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Matern Child Health J. Author manuscript; available in PMC 2013 July 10.

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Published in final edited form as:

Matern Child Health J. 2012 January ; 16(1): 125132. doi:10.1007/s10995-011-0756-2.

Gestational Diabetes and Subsequent Growth Patterns of

Offspring: The National Collaborative Perinatal Project
Kesha Baptiste-Roberts,
School of Nursing, Penn State University, University Park, 1300 ASB/A110, 600 Centerview
Drive, Hershey, PA 17033, USA
Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA,
USA
Wanda K. Nicholson,
Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill, NC, USA

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Nae-Yuh Wang, and

Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
Department of Biostatistics, Johns Hopkins University, Baltimore, MD, USA
Frederick L. Brancati
Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
Kesha Baptiste-Roberts: [email protected]

Abstract

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Our objective was to test the hypothesis that intrauterine exposure to gestational diabetes [GDM]
predicts childhood growth independent of the effect on infant birthweight. We conducted a
prospective analysis of 28,358 mother-infant pairs who enrolled in the National Collaborative
Perinatal Project between 1959 and 1965. The offspring were followed until age 7. Four hundred
and eighty-four mothers (1.7%) had GDM. The mean birthweight was 3.2 kg (range 1.15.6 kg).
Maternal characteristics (age, education, race, family income, pre-pregnancy body mass index and
pregnancy weight gain) and measures of childhood growth (birthweight, weight at ages 4, and 7)
differed significantly by GDM status (all P < 0.05). As expected, compared to their non-diabetic
counterparts, mothers with GDM gave birth to offspring that had higher weights at birth. The
offspring of mothers with GDM were larger at age 7 as indicated by greater weight, BMI and BMI
z-score compared to the offspring of mothers without GDM at that age (all P < 0.05). These
differences at age 7 persisted even after adjustment for infant birthweight. Furthermore, the
offspring of mothers with GDM had a 61% higher odds of being overweight at age 7 compared to
the offspring of mothers without GDM after adjustment for maternal BMI, pregnancy weight gain,
family income, race and birthweight [OR = 1.61 (95%CI:1.07, 1.28)]. Our results indicate that
maternal GDM status is associated with offspring overweight status during childhood. This
relationship is only partially mediated by effects on birthweight.

Springer Science+Business Media, LLC 2011

Correspondence to: Kesha Baptiste-Roberts, [email protected].
This data was presented, in part, at the American Diabetes Associations 66th Scientific Session, Washington DC, June 913, 2006.

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Keywords

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Gestational diabetes; Childhood growth; Body mass index

Introduction
A growing body of evidence suggests that predisposition to a host of chronic diseases in
adulthood may be programmed in utero. Fetal programming stems from work by Barker
and colleagues which demonstrated a relationship between birthweight and adult
hypertension [1], insulin resistance [2], dyslipidemia [3] and cardiovascular disease [46],
all of which share obesity as a common risk factor. Most of these associations have been
confirmed by epidemiological studies in several different populations [7]. As a result, there
has been growing interest in investigating whether obesity itself, is programmed in utero by
the presence of a prenatal insult or an adverse hyperglycemic intrauterine environment [8
12].

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Gestational diabetes [GDM] as diagnosed using current criteria, complicates up to 7% of

U.S. pregnancies [13] and is the most common cause of sustained intrauterine
hyperglycemia [14, 15]. The prevalence of GDM in the United States has increased
dramatically between 1989 and 2004 along with the increasing trend in overweight status
and obesity among women of reproductive age, with one study reporting a relative increase
of 122% [16]. GDM is characterized by maternal insulin sensitivity and hyperglycemia.
Through facilitated-diffusion, glucose is transported across the placenta resulting in fetal
hyperinsulinemia, accelerated fetal growth and potential neonatal hypoglycemia at delivery
[17, 18]. Results from the Hyperglycemia and Adverse Pregnancy Outcomes [HAPO] study
indicate that maternal hyperglycemia even in the absence of overt diabetes, adversely affects
neonatal outcomes [19]. The consequences of maternal hyperglycemia in pregnancy may
extend beyond the neonatal period since high infant birthweight is independently predictive
of overweight status in childhood [20, 21]a condition which has increased at alarming
rates in the Unites States. Animal studies suggest that fetal hyperinsulinemia, stimulated by
maternal hyperglycemia, can alter the expression of hypothalamic neurotransmitters, leading
to hyperphagia and increased weight in offspring [22, 23].

