Maternal gestational diabetes mellitus is associated with advanced bone
age at peripubertal stage in female offspring: Taiwan birth panel study
II
Abstract
Objective: This study aims to determine the impact of maternal
gestational diabetes mellitus (GDM) on peripubertal growth of offspring.
Design: Population-based prospective cohort study.
Setting: University Hospital. Population: 478
mother-offspring pairs from cohort Taiwan Birth Panel Study II (TBPS
II). Methods: Maternal GDM status was tested at gestational
weeks 24-28 using two-step or one-step oral glucose tolerance test.
Offspring received follow-up questionnaire, physical examination, and
bone age study at the age of 6 to 8. Associations between maternal GDM
and offspring outcomes were analyzed using multiple linear or logistic
regression models to adjust for maternal pre-gravid BMI, household
income, maternal age at delivery, and maternal menarche age.
Main Outcome Measures: Offspring bone age, serum sex hormone
levels, Tanner stage for breast and testes, and penile length.
Results: There were 43 (9.0%) children born from mothers with
GDM, and 435 (91.0%) in the control group. In girls, there was a more
advanced bone age in the GDM group (n=19) than the control group (n=203)
after adjusting for potential confounding factors (0.48-year, 95%
CI=0.002-0.97-year). For boys, the GDM group (n=24) showed no
advancement in the bone age compared with the control group (n=232)
(-0.13-year, 95% CI= -0.66-0.40). The serum sex hormone levels and
secondary sexual characteristics of children in the GDM group were
comparable to those in the control group. Conclusions: Girls
born from GDM mothers had more advanced bone age at peripubertal stage
than the control group. This phenomenon was not observed in boys, nor
were other secondary sexual characteristics and serum sex hormone
levels.