Aims/hypothesis Offspring of mothers with diabetes (ODM) are at greater risk of adverse metabolic outcome in later life. Increased adiposity is a plausible mediator. We performed a systematic review and meta-analysis of studies examining adiposity in children in relation to maternal diabetes.
Methods Citations were identified in Pubmed. Authors were contacted for additional data. Fat-free mass, fat mass, body fat percentage, triceps and subscapular skinfold thickness were compared in children of mothers with and without diabetes. Subgroup analysis of type of maternal diabetes was performed. A random effects analysis was used.
Results Ten studies examining body composition and eight examining skinfold thickness were included in the meta-analysis. The mean (SD) age of children was 8.1 (3.7) years. ODM had higher fat mass (1.69 kg [0.96, 2.43]; p < 0.00001), fat-free mass (0.58 kg [0.10, 1.06]; p = 0.02), body fat percentage (2.3% [1.0, 3.7]; p = 0.0008), triceps (1.2 mm [0.3, 2.2]; p = 0.01) and subscapular skinfold thickness (1.6 mm [0.6, 2.6]; p = 0.001), than children of non-diabetic mothers. Offspring of mothers with gestational diabetes had higher fat mass, body fat percentage, triceps and subscapular skinfold thickness, but similar fat free mass. Separate data for type 1 diabetes and type 2 diabetes were only available in 3 studies for body fat percentage, which was higher in ODM.
Conclusion ODM have greater adiposity than children born to non-diabetic mothers. Persistence or amplification of adiposity in adult life may explain the increased risk of type 2 diabetes and cardiovascular disease in ODM. Differences related to type of maternal diabetes require further investigation.