Link Between Gestational Diabetes and Infant Fat Growth

Infants exposed to gestational diabetes gain less fat in their first year, challenging assumptions about obesity risk and growth patterns.

Highlights:

Babies exposed to gestational diabetes mellitus (GDM) in utero gain less fat in their first year but have equivalent lean body mass growth compared to non-GDM infants
Gestational diabetes doesn’t necessarily predispose infants to obesity, suggesting natural flexibility in early growth patterns
Current assumptions about GDM and childhood obesity risk require reevaluation, emphasizing the need for nuanced early-life monitoring

Unexpected discoveries about how babies with gestational diabetes mellitus (GDM) develop during their first year of life have been demonstrated by a new study by researchers from The University of Texas at Austin and Harvard Medical School. The study, published in the American Journal of Clinical Nutrition, calls into question current perspectives on obesity risk by demonstrating that these infants develop fat at a slower rate than others in their first year (1). This shows that newborns' early growth may adapt and self-correct more than previously assumed and that infants with GDM are not necessarily prone to obesity, but may benefit from increased monitoring to maintain healthy growth.

Link Between Gestational Diabetes and Child Obesity

"We often believe that babies exposed to gestational diabetes are automatically at a higher risk for childhood obesity, but our findings paint a more complicated picture," said Elizabeth Widen, corresponding author and assistant professor of nutritional sciences at UT Austin. "While these infants are born with more body fat, many seem to naturally balance out over time."

Gestational diabetes
The condition is not caused by a lack of insulin, but by the action of hormones produced during pregnancy that blocks the action of insulin.

‘New research shows infants born to mothers with gestational diabetes gain less fat in their first year, challenging long-held beliefs about obesity risk. #gestationaldiabetes #infanthealth #medindia’

Babies born to mothers with GDM had higher levels of body fat at birth, but they gained less fat during their first year of life, indicating a flexibility in early-life growth patterns that previous research may have overlooked.

GDM occurs in around 8.3% of pregnancies in the United States, a figure that has increased dramatically over the last two decades. Mothers with GDM are more likely to experience pregnancy problems and ultimately develop Type 2 diabetes. Infants with Type 2 diabetes typically have higher-than-average birth weights, a higher percentage of fat (adipose) tissue, and higher body mass indexes. Previous research has shown that infants who were exposed to GDM in utero had a higher chance of developing Type 2 diabetes and obesity later in life.

Impact of Gestational Diabetes Exposure During Pregnancy

The study tracked 198 infants, half of whom had been exposed to GDM in utero. The data were obtained between 1996 and 2006, with the majority of the participants recruited before GDM was commonly treated with blood sugar-controlling medications such as metformin or insulin.

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"These data are consistent with the Maternal Fetal Medicine Units Network's treatment of mild GDM in pregnancy, showing that there was no reduction in childhood obesity or metabolic dysregulation between ages 5 to 10 in offspring of treated GDM mothers as compared with controls," said Patrick Catalano, professor of reproductive endocrinology at Harvard Medical School who led data collection.

Researchers measured each baby's weight, length, and body fat at birth and multiple times during the first year of life. Using modern statistical tools, the research team analyzed each infant's growth pattern and discovered three distinct growth paths.

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"Surprisingly, GDM-exposed infants were more likely to experience slower body fat gain, but equivalent gain of lean body mass compared with infants of women without GDM, a trend called catch-down growth, which is typically seen in heavier babies who later align with typical growth patterns," according to Widen.

The analysis found that GDM-exposed newborns had significantly slower growth of fat mass and body fat percentage, as well as being in the group with the slowest BMI increase or even lowering BMI.

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"Previous studies have not really looked at this critical first year of life with the kind of sensitive body fat measures that we were able to use," said Rachel Rickman, the study's lead author and a former Widen Ph.D. student. "The data here is really quite striking, and it raises a lot of questions."

References:

Infant body composition trajectories differ by in utero exposure to gestational diabetes mellitus: a prospective cohort from birth to 12 months (Rachel R Rickman, Elizabeth M Widen, Charlotte E Lane, Marcela R Abrego, Amy R Nichols, Saralyn F Foster, Patrick Catalano, Infant body composition trajectories differ by in utero exposure to gestational diabetes mellitus: a prospective cohort from birth to 12 months, The American Journal of Clinical Nutrition, 2024, , ISSN 0002-9165, https://doi.org/10.1016/j.ajcnut.2024.10.020. (https://www.sciencedirect.com/science/article/pii/S000291652400861X))

Source-Medindia