Gestational weight trajectory and early offspring growth differed by gestational diabetes: a population-based cohort study

AimsTo investigate the association of gestational weight gain (GWG) trajectory with early children growth, and explore whether this association varies by gestational diabetes mellitus (GDM) status.MethodsMaternal weight and offspring anthropometric outcomes before 36 months were extracted from Electronic Medical Record of Zhoushan, China. GWG trajectory was modeled using latent-class trajectory analysis. Multiple generalized estimating equations models were applied to analyze associations of GWG trajectory categories with early children growth.ResultsThree GWG trajectory classes were identified in all participants (n = 13 424), the non-GDM (n = 10 984) and GDM (n = 2440) groups, respectively. In all participants, the Slow-Rapid pattern was significantly associated with lower length z-scores of offspring (beta = -0.084; se = 0.015), compared to the Moderate pattern, while the Rapid-Slow pattern was significantly associated with higher length z-scores (beta = 0.083; se = 0.022), with no significant effects on other anthropometric outcomes. Similar results were also observed in the non-GDM group. However, in the GDM group, offspring of mothers with the Rapid-Slow pattern showed significantly higher weight z-scores (beta = 0.093; se = 0.046), BMI z-scores (beta = 0.113; se = 0.052), and risk of overweight/obesity (OR = 1.40, 95%CI: 1.11, 1.76).ConclusionGWG trajectory significantly impacted offspring growth before 36 months, with different effects observed based on GDM status. GWG trajectory primarily affected offspring length in the non-GDM group, whereas earlier high weight gain appeared to increase offspring weight, BMI, and risk of overweight/obesity in the GDM group.