Maternal gestational diabetes mellitus and risk of long term pediatric infectious diseases of the offspring

Tamar Eshkoli, Tamar Wainstock, Eyal Sheiner

Research output: Contribution to journalMeeting Abstract

Abstract

Objective
To assess the implications of gestational diabetes mellitus (GDM) on long-term gastro-intestinal morbidity related hospitalizations of the offspring.

Study Design
A population-based cohort analysis including singleton pregnancies delivered between the years 1991 to 2014 in a tertiary referral hospital was conducted. Incidence of hospitalizations (up to age 18 years) due to various gastro-intestinal diseases was compared between offspring of GDM-complicated pregnancies and normoglycemic pregnancies. Gastro-intestinal related morbidities included hospitalizations involving a pre-defined set of ICD-9 codes. Mothers with pregestational diabetes, insufficient prenatal care, infants with congenital malformations, multiple gestations, and perinatal deaths were excluded from the analysis. Kaplan-Meyer curves were used to assess cumulative hospitalization incidence. Cox proportional hazards model was used to control for baseline selected confounders.

Results
The study population included 218,989 newborns which met the inclusion criteria; among them 4.4% (9,534) were born to mothers with GDMA1 and 0.3% were born to mothers with GDMA2. During the follow-up period, there was not significant high rate of gastro-intestinal morbidity among children exposed in utero to GDM (5.7% of those without exposure to GDM vs. 5.4% of those who were exposed to GDM, p=0.219). Some specific gastro-intestinal morbidities such as gastro-duodenal and appendix morbidities were higher among those exposed to GMD in utero (p=0.004). While adjusting for confounders the association remained non significant with an adjusted hazards ratio of 0.87 (95% CI 0.90-1.07, p=0.771). Using a Kaplan-Meier survival curve, children exposed to GDM did not have a significantly higher cumulative incidence of long term gastro-intestinal morbidity (Log Rank=0.182).

Conclusion
There is no significant association between GDM and the rate of overall gastro-intestinal hospitalizations of the offspring, but among the study population offspring born to mothers with GDM have significant higher rate of specific gastro-intestinal morbidities.
Original languageEnglish GB
Pages (from-to)S252-S252
JournalAmerican Journal of Obstetrics and Gynecology
Volume222
Issue number1
DOIs
StatePublished - Jan 2020

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