Original Article

This is an unedited manuscript that has been accepted for publication. Nature Research are providing this early version of the manuscript as a service to our customers. The manuscript will undergo copyediting, typesetting and a proof review before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers apply.

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

Published online:



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 (BMI 25 kg/m2) 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. GDM 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/m2 (95% confidence interval 0.57, 2.72); women 1.41 kg/m2 (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)]. BMI was non-significantly different between OGDM-participants and controls [men 0.88kg/m2 (−0.17, 1.92); women 0.82 kg/m2 (−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.

  • Subscribe to International Journal of Obesity for full access:



Additional access options:

Already a subscriber?  Log in  now or  Register  for online access.

Author information


  1. National Institute for Health and Welfare, Helsinki and Oulu, Finland

    • N Kaseva
    • , M Vääräsmäki
    • , H-M Matinolli
    • , M Sipola-Leppänen
    • , M Tikanmäki
    • , G Eriksson Johan
    •  & 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

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

    • G Eriksson Johan


  1. Search for N Kaseva in:

  2. Search for M Vääräsmäki in:

  3. Search for H-M Matinolli in:

  4. Search for M Sipola-Leppänen in:

  5. Search for M Tikanmäki in:

  6. Search for K Heinonen in:

  7. Search for A Lano in:

  8. Search for D Wolke in:

  9. Search for S Andersson in:

  10. Search for M-R Järvelin in:

  11. Search for K Räikkönen in:

  12. Search for G Eriksson Johan in:

  13. Search for E Kajantie in:

Corresponding author

Correspondence to N Kaseva.