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Although several epidemiologic studies have investigated the association between GDM and
offspring overweight status and obesity during childhood, the results are mixed. Several
prospective and retrospective cohort studies reported evidence of a positive association [17,
20, 21, 2428], and one prospective cohort study showed no association [18]. Few studies
have examined whether the effect of GDM on childhood growth is independent of infant
birthweight [20, 24]. Our objectives were to (1) determine the magnitude of association of
GDM with infant birth weight and anthropometric measures (weight, body mass index
[BMI] and BMI z-score) during childhood at ages 3, 4 and 7 years and (2) determine
whether the association was independent of infant birth weight. We conducted a prospective
analysis of 28,358 mother-infant pairs who enrolled in the National Collaborative Perinatal
Project [NCPP] in 19591965 to estimate these associations.
We hypothesized that GDM would be predictive of early childhood growth at each age
interval, independent of infant birthweight. If infant birthweight mediates the association
between GDM and early childhood growth, then clinicians may need to develop perinatal
interventions that target infant birthweight. Alternatively, if GDM is independently
predictive of early childhood growth, clinicians might focus on peri-conceptional
interventions that prevent insulin sensitivity and the development of GDM.

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Methods
Study Design and Population

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The National Collaborative Perinatal Project [NCPP] was a prospective cohort study of
pregnancy and child health. It was specifically designed to identify determinants of cerebral
palsy and allied neurological defects [29]. A detailed description of the methods is described
elsewhere [29]. Briefly, approximately 42,000 pregnant women were enrolled at 12
hospitals across the United States (Baltimore MD, Boston MA, Buffalo NY, Memphis TN,
Minneapolis MN, New Orleans LA, New York NY [2 hospitals], Philadelphia PA, Portland
OR, Providence RI and Richmond VA). Pregnant women were enrolled usually at their first
prenatal visit between 1959 and 1966. Participants were deemed ineligible if there were
incarcerated, if they were planning to move from the area or to give the child up for
adoption or if they gave birth on the day they were recruited into the study. Records were
not kept for women who refused participation at baseline. Four percent of the subjects
enrolled were lost to follow up before delivery. Of the live-born children in the
Collaborative Project, 71% were followed to 7 years of age.
Identification of Cohort

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For the present analysis eligible motherchild pairs met the following criteria: (1) singleton
live-born infants, (2) no congenital anomalies, (3) black or white race, and (4) gestational
age at delivery between 36 and 42 weeks gestation. From the 34,345 initially eligible
motherchild pairs, 5,987 were excluded from the analysis because of missing values for
variables of interest (birth weight, gestational diabetes, family income and pregnancy weight
gain and maternal BMI), producing an analytic sample of 28,358 motherchild pairs.
Characteristics of the analytic sample were compared with those of the eligible cohort.
Compared to the counterparts excluded from the analysis, mothers in the analytic sample
were slightly older, more educated and had a higher pre-pregnancy BMI (all P < 0.05).
There was no difference in pregnancy weight gain. Mothers included were more likely to be
black (51% vs. 43%) and less likely to have gestational diabetes (1.7% vs. 2.6%). Among
both the included and the excluded group, black mothers were less likely to have gestational
diabetes (36 and 15% respectively). Due to loss to follow up, there was some attrition with
increasing offspring age.
Diagnosis of GDM in the National Collaborative Perinatal Project

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Several glucose tolerance tests were performed for each mother utilizing 5 specimens: a
fasting specimen and specimens obtained at 30 min, 1, 2 and 3 h after oral administration of
100 g glucose in solution. In general, glucose tolerance was considered indicative of
diabetes if the glucose level of the fasting blood specimen was 120 mg/dL or higher, or if it
rose to over 175 mg/dL at the end of 1 h and did not return to normal in the 2- and 3-h
specimens. The mother was classified as having GDM if any one of the following four
conditions were met: (1) she was newly diagnosed with diabetes during pregnancy; (2) she
initiated insulin during pregnancy; (3) she displayed an abnormal glucose tolerance test
result; or (4) she had a blood glucose level of 200 mg or more at any time during pregnancy.
Data Collection
Maternal socio-demographic characteristics (age, sex, education, income, marital status)
were obtained by interview. Maternal weight and height were measured upon enrollment;
pre-pregnancy weight was self-reported. Pre-pregnancy maternal body mass index (BMI)
was calculated as self reported pre-pregnancy weight in kilograms divided by height in
meters squared. Just prior to delivery, the mothers weight was measured again and used to

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calculate pregnancy weight gain (i.e. pregnancy weight at delivery minus self-reported prepregnancy weight).

