Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Pre-pregnancy overweight or obesity and gestational diabetes as predictors of body composition in offspring twenty years later: evidence from two birth cohort studies



Global prevalence of overweight/obesity and gestational diabetes (GDM) is increasing. In pregnant women both conditions affect offspring’s later health. Overweight/obesity is a risk factor of GDM; to what extent maternal overweight/obesity explains long-term effects of GDM in offspring is unknown.


To evaluate effects of maternal pre-pregnancy overweight/obesity (body mass index (BMI) 25 kg m−2) and GDM, occurring together or separately, on body composition among adult offspring.


Participants include 891 individuals aged 24.1 years (s.d. 1.4) from two longitudinal cohort studies (ESTER and AYLS). Adult offspring of normoglycemic mothers with overweight/obesity (ONOO, n=153), offspring of mothers with GDM (OGDM; n=191) and controls (n=547) underwent anthropometric measurements and bioimpedance analysis. Gestational diabetes mellitus was diagnosed by oral glucose tolerance test. Data were analyzed by linear regression models adjusted for confounders.


Compared with controls, ONOO-participants showed higher BMI (men 1.64 kg m−2 (95% confidence interval 0.57, 2.72); women 1.41 kg m−2 (0.20, 2.63)) and fat percentage (men 2.70% (0.99, 4.41); women 2.98% (0.87, 5.09)) with larger waist circumferences (men 3.34 cm (0.68, 5.99); women 3.09 cm (0.35, 5.83)). Likewise, OGDM-participants showed higher fat percentage (men 1.97% (0.32, 3.61); women 2.32% (0.24, 4.41)). Body mass index was non-significantly different between OGDM-participants and controls (men 0.88 kg m−2 (−0.17, 1.92); women 0.82 kg m−2 (−0.39, 2.04)). Also waist circumferences were larger (men 2.63 cm (−0.01, 5.28); women 3.39 cm (0.60, 6.18)); this difference was statistically significant in OGDM-women only. Differences in body composition measures were stronger among offspring of women with both GDM and overweight/obesity. For instance, fat mass was higher among OGDM-participants of overweight mothers (men 4.24 kg (1.36, 7.11) vs controls; women 5.22 kg (1.33, 9.11)) than OGDM participants of normal weight mothers (men 1.50 kg (−2.11, 5.11) higher vs controls; women 1.57 kg (−3.27, 6.42)).


Maternal pre-pregnancy overweight and GDM are associated with unhealthy body size and composition in offspring over 20 years later. Effects of maternal pre-pregnancy overweight appear more pronounced.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1


  1. WHO. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2004; 894:i-xii: 1–253.

    Google Scholar 

  2. Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D . Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. Lancet 2010; 376: 1775–1784.

    Article  Google Scholar 

  3. Loring B, Robertson A . Obesity and inequities. Guidance for addressing inequities in overweight and obesity. World Health Organization: Geneva, 2014,

    Google Scholar 

  4. van Dijk SJ, Molloy PL, Varinli H, Morrison JL, Muhlhausler BS, Members of EpiSCOPE. Epigenetics and huZman obesity. Int J Obes (Lond) 2015; 39: 85–97.

    Article  CAS  Google Scholar 

  5. Drake AJ, Reynolds RM . Impact of maternal obesity on offspring obesity and cardiometabolic disease risk. Reproduction 2010; 140: 387–398.

    Article  CAS  Google Scholar 

  6. Starling AP, Brinton JT, Glueck DH, Shapiro AL, Harrod CS, Lynch AM et al. Associations of maternal BMI and gestational weight gain with neonatal adiposity in the Healthy Start study. Am J Clin Nutr 2015; 101: 302–309.

    Article  CAS  Google Scholar 

  7. Castillo H, Santos IS, Matijasevich A . Relationship between maternal pre-pregnancy body mass index, gestational weight gain and childhood fatness at 6–7 years by air displacement plethysmography. Matern Child Nutr 2015; 11: 606–617.

    Article  Google Scholar 

  8. Pirkola J, Pouta A, Bloigu A, Hartikainen AL, Laitinen J, Järvelin MR et al. Risks of overweight and abdominal obesity at age 16 years associated with prenatal exposures to maternal prepregnancy overweight and gestational diabetes mellitus. Diabetes Care 2010; 33: 1115–1121.

    Article  Google Scholar 

  9. Vääräsmäki M, Pouta A, Elliot P, Tapanainen P, Sovio U, Ruokonen A et al. Adolescent manifestations of metabolic syndrome among children born to women with gestational diabetes in a general-population birth cohort. Am J Epidemiol 2009; 169: 1209–1215.

    Article  Google Scholar 

  10. Sipola-Leppänen M, Vääräsmäki M, Tikanmäki M, Matinolli HM, Miettola S, Hovi P et al. Cardiometabolic risk factors in young adults who were born preterm. Am J Epidemiol 2015; 181: 861–873.

    Article  Google Scholar 

  11. Järvelin MR, Hartikainen-Sorri AL, Rantakallio P . Labour induction policy in hospitals of different levels of specialisation. Br J Obstet Gynaecol 1993; 100: 310–315.

    Article  Google Scholar 

  12. Heinonen K, Räikkönen K, Pesonen AK, Kajantie E, Andersson S, Eriksson JG et al. Prenatal and postnatal growth and cognitive abilities at 56 months of age: a longitudinal study of infants born at term. Pediatrics 2008; 121: e1325–e1333.

    Article  Google Scholar 

  13. Wolke D, Sohne B, Riegel K, Ohrt B, Österlund K . An epidemiologic longitudinal study of sleeping problems and feeding experience of preterm and term children in southern Finland: comparison with a southern German population sample. J Pediatr 1998; 133: 224–231.

