Maternal glycemia during pregnancy and child lung function: A prospective cohort study

OBJECTIVE: Gestational diabetes mellitus (GDM) is known to be associated with certain respiratory impairments in offspring. However, the specific association between maternal GDM and childhood lung function remains unclear. We aimed to examine the association of maternal glycemia, as measured by oral glucose tolerance test (OGTT) values, with childhood lung function outcomes in a birth cohort.

RESEARCH DESIGN AND METHODS: A follow-up study was conducted on 889 children ages 6 years, whose mothers underwent a 75-g OGTT between 24 and 28 weeks of gestation. After adjusting for prenatal and postnatal factors, multivariable regression models were used to evaluate the relationship between maternal glycemia and offspring lung function.

RESULTS: In total, 10.7% of the offspring were exposed to maternal GDM. Maternal GDM significantly reduces z-score of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and forced expiratory flow at 25-75% of FVC (FEF25-75%) in children, with more pronounced effects in female offspring. Maternal 1-hour, 2-hour post-OGTT glucose and the sum of glucose z-scores, but not fasting glucose, were inversely associated with several measures of children's lung function. Additionally, maternal GDM increased the risk of impaired lung function in children (OR, 2.64; 95%CI, 1.10 to 5.85), defined as an FVC less than 85% of the predicted value. There were no significant associations with FEV1/FVC.

CONCLUSIONS: Maternal hyperglycemia was negatively associated with lung function in children, particularly among girls. Further studies are warranted to elucidate the underlying mechanisms of this association and to explore potential interventions to mitigate its effects.