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|Nachuntersuchung von Kindern aus Schwangerschaften mit Gestationsdiabetes|
|Main title||Nachuntersuchung von Kindern aus Schwangerschaften mit Gestationsdiabetes|
|Subtitle||Untersuchung des Zusammenhangs der anthropometrischen Entwicklung von 3- 8 jährigen Kindern mit der Höhe des Blutdrucks und der Art der frühkindlichen Ernährung|
|Title variations||Association of breastfeeding, blood pressure level and early childhood overweight in children from mothers with Gestational diabetes mellitus|
Place of birth: Berlin
|1. Referee||Priv.-Doz. Dr. med. U. Schäfer-Graf|
|Further Referee(s)||Prof. Dr. med. F. Kainer
Prof. Dr. med. H. Przyrembel
|Classification (DDC)||610 Medical sciences; Medicine|
|Summary||This study investigates the growth of children from pregnancies with gestational diabetes mellitus (GDM) in a population of Caucasian women. The study aims to evaluate the association of breastfeeding during infancy and the prevalence of overweight in early life. We show that breastfeeding longer than 3 month appears to be negatively associated with overweight in early childhood. Moreover investigates this survey the association between the prevalence of overweight and the blood pressure level of the offspring of gestational diabetic mothers. Further we show that obese offspring of mothers with GDM develop symptoms of the metabolic syndrome, as high blood pressure levels.
The study was recruited from 324 children of mothers who had GDM and attended the Diabetes Prenatal Care Clinic of the Department of Obstetrics at the Vivantes Medical Centre Berlin from 1995 through 2000. The infants were selected from an ongoing database where clinical, glycemic, fetal ultrasound, and delivery data of all woman attending the clinic were prospectively entered. Antenatal maternal BMI, birth weight and length were obtained from the database. Anthropometric data in childhood were prospectively obtained. The actual weight and height as well as blood pressure of the children were taken. The actual weight and height of mother and father were obtained, and the BMI was calculated. Furthermore, prior anthropometric data were retrospectively obtained from routine examinations, which are offered to all children within the German health care system. The examinations were performed by outside paediatricians and documented in a special booklet given do parents at delivery. In addition mothers were retrospectively queried about details pertaining to their breastfeeding.
Birth weight and BMI were transformed into percentiles according to gestational age at delivery. The standard deviation score (SDS) of BMI at follow- up examination
was calculated by using a age correspondent data of a normal German population. Overweight in childhood was defined as BMI ≥ 90th percentile, parental overweight was defined as BMI ≥ 25 kg/m². Blood pressure value was calculated into age, height and gender specific percentiles.
In our study the prevalence of childhood overweight decreased with increased duration of nursing. The highest prevalence was observed in children who were never breastfed. Exclusive breastfeeding revealed to be an independent preventive indicator of childhood overweight. Furthermore, our data indicate that the risk of childhood overweight in children of gestational diabetic mothers may be reduced when breastfeeding is > 3 month. We found that maternal obesity was associated with a shorter duration of nursing. In obese women the proportion of mothers who never breastfed, was twofold higher than that of non obese women. Importantly, the protective effect of breast feeding was more pronounced in children of mothers with
According to previous studies we found, that gestational diabetes mellitus has an increased risk for negative long- term effects in offspring. Overweight and obesity in childhood is high risk factors to develop a metabolic syndrome in later life. In our study we found significant higher systolic blood pressure levels in overweight children. Our findings have shown that childhood obesity predicts the development of the metabolic syndrome in children of gestational diabetic mothers.
In conclusion, women whose pregnancies were complicated by GDM particularly those who are obese, should be encouraged to nurse for at least 3 months to reduce the risk of overweight and obesity in their children. Furthermore should families with offspring of GDM mothers promote healthy lifestyle combined with a close follow- up
of the somatic development of the children to reduce the risk of obesity. For long-term prevention of obesity and metabolic syndrome, GDM management should not stop after delivery.
Dataobject from FUDISS_thesis_000000005586
|Number of pages||72|
|FU Department||Department of Medicine - Charité - University Medicine Berlin|
|Year of publication||2008|
|Document type||Doctoral thesis|
|Date of defense||2008-10-20|
|Created at||2008-10-13 : 08:49:11|
|Last changed||2010-02-19 : 02:12:46|