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At delivery, weight and length of the infant were measured. At ages 3, 4 and 7 the childrens
height and weight were measured according to study protocol. BMI at ages 3, 4 and 7 were
calculated as weight in kilograms divided by height in meters squared. Using Epi Info v.
3.3.2, we calculated sex-specific weight for height percentiles and z-scores of BMI using the
1978 WHO/CDC growth reference curve, the earliest standard available for this group of
children based on data from the Fels Longitudinal Growth Study conducted in Yellow
Springs Ohio between 1929 and 1975 [30]. We classified children as being overweight if
their weight for height exceeded the 85th percentile.
Statistical Analysis
Descriptive statistics, frequencies for categorical variables and means and standard
deviations for continuous variables were calculated after stratification by maternal
gestational diabetes status. Chi-square (2) statistics and Students t-tests with unequal
variance were used to compare variables by maternal gestational diabetes status.

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We constructed multiple linear regression models to assess the independent relationship

between maternal gestational diabetes and weight, BMI and BMI z-score at ages 3, 4 and 7
years. We also constructed multiple logistic regression models to calculate the relative odds
of overweight at ages 3, 4 and 7 for offspring of mothers with gestational diabetes compared
to mothers without gestational diabetes with adjustment for maternal BMI, pregnancy
weight gain, family income, race and birthweight. We used generalized estimating equations
(GEE) approach to estimate the population average odds of being overweight over the 7
years of follow-up for offspring having mothers with gestational diabetes compared to those
having mothers without gestational diabetes accounting for the data correlation structure for
each individual. All analyses were conducted using STATA statistical software (version 9.0;
Stata Corporation, College Station, Texas). All tests of significance were two-tailed. This
study protocol 04-08-16-06 was approved by the Johns Hopkins Medicine Institutional
Review Board.

Results
Characteristics of the Study Population

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The average maternal age was 24.4 years. A little more than half of the mothers were nonwhite (56%) and had not completed high school (53.4%). The majority, 72%, had an annual
family income less than $5000equivalent to about $30,000 in 2005. The mean birthweight
overall was 3.2 kg. By present standards, the children were fairly lean with a mean weight of
14.4 kg at age 3; 16.1 kg at age 4; and 23.4 kg at age 7. Table 1 summarizes characteristics
of 28,358 motherchild pairs by maternal gestational diabetes status. Mothers with
gestational diabetes were older and heavier prior to pregnancy, but gained significantly less
weight during pregnancy. Compared to their non-diabetic counterparts, women with GDM
were less likely to be Black and more likely to have a family income greater than $5000.
Moreover, offspring of mothers with GDM had a significantly higher birthweight on average
than their counterparts whose mothers did not have GDM. In addition, offspring of mothers
with GDM were heavier in terms of weight and z-score of BMI at ages 4 and 7 compared to
offspring of mothers without GDM. Compared to offspring of mothers without GDM, there
was a higher proportion of overweight at ages 3, 4 and 7 among offspring of mothers with
GDM (Table 2).

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Association of GDM with Early Childhood Growth

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We estimated the crude and adjusted mean difference in weight at birth and ages 3, 4, and 7
for offspring of mothers with vs. without GDM (Table 3). Offspring of mothers with GDM
had a significantly higher mean birthweight even after adjustment for maternal BMI,
pregnancy weight gain, family income, and race ( = 0.05 kg; 95% CI: 0.01, 0.09). There
was no relationship between mothers GDM status and offspring weight at ages 3 and 4 after
adjustment for maternal BMI, pregnancy weight gain, family income, race and birthweight.
However, offspring of mothers with GDM were 0.46 kg heavier at age 7 than offspring of
mothers without GDM (95%CI: 0.02, 0.91) after adjustment for maternal BMI, pregnancy
weight gain, family income, race and birthweight. We repeated this analysis using BMI and
BMI z-score as the outcome and the results were similar.
Association of GDM with Childhood Overweight Status

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GDM was associated with an increased likelihood of being overweight [OR = 1.81 (95% CI:
1.18, 2.86) and OR = 1.61 (95% CI:1.07, 1.28) at ages 4 and 7 respectively]. The
associations attenuated with increasing age although there was no significant linear trend P =
0.729. Although the results did not meet statistical significance, our results suggest that on
average, children of mothers with GDM were 70% more likely to be overweight [OR = 1.70
(95% CI: 0.97, 2.96)] after adjustment for maternal BMI, pregnancy weight gain, family
income, race and birthweight and the correlation among multiple assessments of body
weight from the same child over time. This result is based on GEE analysis using data from
participants with values at each age only (Table 4).

