Healthy Lifestyles Can Offset Respiratory/Psych-behavioral Comorbidities Due to Gestational Diabetes Mellitus or Prenatal Smoking Exposure in Children Aged 2-16 Years

Aim The aim of this study was to test whether healthy lifestyles can offset the increased risk of childhood respiratory and psycho-behavioral comorbidities attributed to gestational diabetes mellitus (GDM) or prenatal smoking exposure. Methods From April to May 2024, we conducted a cross-sectional cluster sampling of children aged 2–16 years in Beijing. Fetal and neonatal related factors, family-related factors, and lifestyle-related information were collected through an electronic questionnaire. A weighted healthy lifestyle score was calculated by aggregating diet, physical activity, sleep time, and screen time; it was categorized into healthy, intermediate and unhealthy lifestyles. Logistic regression was used to estimate odds ratio (OR) and 95% confidence interval (95% CI) for the association of GDM or smoking during pregnancy with respiratory and psych-behavioral comorbidities. Interaction terms were used to explore the offsetting effect of lifestyle factors. Results The prevalence of respiratory and psych-behavioral comorbidities among Chinese children aged 2–16 years was 15.18%. GDM and smoking during pregnancy were associated with an increased risk of childhood comorbidities (multi-adjusted OR, 95% CI: 1.40, 1.07–1.82 and 1.71, 1.22–2.40). Children with unhealthy lifestyles faced a significantly higher risk of developing comorbidities compared to their peers with healthy lifestyles (1.91; 1.48–2.45). Adhering to healthy lifestyles can offset the increased risk of childhood comorbidities due to GDM (1.42, 0.81–2.48) or smoking during pregnancy (1.29, 0.50–3.31). Conclusions Our findings indicated that adherence to healthy lifestyles might offset the increased risk of childhood respiratory and psycho-behavioral comorbidities that were attributed to prenatal GDM or smoking during pregnancy.