Maternal obesity and gestational diabetes may have important effects on early child body composition, but likely do not directly affect left ventricular mass in offspring, according to study results published in Diabetic Medicine.

While evidence shows that maternal obesity before pregnancy and gestational diabetes can lead to excess adiposity and increased cardiovascular risk in offspring, there is ongoing controversy regarding the influence of gestational diabetes and maternal adiposity on the development of the heart in early pregnancy. The goal of the current study was to assess the impact of these maternal factors on body composition in early childhood and left ventricular mass at 6 years of age.

The observational follow-up study included 201 mother-child pairs (111 boys; 55%) from the Finnish Gestational Diabetes Prevention Study (RADIEL), a randomized controlled trial of women at increased risk for gestational diabetes (previous gestational diabetes or obesity).

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Mother-child pairs were assessed 6.1±0.5 years after delivery. There was a correlation between maternal lean body mass and child lean body mass (r=0.41; P <.0001). Pre-pregnancy body mass index (BMI) was also associated with child body fat percentage, but this was only evident with maternal BMI >30 kg/m2 (0.26% increase in child body fat percentage per 1 kg/m2 increase in pre-pregnancy BMI; 95% CI, 0.08%-0.44%). Overall, child BMI z score was significantly different from the national population reference (0.45±0.93; P <.0001).

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There was no association between left ventricular mass, left ventricular mass index, or left ventricular mass z score with gestational diabetes, pre-pregnancy BMI, or child body fat percentage. Following adjustment for sex, age, body fat percentage, birth weight, systolic blood pressure, maternal lean body mass, pre-pregnancy BMI, and gestational diabetes, child left ventricular mass increased by 3.08 g (95% CI, 2.25-3.91 g) for each 1 kg of child lean body mass.

The researchers acknowledged several study limitations, including the inclusion of a high percentage of mothers with obesity, thus the results may not apply to other forms of gestational diabetes; results are also limited to early childhood and may include potential bias secondary to child diet, physical activity, or other environmental factors.

“Maternal pre-gestational adiposity is reflected in child adiposity, but no direct association between [left ventricular mass] and child adiposity or evidence of [fetal] programming related to [gestational diabetes] or maternal obesity was found in early childhood,” concluded the researchers.

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Litwin L, Sundholm JKM, Rönö K, Koivusalo SB, Eriksson JG, Sarkola T. Transgenerational effects of maternal obesity and gestational diabetes on offspring body composition and left ventricle mass: the Finnish Gestational Diabetes Prevention Study (RADIEL) 6-year follow-up [published online July 25, 2019]. Diabet Med. doi:10.1111/dme.14089