In-Utero Exposure to GGI-1 and GDM Linked to Higher Obesity Risk in Offspring: Study

A new study published in The Journal of Clinical Endocrinology & Metabolism showed that older children and adolescents exposed to gestational glucose intolerance (GGI-1) or gestational diabetes mellitus (GDM) in utero show a higher risk of obesity when compared to those from normal glucose tolerance (NGT) pregnancies, independent of maternal BMI.

It has been suggested that gestational diabetes mellitus and fetal exposure to hyperglycemia are the causes of increased adiposity in children since children born to mothers who had a pregnancy impacted by the condition are more likely to be overweight and obese. However, because maternal obesity is a powerful predictor of gestational diabetes mellitus and a risk factor for offspring obesity and overweight, probably due to shared genes and environment, it probably muddies this link. This study attempted to establish the relationship between child obesity and in utero exposure to GG-1 (abnormal glucose screening without gestational diabetes), as this association has not been consistently documented.

This research examined the risk of obesity (body mass index [BMI] > 95th percentile) in children aged 2–5, 6–10, and 11–18 who were exposed to different levels of maternal glycemia during pregnancy, including NGT, GGI (0 abnormal glucose values, GGI-0, or 1 abnormal value, GGI-1), or gestational diabetes mellitus (GDM > 2 of 4 abnormal values) in a retrospective cohort.

After controlling for mother's age, parity, race/ethnicity, insurance, gestational age, marital status, infant sex, and gestational weight gain, they estimated odds ratios for obesity in each glycemic group relative to NGT using generalized estimating equations for logistic regression. Maternal BMI in the first trimester was also taken into account in a second model.

A total of 27,876 kids and teenagers from 23,334 (83.7%) NGT pregnancies, 3,413 (12.2%) GGI pregnancies, and 1,129 (4.1%) GDM pregnancies were included in the study. At ages 2–5, the prevalence of obesity was 13.5%; at ages 6–10, it was 20.3%; and at ages 11–18, it was 23.4%. When compared to NGT, those exposed to GGI-1 and GDM were more likely to be obese.

This association was lessened in all age and glycemic exposure groups when maternal BMI was taken into account, but it was still significantly higher in children aged 6–10 who were exposed to GDM (odds ratio (OR): 1.21, 95%CI [1.01, 1.46]) and children aged 11 to 18 who were exposed to both GGI-1 and GDM (GGI-1 OR: 1.44 [1.14, 1.81]; GDM OR: 1.28 [1.03, 1.59]).

Overall, regardless of the mother's body mass index, older children and adolescents who are exposed to gestational glucose intolerance or gestational diabetes mellitus in utero have a greater risk of obesity than those from normal glucose tolerance pregnancies.

Source:

Maya, J., Schulte, C. C. M., Hsu, S., James, K., Thaweethai, T., Pant, D., Hivert, M.-F., & Powe, C. E. (2025). Gestational glucose intolerance and risk of obesity in childhood and adolescence. The Journal of Clinical Endocrinology and Metabolism. https://doi.org/10.1210/clinem/dgaf345