Abstract 574 Poster Session II, Sunday, 5/2 (poster 202)

Adiposity and its associated morbidities are prevalent in the United States in both pediatric and adult populations. We previously showed that prenatal factors including maternal gestational diabetes and weight gain in pregnancy predisposed to increased adiposity at birth and 1 year. The purpose of this study was to investigate the long term effects of maternal adiposity and gestational diabetes on child body size and adiposity at 9 years. 104 children (21 large for gestation (LGA) & 33 appropriate for gestation (AGA) IGDM and 24 LGA & 26 AGA Controls) followed prospectively were evaluated. It was hypothesized that the altered intrauterine environment in gestational diabetes imparts permanent changes affecting the subsequent development of increased adiposity, hypertension, and glycemia and that LGA OGDM are at greatest risk. (Table) At 9 years LGA OGDM had a larger calf and chest circumference than all other study groups and weighed more than AGA OGDM and LGA controls. The LGA OGDM had larger abdominal skinfolds than AGA OGDM and controls. In addition, fasting blood glucose (FBG) was higher (68±10 vs 63±7, p<.02) for OGDM than controls. FBG correlated with child BMI for OGDM, r=.34, p<.02, but not controls. Systolic BP correlated with BMI for both OGDM (r=.47, p<.0004) and controls (r=.48, p<.0006). Multiple regression analyses estimated the relationship between risk factors and weight/BMI at 9 years. For OGDM, a model was sig. in which maternal prepregnant BMI (b=.53, p<.006) and infant birth wt. (b=.005, p<.02) predicted 9 year Wt. In a second model with 9 year OGDM BMI as the dependent variable only maternal prepregnant BMI (b=.29, p<.0006) was sig. associated. Significant regression models were not identified for control children. We conclude that among OGDM, maternal prepregnant adiposity is associated with ↑ child body mass and adiposity at 9 years and that ↑ child adiposity is associated with the child's ↑ fasting blood sugar. OGDM who were LGA at birth appear to have increased risk for adiposity, glycemia and increased blood pressure.

Table 1 No caption available.