A groundbreaking study led by researchers from The University of Texas at Austin and Harvard Medical School has revealed unexpected findings regarding the growth patterns of infants exposed to gestational diabetes mellitus (GDM). Published today in the American Journal of Clinical Nutrition, the research challenges prevailing assumptions about obesity risk in these infants, showing that they experience slower fat gain during their first year of life compared to their peers.
The study suggests that early growth in babies exposed to GDM may be more adaptable than previously believed, indicating that these infants are not necessarily destined for obesity. Instead, they may require additional monitoring to ensure healthy growth.
Elizabeth Widen, the study’s corresponding author and an assistant professor of nutritional sciences at UT Austin, stated, “We often think that babies exposed to gestational diabetes will automatically be at higher risk for childhood obesity, but our findings show a more complex picture. While these infants are born with more body fat, many seem to naturally balance out over time.”
GDM affects approximately 8.3% of pregnancies in the United States, a figure that has risen significantly in recent years. Mothers with GDM face heightened risks of pregnancy complications and a greater likelihood of developing Type 2 diabetes later in life. Infants exposed to GDM typically have higher birth weights and body fat percentages, leading previous research to suggest an increased risk of obesity and Type 2 diabetes in later life.
The study followed 198 infants, half of whom were exposed to GDM in utero. Data was collected between 1996 and 2006, primarily before the advent of pharmacological treatments like metformin or insulin for managing blood sugar levels during pregnancy.
Patrick Catalano, a professor of reproductive endocrinology at Harvard Medical School and the lead data collector, noted, “These data are consistent with findings from the Maternal Fetal Medicine Units Network, which showed no reduction in childhood obesity or metabolic dysregulation between ages 5 to 10 in children of mothers treated for mild GDM compared to controls.”
Researchers assessed each infant’s weight, length, and body fat at birth and at several intervals during their first year. Using advanced statistical methods, the team identified three distinct growth trajectories among the infants.
“Surprisingly, GDM-exposed infants were more likely to experience slower body fat gain while showing equivalent increases in lean body mass,” Widen explained. This phenomenon, known as catch-down growth, typically occurs in heavier infants who later align with standard growth patterns.
The analysis revealed that infants exposed to GDM were significantly more likely to experience slow growth in both fat mass and body fat percentage, as well as to fall within the group with the slowest growth in body mass index (BMI) or even a decrease in BMI.
“Previous studies have not closely examined this critical first year of life with the sensitive body fat measurements we used,” said Rachel Rickman, the study’s lead author and a former doctoral student of Widen. “The data here is striking and raises many questions.”
The research team also included Marcela R. Abrego and Saralyn F. Foster from UT Austin, Amy R. Nichols from the University of California, Davis, and Charlotte E. Lane from Food Security Evidence Brokerage. The study was funded by the National Institute of Child Health and Human Development and the General Clinical Research Center.
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