Association between maternal glucose levels in pregnancy and offspring’s metabolism and adiposity: an 18-year birth cohort study

Abstract

AIMS/HYPOTHESIS: The study aimed to explore the association between maternal glucose levels in pregnancy and offspring's metabolism and adiposity at approximately 18 years of age. METHODS: Pregnant women from the Hong Kong Field Centre enrolled in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study underwent a 75 g OGTT at 24-32 gestational weeks. Offspring's metabolic and adiposity traits were assessed at 18 years postpartum. Associations were evaluated using multiple linear regression and logistic regression. RESULTS: Among the 506 mother-child pairs followed up to 18 years, maternal fasting plasma glucose (FPG) in pregnancy was positively associated with offspring's FPG (β = 0.06 [95% CI 0.02, 0.09]), while maternal 1 h plasma glucose (PG) showed a positive association with offspring's FPG (β = 0.05), 30 min PG (β = 0.21) and 2 h PG (β = 0.14). All maternal glycaemic levels were associated with an increased risk of offspring being overweight/obese, particularly maternal 1 h PG (OR 1.50 [95% CI 1.17, 1.93]). Offspring of mothers with gestational diabetes mellitus showed a higher prevalence of abnormal glucose tolerance (11.86% vs 7.97%), impaired fasting glucose (1.89% vs 0.49%) and impaired glucose tolerance (10.34% vs 7.13%) than offspring of mothers with normal glucose tolerance, although these associations did not reach statistical significance in fully adjusted models, underscoring the benefit of considering maternal glucose as a continuous trait. CONCLUSIONS/INTERPRETATION: Maternal glucose levels in pregnancy showed a long-term association with offspring's metabolic health into young adulthood, with continuous associations across the full maternal glucose spectrum, suggesting a graded effect of maternal hyperglycaemia on offspring's metabolic risk.

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