Gestational diabetes is associated with an increased risk for diabetes in offspring during childhood and youth, according to study results published in the Canadian Medical Association Journal.

A previous study from Sweden reported an association between maternal gestational diabetes and type 2 diabetes with pediatric diabetes. In the current study, the investigators aimed to assess gestational diabetes as a risk indicator for incident diabetes in offspring during childhood and youth.

Provincial health administrative data in the province of Quebec, Canada, combined with information from the birth and death registries were used in this study. For each mother with gestational diabetes, the researchers randomly selected a matched control in the cohort of mothers in the same age group with singleton live births between April 1, 1990 and December 31, 2007 and no history of gestational diabetes.

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The primary outcome was incident diabetes in offspring from birth up to age 22 years. In the secondary analysis, the association of diabetes in offspring with maternal gestational diabetes was also assessed separately for age groups of birth to age 12 years and age 12 to 22 years. Follow-up continued until March 31, 2012, departure from the province, or death.

Of 80,000 mother-offspring-father triads identified, the study included 36,590 cases with gestational diabetes and a similar number of cases without gestational diabetes. The researchers reported 359 cases of offspring (0.49%) developing diabetes, including 234 (0.32%) from birth to age 12 years and 125 (0.27%) from age 12 to 22 years.

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The incidence of diabetes per 10,000 person-years was 4.52 (95% CI, 4.47-4.57) in offspring born to mothers with gestational diabetes compared with 2.41 (95% CI, 2.37-2.46) in offspring born to mothers without gestational diabetes. The adjusted hazard ratio (HR) for diabetes from birth to age 22 years associated with gestational diabetes was 1.77 (95% CI, 1.41-2.22).

In the secondary analysis, maternal gestational diabetes was associated with the development of diabetes between birth and age 12 years (adjusted HR, 1.43; 95% CI, 1.09-1.89) and between age 12 and 22 years (adjusted HR, 2.53; 95% CI, 1.67-3.85).

In addition, the investigators reported that female sex (adjusted HR, 1.86; 95% CI, 1.28-2.70), gestational diabetes <32 weeks (adjusted HR, 2.97; 95% CI, 1.19-7.42), and previous pregnancy in the mother (adjusted HR, 1.70; 95% CI, 1.20-2.54) were also associated with diabetes in offspring between age 12 and 22 years.

The limitations of this study are the limited data available in health administrative databases, lack of data regarding maternal body mass index or weight gain during pregnancy, and inability to distinguish between type 1 and type 2 diabetes.

“Our analyses show that [gestational diabetes] is associated with incident diabetes in offspring from birth to age 22 years, both overall and when stratified into [childhood and youth age groups],” concluded the researchers.

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Blotsky AL, Rahme E, Dahhou M, Nakhla M, Dasgupta K. Gestational diabetes associated with incident diabetes in childhood and youth: a retrospective cohort study [published online April 15, 2019]. CMAJ. doi:10.1503/cmaj.181001