Original Article

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

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Abstract

Background:

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.

Objective:

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.

Methods:

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.

Results:

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)).

Conclusions:

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.

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Acknowledgements

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

Affiliations

  1. Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki and Oulu, Finland

    • N Kaseva
    • , M Vääräsmäki
    • , H-M Matinolli
    • , M Sipola-Leppänen
    • , M Tikanmäki
    • , J G Eriksson
    •  & E Kajantie
  2. PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland

    • M Vääräsmäki
    • , M Sipola-Leppänen
    •  & E Kajantie
  3. Institute of Health Sciences, University of Oulu, Oulu, Finland

    • H-M Matinolli
    • , M Sipola-Leppänen
    • , M Tikanmäki
    •  & M-R Järvelin
  4. Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland

    • K Heinonen
    •  & K Räikkönen
  5. Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

    • A Lano
    • , S Andersson
    •  & E Kajantie
  6. Department of Psychology, University of Warwick, Warwick, UK

    • D Wolke
  7. Imperial College, London, UK

    • M-R Järvelin
  8. Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    • J G Eriksson
  9. Folkhälsan Research Center, Helsinki, Finland

    • J G Eriksson

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Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to N Kaseva.

Supplementary information

Supplementary Information accompanies this paper on International Journal of Obesity website (http://www.nature.com/ijo)