Large babies born to diabetes have almost triple the risk of obesity

Children who are larger than the average birth (large for gestational or LGA age) and who are born of mothers with gestational diabetes are almost three times so likely to be obese that children born of normal size of normal sizeof mothers without diabetes.

This follows from a new research published in 'Diabetologia' (the magazine of the European Association for the Study of Diabetes [EASD), conducted by Dr. Padma Kaul, of the Department of Medicine of the University of the University of the University of the University of the University of the UniversityDe Alberta, in Edmonton, Alberta, Canada, and colleagues.

There are multiple causes of overweight or obesity in childhood.Research has established that children born are more likely to be larger in childhood.Maternal weight, pre-emotional and gestational weight gain, and the state of maternal diabetes during pregnancy are established risk factors to have babies with LGA.However, little is known about the relative impact of LGA and maternal diabetes during pregnancy in overweight/obesity in early childhood.

The study analyzed 81,226 children born between January 2005 and August 2013. Almost all mothers resided in the Calgary area in the province of Alberta, Canada, with a lower proportion of other parts of the state.Data on height and weight at the time of the preschool immunization visit (age of 4-6 years) of the offspring between January 2009 and August 2017, as well as the state of breastfeeding in the first fiveMonths of life, related to maternal hospitalization and records of outpatient patients and birth registration.

Children were grouped into six categories according to the state of maternal diabetes during pregnancy (without diabetes, gestational diabetes or pre -existing diabetes) and birth weight (appropriate for gestational age [AGA) or LGA).The criteria of the World Health Organization (WHO) were used to identify overweight or obese children.There were 69,506 children in the group without diabetes/AGA (Control Group), 5,926 in the group without diabetes/LGA, 4,563 in the Gestational/Aga diabetes group, 5.73 in the Gestational/LGA diabetes group, 480 in pre -existing/diabetes pre -existing/AGA and 178 in the pre -existing diabetes/LGA group.

The overweight/obesity rates in preschool age ranged from 21 percent in the control group and 43 percent in the Gestational/LGA diabetes group.The overweight/obesity rates were also high in the group with pre -existing diabetes (36 percent) and in the group without diabetes/LGA (35 percent).Statistical calculations showed that a child's risk of being overweight/obesity was almost triple (a risk 2.79 times higher) if they were in the Gestational/LGA diabetes group compared to the control group without diabetes/AGA.

Large size at birth, overweight risk factor

In the pre -existing diabetes/LGA group and the non -diabetes/LGA group, the risk was doubled compared to controls, which clearly indicates that LGA is an independent risk factor for overweight/obesity in the child.An additional analysis showed that the LGA only contributed 39 percent to the risk of obesity in the child, much greater than the one detected for maternal gestational diabetes alone (16 percent) or pre -existing diabetes alone (15 percent).The risk contribution to the combinations of gestational/LGA diabetes and pre -existing/LGA diabetes was 50 and 39 percent, respectively.

When the pre -existing diabetes group in type 1 and type 2 subgroups was stratified, the authors found that the prevalence of overweight/obesity was 21 percent in the type 1/AGA group, 31 percent in the group ofType 1/LGA (similar to those of groups without diabetes), 27 percent in type 2/Aga group and 42 percent in type 2/LGA group.

The authors explain that being LGA at birth is a potentially modifiable factor and this study highlights the need to better understand the factors associated with their incidence to develop strategies to reduce overweight rates/childhood obesity.The authors believe that LGA can be a substitute marker for two variables that are not measured in the study: maternal weight (an excess pre-borazo weight or gestational weight gain) or glutemic control during pregnancy.

“Our study establishes that a greater proportion of excess weight in childhood can be attributed to LGA than to maternal diabetes during pregnancy.We hope that these findings reinforce public health campaigns that inform women who planBlood sugar during pregnancy can have a significant impact on the future health of their children, ”they say.

Breastfeeding in the first five months of life was associated with a probability approximately 25 percent of overweight/obesity in childhood, in general, and in all groups, except gestational/LGA diabetes and pre -existing/LGA diabetes (both bothof type 1 as type 2).

The authors add: “The protection offered by breast milk did not extend to gestational diabetes/LGA and Diabetes/LGA groups;neither in general, nor in the type 1/LGA and type 2/LGA subgroups.If, as we believe possible, LGA is a marker of the bad control of blood sugar during pregnancy, more research is needed to examine whether, as previously suggested, glucose and insulin levels in breast milk of mothers with diabetes canIncrease, instead of protecting, against the risk of childhood obesity. ”