUTHOR]

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Background: Passive smoking increased type 2 diabetes mellitus risk, but it is uncertain whether it also increased gestational diabetes mellitus (GDM) risk. We aimed to examine the association of passive smoking during pregnancy and its interaction with maternal obesity for GDM.Methods: From 2010 to 2012, 12 786 Chinese women underwent a 50-g 1-hour glucose challenge test at 24 to 28 weeks of gestation and further underwent a 75-g 2-hour oral glucose tolerance test if the glucose challenge test result was ≥7.8 mmol/L. GDM was defined by the International Association of Diabetes and Pregnancy Study Group's cut points. Self-reported passive smoking during pregnancy was collected by a questionnaire. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Additive interaction between maternal obesity and passive smoking was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S). Significant RERI > 0, AP > 0, or S > 1 indicated additive interaction.Results: A total of 8331 women (65.2%) were exposed to passive smoking during pregnancy. More women exposed to passive smoking developed GDM than nonexposed women (7.8% versus 6.3%, P = 0.002) with an adjusted OR of 1.29 (95%CI, 1.11 to 1.50). Compared with nonobesity and nonpassive smoking, prepregnancy obesity and passive smoking was associated with GDM risk with an adjusted OR of 3.09 (95%CI, 2.38-4.02) with significant additive interaction (P < .05 for RERI and AP).Conclusions: Passive smoking during pregnancy increased GDM risk in Chinese women independently and synergistically with prepregnancy obesity. [ABSTRACT FROM AUTHOR]

Objective To compare pregnancy outcomes of women with gestational diabetes mellitus (GDM) newly defined by the International Association of Diabetes and Pregnancy Study Group (IADPSG)'s criteria vs GDM cases missed by a shift from the 1999 World Health Organization (WHO)'s criteria to the IADPSG's. Methods From 2010 to 2012, we recruited 17 808 women who registered within 12 weeks of gestation in Tianjin, China. All women underwent a 50-g 1-h glucose challenge test (GCT) at 24-28 weeks of gestation and further underwent a 75-g 2-h oral glucose tolerance test (OGTT) if the GCT result was ≥7·8 mmol/l. Women were divided into four groups, i.e., GDM defined by both criteria, GDM defined by the IADPSG's only, GDM defined by the 1999 WHO's only and non-GDM by either of them. Large for gestational age (LGA), macrosomia, pregnancy-induced hypertension (PIH) and preterm birth were compared among the four groups. Logistic regression was used to control for confounders. Results The use of IADPSG's and the 1999 WHO's criteria detected that 7·7% ( n = 1378) and 6·8% ( n = 1206) of women had GDM, respectively, with 429 GDM newly identified and 257 women missed by a shift from the 1999 WHO's to the IADPSG's. The IADPSG's newly defined GDM had significantly increased risks of LGA (adjusted OR: 2·23, 95%CI: 1·36-3·64) and macrosomia (2·65, 95%CI: 1·50-4·66) than the 1999 WHO's only defined GDM cases. Conclusions A shift of the 1999 WHO's criteria to the IADPSG's diagnosed more GDM cases who had worse pregnancy outcomes than those cases missed. [ABSTRACT FROM AUTHOR]

Background: The ABO blood types are associated with cancers, cardiovascular diseases and type 2 diabetes mellitus but whether they are also associated with gestational diabetes mellitus (GDM) is unknown. We examined the relationship between the ABO blood types and the risk of GDM in a prospective population-based Chinese cohort.Methods: From 2010 to 2012, we recruited 14,198 pregnant women within the first 12 weeks of gestation in Tianjin, China. All women had a glucose challenge test (GCT) at 24-28 gestational weeks, followed by a 75-g 2-h oral glucose tolerance test if the results from GCT were ≥7.8 mmol/L. GDM was diagnosed based on the glucose cut-points of the International Association of Diabetes and Pregnancy Study Group criteria. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for traditional risk factors. Stratified analysis was performed by family history of diabetes (yes versus no). Sensitivity analyses were also performed by using the World Health Organization (WHO) criteria for GDM.Results: Women with blood groups A, B or O (i.e. non-AB) were associated with increased risk of GDM as compared with those with blood group AB (adjusted OR: 1.44, 95% CI: 1.13-1.83). Sensitivity analyses showed that the result was consistent using WHO criteria. The adjusted OR of blood group non-AB versus AB for GDM was enhanced among women with a family history of diabetes (2.69, 1.21-5.96) and attenuated among those without (1.33, 1.03-1.71).Conclusions: Blood group AB was a protective factor against GDM in pregnant Chinese women. [ABSTRACT FROM AUTHOR]

