O-50: Early-life events and cardiometabolic risk in offspring of women with gestational diabetes: a longitudinal study with 2- to 14-year postpartum follow-up
M C Jordão, P Medici Dualib, F D Souza, M F Montero, M C O Abate, L Luna, R Mattar, B Almeida-PitittoAbstract
Introduction
Gestational diabetes mellitus (GDM) affects 6%–15% of pregnancies and is associated with increased long-term risk of obesity, dyslipidemia, hypertension, and type 2 diabetes in the offspring. Early-life exposures during the pregnancy–puerperal period may further influence this risk.
Objectives
To investigate whether cumulative exposure to early-life events is associated with an unfavorable cardiometabolic profile in offspring aged 2–14 years.
Methods
This longitudinal study included 182 offspring of mothers with GDM followed at a tertiary diabetes center. Children underwent interview, physical examination, and laboratory assessment. Outcomes included dysglycemia, hypertriglyceridemia, low HDL-cholesterol, elevated blood pressure, overweight/obesity, and increased waist circumference. Exposure was defined as the presence of ≥3 early-life events: prepregnancy obesity, hypertensive disorders of pregnancy, insulin use during pregnancy, cesarean delivery, and shorter exclusive breastfeeding duration. Analyses were stratified into preschool-aged (2–4 years) and school-aged (5–14 years) groups.
Results
Prevalences were as follows: overweight/obesity, 80.5%; dysglycemia, 10.0%; elevated blood pressure, 13.7%; hypertriglyceridemia, 26.4%; low HDL-cholesterol, 39.1%; increased waist circumference, 26.4%; and metabolic syndrome components, 13.7%. In preschool-aged children, exposure to ≥3 events was associated with higher mean systolic blood pressure [91.5 (10.2) vs 85.4 (10.2) mmHg; p=0.023]. In school-aged children, it was associated with higher HbA1c [5.4 (0.3) vs 5.1 (0.4)%; p=0.001] and higher prevalence of elevated HbA1c (21.7% vs 4.4%; p=0.011).
Conclusions
In offspring of women with GDM, cumulative exposure to early-life events was associated with worse glycemic and blood pressure outcomes, supporting early risk stratification and targeted preventive strategies in this vulnerable population.