Oral Presentation ESA-SRB-APEG-NZSE 2022

Association between maternal hyperglycaemia in pregnancy and offspring anthropometry in early childhood the PANDORA Wave 1 study (#66)

Angela Titmuss 1 2 , Federica Barzi 3 , Elizabeth LM Barr 1 4 , Vanya Webster 1 , Anna Wood 1 5 , Joanna Kelaart 6 , Marie Kirkwood 1 , Christine Connors 7 , Jacqueline A Boyle 8 , Liz Moore 9 , Jeremy Oats 10 , H. David McIntyre 11 , Paul Zimmet 12 , Alex DH Brown 13 14 15 16 , Jonathan E Shaw 4 , Maria E Craig 17 , Louise J Maple-Brown 1 5
  1. Menzies School of Health Research, Darwin, NT, Australia
  2. Paediatric Department, Division of Women, Children and Youth, Royal Darwin Hospital, Darwin, NT, Australia
  3. Poche Centre for Indigenous Health, University of Queensland, Brisbane, Qld, Australia
  4. Baker IDI Heart and Diabetes Institute, Melbourne, Vic
  5. Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
  6. Aboriginal Health Domain, Baker Heart and Diabetes Institute, Alice Springs, NT, Australia
  7. NT Department of Health, Darwin, NT
  8. Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, Vic, Australia
  9. Aboriginal Medical Services Alliance, NT, Darwin, NT
  10. Melbourne School of Population and Global Health, Melbourne, Vic
  11. Mater Medical Research Institute, Brisbane, Qld
  12. Monash University, Melbourne, Vic
  13. South Australian Health and Medical Research Institute, Adelaide, SA
  14. University of South Australia, Adelaide, SA
  15. Australian National University, Canberra, ACT, Australia
  16. Telethon Kids Institute, Perth, WA, Australia
  17. School of Women and Children's Health, University of New South Wales, Sydney, NSW, Australia

Exposure to in-utero hyperglycaemia influences later cardiometabolic risk, although few studies include women with type 2 diabetes (T2D) or assess maternal body mass index (BMI) as a potential confounder. This study explored the association of maternal T2D and gestational diabetes mellitus (GDM) with childhood anthropometry, and the influence of maternal BMI on these associations.

The PANDORA birth cohort comprises 1138 women and 1163 children, women with GDM and T2D recruited from a hyperglycaemia in pregnancy register, and women with normoglycaemia from the community. Wave 1 follow-up included 423 children, aged 1.5-5 years (median 2.5 years). Multivariable linear regression assessed associations between maternal antenatal variables with offspring anthropometry (weight, height, BMI, skinfold thicknesses, waist, arm and head circumferences).

Greater maternal BMI was associated with increased anthropometric measures in offspring independent of maternal glycaemic status. After adjustment, including for maternal BMI, children exposed to GDM had lower mean weight (-0.54kg, 95% CI -0.99, -0.11), BMI (-0.55kg/m2, 95% CI -0.91, -0.20), head (-0.52cm, 95% CI -0.88, -0.16) and mid-upper arm (-0.32cm, 95% CI -0.63, -0.01) circumferences, and greater mean suprailiac skinfold (0.78mm, 95% CI 0.13, 1.43), compared to children exposed to normoglycaemia. Children exposed to T2D had smaller mean head circumference (-0.82cm, 95% CI -1.33, -0.31) than children exposed to normoglycaemia. Adjustment for maternal BMI strengthened the negative association between GDM and child weight, BMI and circumferences. Maternal T2D was no longer associated with greater mean skinfolds (p=0.14) and waist circumference (p=0.18) in children after adjustment for maternal BMI.   

Compared to children exposed to normoglycaemia, children exposed to GDM had greater suprailiac skinfold thickness, despite having lower mean weight, BMI and mid-upper arm circumference, and both GDM and T2D were associated with smaller head circumference. Future research should assess whether childhood anthropometric differences influence lifetime cardiometabolic and neurodevelopmental risk.