Discussion
We conducted an analysis using data from the NCPP to better understand the effect of GDM
on childhood growth. Our results expand the knowledge in this area as we found that
maternal GDM status is associated with childhood growth independent of birthweight. We
observed that offspring of mothers with GDM were heavier as determined by three
anthropometric measures examined at age 7, compared to offspring of mothers without
GDM, even after adjustment for birthweight. Also, offspring of mothers with GDM show a
6181% higher odds of overweight status ages 7 and 4, respectively, compared to offspring
of mothers without GDM.

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Previous studies examined several different anthropometric measures during childhood at

different points during childhood among offspring of mothers with GDM. Several studies
evaluated overweight or obesity defined using either the 85th, 90th or 95th percentile of
BMI or weight [20, 27], BMI z-score [18, 26, 28], BMI [21, 25, 27] and skinfold thickness
[25, 26, 28]. Only one study evaluated offspring fat mass and waist circumference [26]. In
addition, with the exception of birthweight, few of the studies assessed childhood
anthropometry before the age of 5 [21, 28]. In one study, Gillman and colleagues [24]
included birthweight in the multivariable model and unlike the results of our study, they did
not find a statistically significant association between offspring exposure to GDM and
overweight status in childhood among 914 year old participants [OR = 1.3; 95% CI 0.9,
1.9] and after the addition of mothers BMI at the time of the childs anthropometry
assessment, the association attenuated [OR = 1.2; 95% CI 0.8, 1.7]. Whitaker and colleagues
did not find an association between intrauterine exposure to GDM and overweight status in
childhood defined by BMI z-score for offspring ages 810 years of age in a sample of
medically insured, non-Hispanic white diet-treated GDM mothers even without adjustment
for birthweight [18]. Our study results may differ from the null findings in previous studies
due to several factors. First, the difference in results may be explained by the secular
improvements in the detection and treatment of GDM. Second, our study was conducted

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using data from a historical cohort unexposed to the nutritional affluence of more
contemporary cohorts used in other studies. Given strong influence of environmental factors
and increased access and availability of calories in a contemporary cohort, these factors may
be more overwhelming than the effect of the intrauterine exposure to maternal
hyperglycemia. Third, overweight in these studies were assessed at older ages which allows
for increased influence of the environmental factors with increasing age.
However, similar to Wright et al., we observed no significant difference in childhood growth
in offspring of mothers with GDM compared to offspring of mothers without GDM at ages 3
and 4. Several factors may have contributed to the lack of association between GDM and
childhood growth at ages 3 and 4. First, weight and BMI do not fully capture growth. Body
composition measures, including fat free mass and lean mass which were unavailable for
analysis, may be better measures of growth in childhood. Second, data from previous studies
suggest that it is not until after ~5 years of age that there is a significant difference in weight
of offspring of mothers with GDM compared to those whose mothers did not have GDM.
These studies suggest that GDM may have a delayed influence that increases with time [17,
24, 28].

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There are several mechanisms that may explain our findings. First, our findings support the
idea that intrauterine exposures and programming may have long term effects on childhood
growth. While the short term effect may be manifested in infant birthweight, there may be
an alternative pathway linking GDM to overweight status in childhood since the observed
association persisted even after adjustment for birthweight. This idea of an alternative
pathway is supported by Pettits finding in the Pima Indians that offspring of mothers with
GDM with normal birthweight had an increased risk of childhood obesity [31]. Second,
there may be a combination of metabolic alterations or genetic factors that play a role. In a
recent study, Catalano et al. found that newborns of mothers with mild glucose intolerance
had a 20% higher body fat mass than infants born to mothers with normal glucose tolerance,
suggestive of an early alteration in fat metabolism due to antenatal exposure to maternal
hyperglycemia [32]. Another possible explanation for the persistent relationship between
GDM and overweight status in childhood may be that offspring of mothers with GDM adopt
some unhealthy dietary and physical activity patterns of their mothers and may share
obesity-related genes. This explanation however, is challenged by the results of Dabelea et
al. [33] which show that among Pima Indians, offspring exposed to diabetes in utero had
higher BMI than their unexposed siblings. These results suggest that there may be some
programming effect of GDM on the fetus, making exposed offspring more susceptible to
being heavier in childhood.

