Prenatal exposure to hyperglycemia and child growth trajectories in the first three years of life: a prospective birth cohort

Background Infants exposed to hyperglycemia in pregnancy (HIP) in utero are known to have higher risks of macrosomia at birth and obesity in adulthood, but little is known about how their growth patterns change over the first 3 years of life. Methods In the prospective Jiangsu Birth Cohort (JBC) Study, 8780 children (23.3% HIP exposed) were included. Linear mixed models were used to evaluate the association between HIP and repeated offspring growth measures. Latent class mixed modeling (LCMM) trajectories were fit for weight-for-age (WAZ), length/height-for-age (LAZ) and weight-for-length z-scores (WFL). Adjusted associations between HIP with trajectory classes were evaluated with modified Poisson regression. Results At birth, children exposed to HIP had a higher risk of LGA. HIP exposure was associated with lower weight-for-age (WAZ, -0.075, 95% CI: -0.117, -0.034), length/height-for-age (LAZ, -0.054, 95% CI: -0.099, -0.009), and weight-for-length z-score (WFL, -0.061, 95% CI: -0.100, -0.022). HIP also correlated with reduced weight and BMI growth velocity at 0–3 and 6–8 months. Three distinct trajectory groups were identified and were labeled as moderate-stable, high-decreasing, and low-increasing group. In adjusted models, children with HIP exposure were more likely to follow the high-decreasing WFL trajectory (aRR = 1.14, 95% CI: 1.01, 1.29). Conclusions HIP exposure is associated with slower growth in early childhood and an increased likelihood of “high-decreasing (HD)” WFL trajectory. Identifying an HD trajectory may be valuable for early risk stratification.