Association of gestational diabetes mellitus with offspring weight status across infancy: a prospective birth cohort study in China.

Background: The association between gestational diabetes mellitus (GDM) and childhood body weight remains controversial, and additional study is needed, especially in Asian populations.
Methods: This prospective study investigated the association between maternal glucose concentration, and GDM status and infant body weight from birth to 12 months of age. Linear mixed effects (LME) models and multiple linear regression were used to assess the longitudinal association of GDM with infant growth measured by weight-for-length z-scores (WFLZ), weight-for-age z-scores (WFAZ), and length-for-age z-scores (LFAZ) at birth, 1, 3, 6, 8, and 12 months of age.
Results: Offspring born to mothers with GDM had higher WFLZ [β: 0.26 SD units (95% CI: 0.13-0.40)] across infancy than those of mothers without GDM. When stratified analysis by maternal pre-pregnancy body mass index (BMI) status, the association was pronounced in normal-weight [β:0.28 SD units (95% CI: 0.11-0.45)] and overweight/obese women [β: 0.34 SD units (95% CI: 0.09-0.58)] but not in underweight women (P for interaction < 0.05). Multiple linear regression found that the effect estimate of GDM on infant WFLZ was highest at birth [β: 0.36 SD units (95% CI: 0.11-0.61)], remained significant at 1 [β: 0.22 SD units (95% CI: 0.03-0.41)] and 3 [β:0.19 SD units (95% CI: 0.01-0.37)] months of age and decreased across infancy. Maternal GDM status was not associated with infant WFAZ or LFAZ.
Conclusions: Maternal GDM status was associated with infant WFLZ, but not WFAZ or LFAZ. The association between GDM status and offspring WFLZ was more pronounced in early infancy or in normal-weight and overweight/obese women. Increased public health efforts to prevent GDM in normal-weight and overweight/obese pre-pregnancy mothers are recommended to control offspring overweight or obesity.