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The relative importance of tight glycemic control and lifestyle behavior change among
mothers with GDM in the prevention of overweight status among offspring is unclear.
Hillier et al. [20] found an almost twofold increased risk of elevated weight at 57 years
among offspring of mothers with untreated GDM, whereas the association with treated
GDM was weaker and similar to milder impaired glucose tolerance. However, results from a
randomized controlled trial, showed that treatment of mild GDM with dietary advice, blood
glucose monitoring and insulin therapy as needed, resulted in reduced incidence of
macrosomia in the intervention group, but there was no effect on BMI in 45 year olds [34].
These results suggest that there is more to the relationship between GDM and overweight
status in childhood beyond shared obesity-related genes between the mother and offspring,
which is a commonly offered explanation. Further investigation of gene environment
interactions in utero and postnatally are necessary to better discern these potential
relationships.

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Our study has several strengths. First, the study has a large diverse population-based sample
though the analytic sample was reduced compared to the initial cohort. Second, we were
able to examine the association of offspring exposure to GDM and weight and overweight
over a 7 year time frame. Third, our study allows us to examine the association between
GDM and childhood growth in a period of time with low prevalence of diabetes and obesity
unlike most other observational studies using more contemporary populations or high risk
populations with high prevalence of obesity and diabetes.

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Nonetheless, several limitations deserve comment. First, there may be some selection bias
due to missing data and differential loss to follow up such that mothers included in the
analysis were more likely to be white and have completed high school. Second, there is
some error in the assessment of gestational age as would be expected since this study was
conducted before the implementation of routine ultrasound to determine gestational age.
Gestational age in this study was determined by using self-reported date of the last
menstrual period (LMP). We were conservative in our approach and limited the analytic
sample births to mothers with a gestational age between 36 and 42 weeks gestation. Third,
we were not able to adjust for unmeasured confounders such as family environment, diet and
exercise which could be independent risk factors for both GDM and overweight status in
childhood. Fourth, there may be some misclassification of GDM. However, the incidence of
metabolic alterations in offspring of mothers with diabetes is not dependent on the type of
diabetes. The risk of overweight and obesity during childhood and adulthood seem to follow
similar profiles in offspring of mothers with Type 1 and Type 2 Diabetes [17, 35]. The
OGTT thresholds used to diagnose GDM in the NCPP are higher (125 mg/dl vs. 95 mg/dl)
compared to those currently recommended by the NDG or Carpenter-Coustan criteria. Thus,
we may have underestimated the number of women with GDM and underestimated the
magnitude of association between GDM and early childhood growth. Finally,
generalizability is limited, since participants in the NCPP were enrolled over 40 years ago
and were comprised largely of low income women.

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We conclude that the GDM is predictor of early childhood growth independent of

birthweight. Therefore clinicians might focus on peri-conceptional interventions that prevent
insulin sensitivity and the development of GDM. Current evidence indicates that physical
activity prior and during pregnancy results in an almost 50% reduction in the development
of GDM [36, 37]. In addition, interventions to improve glucose control and increase healthy
behaviors during pregnancy may impact the development of overweight and obesity in the
offspring. Alternatively, since implementation of a lifestyle intervention may be challenging
during pregnancy, mothers with GDM might be directed to a lifestyle intervention as part of
their post partum follow-up care. Such intervention might reduce the risk of recurrent GDM
with a subsequent pregnancy as well as improve lifestyle behaviors of the mother and child.

Acknowledgments
The authors are supported by the National Institutes of Health. KBR received support from the National Heart,
Lung and Blood Institute (T32-HL07024). WKN received support from the National Institute for Diabetes and
Digestive and Kidney Diseases (K23-DK067944), NW received support by National Institutes of Health (UL1
RR025005) & (P60 DK79637), FLB is supported by the National Institute for Diabetes and Digestive and Kidney
Diseases (K24-DK6222) & (P60 DK79637).