Objective: We compared the increases in the prevalence of gestational diabetes mellitus (GDM) based on the 1999 World Health Organization (WHO) criteria and its risk factors in Tianjin, China, over a 12-year period. We also examined the changes in the prevalence using the criteria of International Association of Diabetes and Pregnancy Study Group (IADPSG). Methods: In 2010-2012, 18589 women who registered within 12 weeks of gestation underwent a glucose challenge test (GCT) at 24-28 gestational weeks. Amongst them, 2953 women with 1-hour plasma glucose ≥7.8 mmol/L underwent a 75-gram 2-hour oral glucose tolerance test (OGTT) and 781 women had a positive GCT but absented from the standard OGTT. An adjusted prevalence of GDM was calculated for the whole cohort of women by including an estimate of the proportion of women with positive GCTs who did not have OGTTs but would have been expected to have GDM. Logistic regression was used to obtain odds ratios and 95% confidence intervals using the IADPSG criteria. The prevalence of GDM risk factors was compared to the 1999 survey. Results: The adjusted prevalence of GDM by the 1999 WHO criteria was 8.1%, a 3.5-fold increase as in 1999. Using the IADPSG criteria increased the adjusted prevalence further to 9.3%. Advanced age, higher pre-pregnancy body mass index, Han-nationality, higher systolic blood pressure (BP), a family history of diabetes, weight gain during pregnancy and habitual smoking were risk factors for GDM. Compared to the 1999 survey, the prevalence of overweight plus obesity had increased by 1.8 folds, age≥30 years by 2.3 folds, systolic BP by 2.3 mmHg over the 12-year period. Conclusions: Increasing prevalence of overweight/obesity and older age at pregnancy were accompanied by increasing prevalence of GDM, further increased by change in diagnostic criteria. [ABSTRACT FROM AUTHOR]

Objective. To examine the association of maternal glycemia during pregnancy and after delivery with anthropometry in the offspring of mothers with gestational diabetes mellitus (GDM). Methods. A total of 1,263 GDM mothers and their children finished the health survey at 1–5 years after delivery. Results. Offspring of GDM mothers who were diagnosed with diabetes during pregnancy had higher prevalence of overweight, higher mean weight for height Z scores, and higher mean BMI for age Z scores at 1–5 years old than the offspring of GDM mothers who were diagnosed with impaired glucose tolerance (IGT) during pregnancy. Offspring of GDM mothers who developed diabetes 1–5 years after delivery had higher mean values of Z scores for weight for height and BMI for age at 1–5 years old than the offspring of GDM mothers who had normal glucose or prediabetes after delivery. Conclusions. Offspring of GDM mothers who were diagnosed with diabetes during pregnancy or after delivery had an increased risk of childhood overweight or weight gain at 1–5 years old compared with children of GDM mothers with IGT during pregnancy or with normal glucose or prediabetes after delivery. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effects of prepregnancy BMI and weight change from prepregnancy to postpartum on postpartum type 2 diabetes (T2D) risk among women with gestational diabetes (GDM). Methods A retrospective cohort study in 1,263 GDM women at 1-5 years after delivery was performed. Cox proportional hazards regression models were used to evaluate the association of prepregnancy BMI and weight change with T2D and prediabetes risks. Results The multivariable-adjusted hazard ratios based on different levels of prepregnancy BMI (<23, 23-24.9, 25-29.9, and ≥30 kg/m2) were 1.00, 1.77, 2.35, and 6.54 ( Ptrend < 0.001) for incident T2D, and 1.00, 1.46, 1.87, and 1.79 ( Ptrend < 0.001) for incident prediabetes, respectively. Compared with women with stable weight (±3 kg), those with weight gain ≥7 kg had an 86% and a 32% increased risk of diabetes and prediabetes, and those with weight loss ≥3 kg had a 45% decreased risk of prediabetes. The positive associations of prepregnancy BMI with incident diabetes and prediabetes risk were persistent in women with different levels of weight change (<3 kg and ≥3 kg). Conclusion Prepregnancy obesity and excessive weight gain from prepregnancy to postpartum increase postpartum diabetes and prediabetes risks among GDM women. [ABSTRACT FROM AUTHOR]

