Gestational diabetes mellitus (GDM) is associated with childhood obesity and there is concern that glyburide is associated with macrosomia and perhaps childhood overgrowth.

We sought to examine if GDM treatment type is associated with differences in early childhood growth using a retrospective cohort of 952 women with GDM and their offspring. We collected pregnancy and breastfeeding data as well as height and weight through age 3. We used bivariate and multivariable regression analyses to compare early childhood growth among maternal GDM treatment.

Treatment was divided into medical nutritional therapy (MNT), glyburide, and insulin. LGA at birth was more common in offspring exposed to insulin and glyburide compared to those treated with MNT (11.7 vs. 9.2 vs. 5.7%, p=0.03). Weight or BMI at 6 months, 1, 2 and 3 years of age did not differ among children born to women with different GDM treatments. GDM treatment type was not predictive of weight or associated with a higher risk for BMI >85th percentile at age 2 or 3 years after adjusting for covariates including gender, age at recorded weight, birth weight category, pre-pregnancy BMI, gestational weight gain, and breastfeeding.

Our findings suggest that maternal pre-pregnancy BMI but not GDM treatment is associated with variations in early childhood growth. Further studies are needed to determine if these findings persist beyond 3 years of age and to explore differences in body composition.

 Factors associated with offspring weight at 2 years Factors associated with offspring weight at 3 years 
 Beta Coefficient (95% CI) P Beta Coefficient (95% CI) P 
MNT (n=344) Glyburide (n=490) Insulin (n=117) Ref -0.16 (-0.48-0.15) -0.27 (-0.74-0.21) n/a 0.30 0.27 Ref -0.13 (-0.53-0.26) 0.35 (-0.22-0.93) n/a 0.50 0.23 
Female gender -0.48 (-0.75- -0.20) 0.001 -0.59 (-0.94- -0.25) 0.001 
Prepregnancy BMI 0.16 (0.06-0.27) 0.003 0.17 (0.02-0.31) 0.026 
Pregnancy weight gain (lbs) 0.0(-0.003-0.02) 0.15 0.036 (0.011-0.061) 0.004 
Any breastfeeding -0.30 (-0.06- -0.02) 0.04 -0.41 (-0.77- -0.04) 0.03 
Birth weight category AGA SGA LGA Ref -1.16 (-1.6- -0.7) 0.88 (0.32-1.44) n/a <0.001 0.002 Ref -1.40 (-1.99- -0.82) 1.53 (0.91-2.15) n/a <0.0 01 <0.001 
 Factors associated with offspring weight at 2 years Factors associated with offspring weight at 3 years 
 Beta Coefficient (95% CI) P Beta Coefficient (95% CI) P 
MNT (n=344) Glyburide (n=490) Insulin (n=117) Ref -0.16 (-0.48-0.15) -0.27 (-0.74-0.21) n/a 0.30 0.27 Ref -0.13 (-0.53-0.26) 0.35 (-0.22-0.93) n/a 0.50 0.23 
Female gender -0.48 (-0.75- -0.20) 0.001 -0.59 (-0.94- -0.25) 0.001 
Prepregnancy BMI 0.16 (0.06-0.27) 0.003 0.17 (0.02-0.31) 0.026 
Pregnancy weight gain (lbs) 0.0(-0.003-0.02) 0.15 0.036 (0.011-0.061) 0.004 
Any breastfeeding -0.30 (-0.06- -0.02) 0.04 -0.41 (-0.77- -0.04) 0.03 
Birth weight category AGA SGA LGA Ref -1.16 (-1.6- -0.7) 0.88 (0.32-1.44) n/a <0.001 0.002 Ref -1.40 (-1.99- -0.82) 1.53 (0.91-2.15) n/a <0.0 01 <0.001 
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Disclosure

M.N. Feghali: None. J. Atlass: None. S. Caritis: None. J.M. Catov: None. C.M. Scifres: None.

© 2018 by the American Diabetes Association.
2018
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