Influence of gestational diabetes on circadian rhythms of children and their association with fetal adiposity

Objective To analyse the circadian rhythm maturation of temperature, activity and sleep during the first year of life in offspring of diabetic mothers (ODM) and its relationship with obesity markers. Methods A prospective analysis of the children of 63 pregnant women (23 controls, 21 gestational diabetes mellitus (GDM) controlled with diet and 19 GDM with insulin). Fetal abdominal circumference was evaluated ecographically during gestation. Skin temperature and rest-activity rhythms were monitored for 3 consecutive days in children at 15days and 1, 3 and 6months. Anthropometrical parameters of the children were evaluated during the first year of life. Results Children from the GDM groups tended to higher fetal abdominal circumference z-score than controls at the beginning of the last trimester (p=0.077) and at delivery (p=0.078). Mean skin temperature or activity was not different among the groups. The I<O sleep index pointed to increasing concordance with parental sleeping at 3 and 6months but no significant GDM-dependent differences. However, some of the parameters that define temperature maturation and also the circadian function index from the temperature-activity variable were significantly lower at 6months in the GDM+insulin group. Fetal abdominal circumference z-score, as a predictor of fetal adiposity, correlated negatively with parameters related to circadian rhythm maturation as the circadian/ultradian rhythm (P-1/P-ult ratio). Conclusions Fetal adiposity correlated with a worse circadian rhythm regulation in ODM. In addition, ODM insulin-treated showed a disturbed pattern of the circadian function index of temperature activity at 6months of age. Copyright (c) 2013 John Wiley & Sons, Ltd.