OBJECTIVE
Infants born to mothers with gestational diabetes mellitus (GDM) are at greater
risk of later adverse metabolic health. We examined plausible candidate mediators;
adipose tissue (AT) quantity and distribution, and intrahepatocellular lipid
(IHCL) content, comparing infants of mothers with GDM and without GDM (control
group) over the first 3 postnatal months.
RESEARCH DESIGN AND METHODS
We conducted a prospective longitudinal study using MRI and spectroscopy to
quantify whole-body and regional AT volumes, and IHCL content, within 2 weeks
and 8–12 weeks after birth. We adjusted for infant size and sex, and maternal
prepregnancy BMI. Values are reported as the mean difference (95% CI).
RESULTS
We recruited 86 infants (GDM group 42 infants; control group 44 infants). Mothers
with GDM had good pregnancy glycemic control. Infants were predominantly
breast fed up to the time of the second assessment (GDM group 71%; control
group 74%). Total AT volumes were similar in the GDM group compared with the
control group at a median age of 11 days (228 cm3 [95% CI 2121, 65], P = 0.55), but
were greater in the GDM group at a median age of 10 weeks (247 cm3 [56, 439], P =
0.01). After adjustment for size, the GDM group had significantly greater total AT
volume at 10 weeks than control group infants (16.0% [6.0, 27.1], P = 0.002). AT
distribution and IHCL content were not significantly different at either time point.
CONCLUSIONS
Adiposity in GDM infants is amplified in early infancy, despite good maternal
glycemic control and predominant breast-feeding, suggesting a potential causal
pathway to later adverse metabolic health. Reduction in postnatal adiposity may
be a therapeutic target to reduce later health risks.