At the time of the original HAPO study, it was controversial whether maternal hyperglycaemia less severe than that in diabetes mellitus is associated with increased risks of adverse pregnancy outcomes.
In HAPO, 25,505 pregnant women underwent 75-g oral glucose-tolerance testing at 24 to 32 weeks of gestation.1
Data remained blinded if the fasting plasma glucose was 105 mg/dL or less and the 2-hour plasma glucose level was 200 mg/dL or less.1
The results indicated that strong, continuous associations of maternal glucose levels below those diagnostics of diabetes with increased birth weight and increased cord-blood serum C-peptide levels.1
How was this study conducted?
The HAPO follow-up study aimed to determine associations of maternal glucose levels during pregnancy with measures of adiposity in offspring at 10-14 years of age, and to determine associations of maternal glucose levels during pregnancy and maternal metabolic disorders 10-14 years later.
A total of 4697 mothers and 4832 children were followed.
Among mothers with a diagnosis of gestational diabetes mellitus (GDM) at study start, 52.2% had disorders of glucose metabolism compared to 20.0% of mothers without a diagnosis of GDM, with a significant association.
The frequency of overweight and obesity in children was 39.5% in those whose mothers had a diagnosis of GDM vs. 28.6% for those whose mothers did not.
In fully adjusted models controlling for child age, sex and maternal characteristics, maternal BMI had significant, positive associations with all childhood adiposity outcomes, while maternal glycemia had significant, positive associations with childhood adiposity outcomes except BMI.
How does this study impact clinical practice?
There was a continuous relationship between maternal glycaemia in pregnancy and adverse pregnancy outcomes.
Maternal GDM/increasing glycaemia was associated with increased postpartum disorders of glucose metabolism.
Maternal BMI along the continuum had significant associations with all measures of childhood adiposity: BMI, body fat %, sum of skinfolds and waist circumference, even when adjusted for GDM.
Maternal glucose across the continuum had a significant positive association with childhood glucose concentrations and an inverse correlation with insulin sensitivity and disposition index, even when adjusted for childhood obesity.
This is a highlights summary of an oral session given at the EASD 2020 Virtual Meeting and presented by:
Patrick M. Catalano, MD
Mother Infant Research Institute, Friedman School of Nutrition and Policy, Tufts University School of Medicine, Boston, USA
The presenting authors of the original session had no part in the creation of this conference highlights summary.
The content is produced by Infomedica. The summary text was drafted by Patrick Moore, PhD, and reviewed by Marco Gallo, MD, an independent external expert, and approved by Florian Toti, MD, the scientific editor of the program.