Effects of diabetes mellitus during pregnancy on pregnancy outcome and development of 0-6-Year-Old offspring

Background: Diabetes mellitus during pregnancy, including pre-pregnancy diabetes and gestational diabetes, has adverse impact on pregnancy outcomes and offspring.

Methods: A retrospective cohort study was conducted in Beijing, China. All pregnant women who underwent routine prenatal care and delivered successfully at the Daxing District of Beijing, along with their offspring who had completed the national standard health check-up for children aged 0 to 6, were included in the study cohort. Pregnant women with pregestational diabetes and those with gestational diabetes were categorized into the diabetes during pregnancy group. R 4.2.2 software was used for statistical analysis. Differences were considered statistically significant at a P-value less than 0.05.

Results: A total of 49,912 deliveries occurred in the three years, including 49,765 live births, with an incidence of diabetes mellitus during pregnancy at 8.6%. There were statistically significant differences in delivery mode, perineal conditions, preterm birth, postpartum hemorrhage, placenta previa, very low birth weight infants, macrosomia, neonatal infection, neonatal asphyxia, neonatal pathological jaundice, and neonatal hypoglycemia between the diabetes during pregnancy and the non-diabetes during pregnancy group. Multivariate logistic regression analysis showed significant differences in cesarean section?OR=1.170?95%CI 1.096~1.249?, neonatal infection?OR=1.479?95%CI 1.213~1.804?, neonatal asphyxia?OR=1.683?95%CI 1.161~2.438?, neonatal pathological jaundice?OR=6.720?95%CI 5.461~8.270?, and neonatal hypoglycemia?OR=7.160?95%CI 5.684~9.021?(P<0.05). Maternal age, gravidity, parity, pregnancy with chronic hypertension, gestational hypertension, pregnancy with heart disease, hypothyroidism, anemia and mental disorders were the influential factors of diabetes during pregnancy (P<0.05).

This study statistically analyzed 18,590 pairs of mothers and children who had completed the health check-up for children aged 0 to 6. Newborns in the diabetes during pregnancy group had significantly higher body length and weight at birth than those in the non-diabetes during pregnancy group (P<0.001), but between 3 and 72 months of age, the body length and weight distribution of children in both groups tended to be consistent, and the differences gradually disappeared.

Diabetes mellitus during pregnancy significantly affected the hearing of the offspring (P<0.05), but there was no significant difference for anemia in children. The results of the mixed-effects model analysis showed that after controlling for confounding factors such as age, gender, neonatal baseline indicators, parity, mode of delivery, and gestational age at delivery, diabetes during pregnancy had a negative impact on the body length of children aged 3 to 36 months (P<0.05), but the impact on weight and head circumference was not significant.

Conclusions: 1.The incidence of diabetes mellitus during pregnancy is high. It affects pregnancy outcomes and significantly increases the risk of adverse maternal and infant outcomes.

2.In the growth and development of offspring, diabetes during pregnancy is a significant influencing factor for birth length and weight, but such difference gradually disappears during subsequent child development, suggesting a certain convergence phenomenon in early growth curves.

3.Diabetes mellitus during pregnancy affects maternal and infant outcomes. It is necessary to strengthen the screening and management of high-risk pregnant women.

TIANZI LI is a PhD candidate in general medicine at Capital Medical University , who is specializing in general practice, family medicine and maternal and child health care. Dr.Li has a wealth of clinical and scientific research experience, has published a number of Chinese and English articles, and participated in the publication of 3 books. She has had many academic exchanges in China, South Korea, Australia and other countries, and is fluent in English and solid in medical professional knowledge.