    Article  CAS  Google Scholar 

  14. Miettola S, Hartikainen AL, Vääräsmäki M, Bloigu A, Ruokonen A, Järvelin MR et al. Offspring's blood pressure and metabolic phenotype after exposure to gestational hypertension in utero. Eur J Epidemiol 2013; 28: 87–98.

    Article  CAS  Google Scholar 

  15. Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33: 676–682.

    Article  Google Scholar 

  16. World Health Organization (WHO) WHO STEPwise approach to surveillance (STEPS). WHO: Geneva, 2008b,

  17. Malavolti M, Mussi C, Poli M, Fantuzzi AL, Salvioli G, Battistini N et al. Cross-calibration of eight-polar bioelectrical impedance analysis versus dual-energy X-ray absorptiometry for the assessment of total and appendicular body composition in healthy subjects aged 21–82 years. Ann Hum Biol 2003; 30: 380–391.

    Article  CAS  Google Scholar 

  18. Sartorio A, Malavolti M, Agosti F, Marinone PG, Caiti O, Battistini N et al. Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis. Eur J Clin Nutr 2005; 59: 155–160.

    Article  CAS  Google Scholar 

  19. Gibson AL, Holmes JC, Desautels RL, Edmonds LB, Nuudi L . Ability of new octapolar bioimpedance spectroscopy analyzers to predict 4-component-model percentage body fat in Hispanic, black, and white adults. Am J Clin Nutr 2008; 87: 332–338.

    Article  CAS  Google Scholar 

  20. Borodulin K, Levälahti E, Saarikoski L, Lund L, Juolevi A, Grönholm M et al Kansallinen FINRISKI 2012-terveystutkimus Osa 2: Tutkimuksen taulukkoliite. 2014;22/2013.

  21. Reynolds RM, Osmond C, Phillips DI, Godfrey KM . Maternal BMI, parity, and pregnancy weight gain: influences on offspring adiposity in young adulthood. J Clin Endocrinol Metab 2010; 95: 5365–5369.

    Article  CAS  Google Scholar 

  22. Eriksson JG, Sandboge S, Salonen M, Kajantie E, Osmond C . Maternal weight in pregnancy and offspring body composition in late adulthood: findings from the Helsinki Birth Cohort Study (HBCS). Ann Med 2015; 47: 94–99.

    Article  Google Scholar 

  23. Eriksson JG, Sandboge S, Salonen MK, Kajantie E, Osmond C . Long-term consequences of maternal overweight in pregnancy on offspring later health: findings from the Helsinki Birth Cohort Study. Ann Med 2014; 46: 434–438.

    Article  Google Scholar 

  24. Zhao P, Liu E, Qiao Y, Katzmarzyk PT, Chaput JP, Fogelholm M et al. Maternal gestational diabetes and childhood obesity at age 9–11: results of a multinational study. Diabetologia 2016; 59: 2339–2348.

    Article  CAS  Google Scholar 

  25. Clausen TD, Mathiesen ER, Hansen T, Pedersen O, Jensen DM, Lauenborg J et al. Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes. J Clin Endocrinol Metab 2009; 94: 2464–2470.

    Article  CAS  Google Scholar 

  26. WHO. Global Health Observatory data repository. Overweight (body mass index >= 25) (age-standardized estimate) Data by country, 2014.

  27. Tanvig M, Vinter CA, Jorgensen JS, Wehberg S, Ovesen PG, Lamont RF et al. Anthropometrics and body composition by dual energy X-ray in children of obese women: a follow-up of a randomized controlled trial (the Lifestyle in Pregnancy and Offspring [LiPO] study). PLoS One 2014; 9: e89590.

    Article  Google Scholar 

Download references


This study was supported by grants from the Academy of Finland (SALVE program for 2009–2012 and grants 127437, 129306, 130326, 134791, 263924 and 274794 to EK, JGE, KR and KH), Doctoral Programme for Public Health, University of Tampere (to MS-L), the Emil Aaltonen Foundation (to EK), European Commission (Framework 5 award QLG1-CT-2000-001643 to M-RJ, H2020 award SC1-2016-RTD-733180 RECAP to EK), the Foundation for Pediatric Research (to EK and AL), the Finnish Government Special Subsidiary for Health Sciences (evo) (to JGE), Finnish Medical Societies: Duodecim (to EK) and Finska Läkaresällskapet (to JGE, SA and NK), the Jalmari and Rauha Ahokas Foundation (to EK), the Juho Vainio Foundation (to EK, MS-L and MV), the National Graduate School of Clinical Investigation (to MT), the Novo Nordisk Foundation (to EK and MV), the Signe and Ane Gyllenberg Foundation (to EK, JGE and NK), the Sigrid Jusélius Foundation (to EK), the Yrjö Jahnsson Foundation (EK, MS-L and MV), the Bundesministerium für Forschung und Technik (Federal Goverment of Germany, Ministryof Science and Technology) program grants PKE 4 and JUG 14 (FKZ’s 0706224, 0706564, and 01EP9504) (to DW), Samfundet Folkhälsan (to JGE) and Päivikki and Sakari Sohlberg Foundation (to SA). The supporters of the study had no role in the study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the paper for publication.

Author information

Authors and Affiliations


Corresponding author

Correspondence to N Kaseva.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on International Journal of Obesity website

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kaseva, N., Vääräsmäki, M., Matinolli, HM. et al. Pre-pregnancy overweight or obesity and gestational diabetes as predictors of body composition in offspring twenty years later: evidence from two birth cohort studies. Int J Obes 42, 872–879 (2018).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links