Gestational Diabetes Linked to Poorer Lung Function and Higher Asthma Risk in Children: JAMA
USA: A study published in Annals of Allergy, Asthma & Immunology has found that children exposed to maternal gestational diabetes mellitus (GDM) have reduced lung function and a significantly higher risk of asthma by the ages of 8 to 9 years. Beyond its well-known links to childhood obesity and type 2 diabetes, gestational diabetes may also have lasting effects on respiratory health, according to lead author Margaret Adgent.
Gestational diabetes is a common pregnancy complication, affecting about 6–9% of pregnancies in the United States. Previous studies have suggested an association between GDM and childhood asthma, but evidence linking prenatal exposure to objective lung function outcomes later in childhood has been limited. Since lung function is a key indicator of long-term respiratory health and a predictor of chronic lung disease and early mortality, understanding early-life influences on lung development is clinically important.
In this prospective cohort study, researchers followed mother–child pairs enrolled between 2007 and 2011. Children were evaluated for respiratory outcomes at 8 to 9 years of age. Gestational diabetes status was confirmed through medical record review, while lung function was assessed using standardized spirometry. Measurements included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and indices of small airway airflow. Parents also completed validated questionnaires to report wheeze and physician-diagnosed asthma.
The study revealed the following findings:
- Among more than 700 children with valid spirometry data, those exposed to gestational diabetes in utero showed lower lung function than unexposed children.
- After adjustment for maternal, prenatal, and childhood factors, gestational diabetes exposure remained linked to modest but significant reductions in FEV1 and measures of small airway airflow.
- These results suggest subtle airway function impairments that may persist beyond early childhood.
- Gestational diabetes exposure was strongly associated with a higher risk of asthma in childhood.
- Children exposed to GDM had more than threefold increased odds of current asthma at 8 to 9 years of age compared with unexposed peers.
- Higher odds of wheezing symptoms were also observed, reinforcing the link between prenatal metabolic disturbances and ongoing respiratory morbidity.
Researchers noted that lung development begins early in gestation and continues through childhood, with lung function trajectories often remaining stable over time. Disruptions during critical developmental periods—potentially driven by maternal hyperglycaemia, systemic inflammation, oxidative stress, or altered immune programming—may therefore result in long-term respiratory consequences. Although the exact biological mechanisms remain unclear, the findings suggest that gestational diabetes may influence both lung structure and immune responses relevant to asthma.
The authors also acknowledged some limitations, such as the relatively small number of GDM cases and the lack of detailed data on diabetes severity or glycaemic control during pregnancy.
Overall, the study identifies gestational diabetes as a potential prenatal risk factor for reduced lung function and persistent asthma in children. The authors call for larger studies with longer follow-up to clarify mechanisms and to inform early prevention strategies aimed at improving lifelong respiratory health in children exposed to GDM.
Reference:
Adgent MA, Gebretsadik T, Moore PE, Hartman TJ, Nickelberry M, Zhang X, Zhao Q, Bush NR, LeWinn KZ, Wright RJ, Carroll KN. Gestational diabetes and childhood lung function at age 8 to 9 years in a diverse US cohort. Ann Allergy Asthma Immunol. 2025 Dec 11:S1081-1206(25)01381-X. doi: 10.1016/j.anai.2025.12.006. Epub ahead of print. PMID: 41386371.
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