Aims: To explore associations between adverse pregnancy outcomes and risk of postpartum diabetes and prediabetes among Chinese women with gestational diabetes mellitus (GDM).Methods: A total of 507 women with GDM who participated in a randomized controlled trial were successfully followed up at a median of 9.1  (interquartile range: 7.7-11.3) weeks after delivery and underwent a 75 g 2-h oral glucose tolerance test. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Group's criteria. Postpartum diabetes and prediabetes were defined by the World Health Organization's. Generalized logit model was used to obtain odds ratios (OR) and 95% confidence interval (CI) of adverse pregnancy outcomes for postpartum diabetes, prediabetes and abnormal glucose regulation (AGR).Results: Of 507 women with GDM, 3.7% (19) women developed postpartum diabetes, 35.1% (178) women developed postpartum prediabetes. Preterm birth was associated with increased risk of postpartum prediabetes and AGR (adjusted OR: 3.24, 95%CI: 1.48-7.07 & 3.16, 1.46-6.85). Low birth weight was associated with the risk of postpartum prediabetes, diabetes and AGR (adjusted OR: 2.78, 95%CI: 1.13-6.86; 5.21, 1.13-24.02 & 2.99, 1.24-7.21).Conclusions: Preterm birth and low birth weight were predictive of postpartum prediabetes, diabetes or AGR in Chinese women with GDM. [ABSTRACT FROM AUTHOR]

Aims: We aimed to examine the association of gestational hypertension and chronic hypertension at the inter-conception examination with type 2 diabetes risk among women with a history of gestational diabetes.Methods: We conducted a population-based study among 1261 women who had a history of gestational diabetes at 1-5years after delivery in Tianjin, China. Logistic regression or Cox regression was used to assess the associations of gestational hypertension and chronic hypertension at the inter-conception examination with pre-diabetes and type 2 diabetes risks.Results: Gestational diabetic women who had a history of gestational hypertension but did not use antihypertensive drugs during pregnancy had a 3.94-fold higher risk (95% CI: 1.94-8.02) of developing type 2 diabetes compared with those who were normotensive in index pregnancy. Compared with gestational diabetic women who had normal blood pressure at the inter-conception examination, hypertensive women at the inter-conception examination were 3.38 times (95% CI: 1.66-6.87) and 2.97 times (95% CI: 1.75-5.05) more likely to develop diabetes and prediabetes, respectively. The odds ratios of type 2 diabetes and prediabetes associated with each 5mmHg increase in systolic blood pressure were 1.25 (95% CI: 1.03-1.51) and 1.20 (95% CI: 1.06-1.35). Each 5mmHg increase in diastolic blood pressure contributed to a 1.49-fold higher risk (95% CI: 1.18-1.88) for type 2 diabetes and a 1.42-fold higher risk (95% CI: 1.22-1.65) for prediabetes.Conclusions: For women with prior gestational diabetes, gestational hypertension and chronic hypertension at the inter-conception examination were risk factors for type 2 diabetes. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To assess whether lifestyle intervention can reduce type 2 diabetes risk in women with prior GDM in the Tianjin Gestational Diabetes Mellitus (GDM) Prevention Program. Methods: 1180 women who were diagnosed with GDM from 2005 to 2009 were randomly assigned to either a lifestyle intervention (n =586) or a control group (n =594). Major elements of the intervention include six face-to-face meetings with study dietitians in the first year, and two additional sessions and two telephone calls in second year. Results: During the first year, average body weight loss in the first 404 subjects was 1.40kg (2.1%) in the intervention group vs 0.21kg (0.3%) in the control group (P =0.001), and the decrease was more significant among baseline overweight women (body bass index [BMI]≥24kg/m2) in the intervention (2.91kg/4.2%) compared with that in the control group (0.51kg/0.7%) (P <0.001). In addition, women in the intervention group, compared with those in the control group, have decreased BMI, body fat, waist circumference, and plasma insulin levels, and have improved behaviors including increased leisure time activity and dietary fiber intake and decreased sedentary time and fat consumptions. Conclusion: The interim results support the efficacy and feasibility of the lifestyle intervention program. [Copyright &y& Elsevier]