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Table 1

NIH-PA Author Manuscript

Characteristics of 28,358 mother-infant pairs from the collaborative perinatal project (19591964) by
gestational diabetes status
GDM+
(n = 484)

GDM
(n = 27,874)

P value

27.3 6.6

24.5 6.0

<0.001

<High School

228 (47.1)

14,926 (53.6)

0.005

High School +

256 (52.9)

12,948 (46.4)

White

312 (64.50)

13,689 (49.1)

Black

172 (35.5)

14,185 (50.9)

<$5,000

288 (59.5)

20,148 (72.3)

$5000+

196 (40.5)

7,726 (27.7)

Primaparous

133 (27.6)

7,958 (28.7)

Multiparous

Maternal characteristics
Maternal age (years)
Maternal education

Maternal race
<0.001

Family income
<0.001

Parity

NIH-PA Author Manuscript

0.591

349 (72.4)

19,760 (71.3)

Maternal pre-pregnancy BMI (kg/m2)

24.4 6.2

22.7 4.2

<0.001

Pregnancy weight gain (kgs)

8.6 5.52

9.6 5.5

<0.001

3302 584

3190 484

0.001

Male

246 (50.8)

14168 (50.8)

0.999

Female

238 (49.2)

13706 (49.2)

Infant characteristics
Birth weight (g)
Gender

All results presented as n (%) or mean SD,

P < 0.05

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15 (11.7)

Overweight

724 (7.0)

1.29 65.11

15.4 3.0

14.4 2.2

P < 0.05

All results presented as n (%) or mean SD

0.51 1.30

15.5 1.65

14.7 2.4

0.13 1.44
29 (21.2)

0.041*

15.67 1.91

16.6 2.7

0.892

0.721

0.173

1063 (9.0)

0.42 1.71

15.36 3.54

16.01 2.2

GDM

GDM+

GDM+

GDM

Age 4 (n = 11,919)

Age 3 (n = 10,413)

BMI z-score

BMI

(kg/m2)

Weightkg)

Anthropometric
measures

90 (23.3)

0.16 1.16

0.050*
<0.001*

16.35 2.57

24.2 5.3

<0.001*
0.310

GDM+

2795 (12.6)

0.17 1.16

15.64 1.99

23.4 4.5

GDM

Age 7 (n = 22,768)

<0.001*

<0.001*

<0.001*

<0.001*

Offspring anthropometry from the collaborative perinatal project (19591964) by maternal gestational diabetes status

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Table 2
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BMI (kg/m2)

BMI z-score

P < 0.05

0.07 (0.24, 0.39)

0.05* (0.01, 0.09)

Weight (kg)

1.26 (10.06, 12.59)

1.49 (9.95, 12.82)

0.12 (0.64, 0.40)

0.06 (0.37, 0.24)

b (95% CI)

0.16 (0.13, 0.44)

0.14 (0.45, 0.73)

0.41* (0.14, 0.68)

a (95% CI)

Age 4 (n = 11,919)

0.07 (0.21, 0.35)

0.03 (0.56, 0.62)

0.21 (0.05, 0.47)

b (95% CI)

Adjust for maternal age, maternal pregnancy BMI, pregnancy weight gain, family income, and birth weight

Adjusted for maternal age, maternal pregnancy BMI, pregnancy weight gain, family income

a (95% CI)

a (95% CI)

0.04 (0.56, 0.48)

Age 3 (n = 10,413)

Birth

0.45* (0.26, 0.65)

0.18* (0.06, 0.29)

0.20* (0.09, 0.32)

0.46* (0.02, 0.90)

b (95% CI)

0.49* (0.30, 0.68)

0.59* (0.15, 1.04)

a (95% CI)

Age 7 (n = 22,768)

Association of gestational diabetes with childhood anthropometry at age 3, 4, and 7 years from linear regression models

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Table 3
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Table 4

Associations of gestational diabetes with childhood overweight from logistic regression models

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Outcomes

Model 1

Model 2

ORa

95% CI

ORb

95% CI

Overweight at age 3 (n = 10,413)

1.39

0.79, 2.43

1.22

0.69, 2.15

Overweight at age 4 (n = 11,919)

2.09*

1.35, 3.21

1.81*

1.18, 2.86

Overweight at age 7 (n = 22,768)

1.68*

1.31, 1.16

1.61*

1.07, 1.28

OR odds ratio
*

P < 0.5

Adjusted for maternal age, maternal pregnancy BMI, pregnancy weight gain, family income

Adjust for maternal age, maternal pregnancy BMI, pregnancy weight gain, family income, and birth weight

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