Intrauterine exposure to hyperglycaemia in pregnancy and risk of adiposity in the offspring at 10 years of age – A community based retrospective cohort study in Sri Lanka

AbstractBackgroundIntrauterine exposure to a hyperglycemic environment can cause long term changes in body composition resulting in increased adiposity and cardio metabolic risk in the offspring. The aim of this study was to determine the association between hyperglycaemia in pregnancy (HIP) and risk of adiposity in the offspring at 10-11 years of age.MethodsA retrospective cohort study was conducted in the Colombo district, Sri Lanka. 7205 children who were born in 2005 were identified through schools and Public Health Midwives in the community. Mothers of these children still possessing antenatal records were interviewed and relevant data were extracted from medical records to identify eligible participants. Exposure status (hyperglycaemia in pregnancy) was ascertained based on client held antenatal records. 159 children of mothers with HIP (exposed) and 253 children of mothers with no HIP (non-exposed) were recruited. Height, weight, waist circumference and triceps skin fold thickness (TSFT) of participants were measured to ascertain outcome status.ResultsThe mean ages (SD) of exposed and non-exposed groups were 10.9 (0.3) and 10.8 (0.3) years respectively. The median BMI (17.6 vs 16.1, p<0.001), waist circumference (63cm vs 59.3 cm, p<0.001) and triceps skinfold thickness (13.7mm vs 11.2mm, p< 0.001) were significantly higher in the exposed group than in the non-exposed group.Children who were exposed to intrauterine hyperglycaemia were more likely to be overweight (aOR=2.5, 95% CI 1.3-4.7), have abdominal obesity (aOR=2.9, 95% CI 1.2-6.8) and high TSFT > 70th centile (aOR=2.1, 95% CI 1.2-3.9) at 10-11 years of age than children who were not exposed after adjusting for maternal BMI, birth weight and birth order.ConclusionsIntrauterine exposure to HIP is associated with significantly higher risk of adiposity in the offspring at 10 years of age.

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Hyperglycaemia in Pregnancy and Anthropometric Parameters in the Offspring at 10 Years: A Community-Based Retrospective Cohort Study in Sri Lanka

Journal of Obesity ◽

10.1155/2020/2735148 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Himali P. Herath ◽

Rasika P. Herath ◽

Rajitha Wickremasinghe

Keyword(s):

Cohort Study ◽

Waist Circumference ◽

Sri Lanka ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Skinfold Thickness ◽

Anthropometric Parameters ◽

Community Based ◽

Triceps Skinfold Thickness ◽

In Pregnancy

Background. Studies of developmental origins of health and disease have highlighted the possible role of intrauterine hyperglycaemia, increasing the future risk of obesity, diabetes, and cardiovascular diseases in the offspring. There is limited evidence from South Asian populations for risk estimates for childhood obesity that are attributable to maternal diabetes in utero. Objective. The aim of this study was to determine the association between hyperglycaemia in pregnancy (HIP) and anthropometric parameters in the offspring at 10-11 years of age. Methods. A community-based retrospective cohort study was conducted in Colombo district, Sri Lanka. In the first stage, children born in 2005 were identified, and the availability of antenatal records was assessed. In the second stage, the exposure status of participants was ascertained based on antenatal records and predefined criteria. In the third stage, height, weight, waist circumference, and triceps skinfold thickness (TSFT) of eligible participants were measured to ascertain the outcome status. Background characteristics were collected by interviewing mothers. A 24-hour dietary recall and a 3-day diet diary were recorded. Results. 159 children of mothers with HIP (exposed) and 253 children of mothers with no HIP (nonexposed) participated. Mean ages (SD) of exposed and unexposed groups were 10.9 (0.3) and 10.8 (0.3) years, respectively. The median BMI (17.6 vs 16.1, p<0.001), waist circumference (63 cm vs 59.3 cm, p<0.001), and triceps skinfold thickness (13.7 mm vs 11.2 mm, p<0.001) were significantly higher in the exposed group. Offspring of women with HIP were more likely to be overweight (aOR = 2.6, 95% CI 1.4–4.9) and have abdominal obesity (aOR = 2.7, 95% CI 1.1–6.5) and high TSFT (aOR = 2.2, 95% CI 1.06–4.7) at 10-11 years than children who were not exposed after adjusting for maternal BMI, maternal age at delivery, and birth order. Conclusions. Intrauterine exposure to HIP is a significant determinant of overweight, high TSFT, and abdominal obesity in the offspring.

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