Children of mothers with gestational diabetes had a greater risk for obstructive sleep apnea vs. children of healthy mothers, whereas risks for respiratory-related hospitalizations were similar between the two groups, according to researchers.
Omri Zamstein, an intern in medicine at the Goldman School of Medicine at Ben-Gurion University of the Negev in Beer-Sheva, Israel, and colleagues evaluated data from 216,197 women with singleton pregnancies who delivered between 1991 and 2014 at Soroka University Medical Center to determine the implications of gestational diabetes on long-term respiratory-related hospitalizations in the offspring. Overall, 9,460 participants had gestational diabetes treated with lifestyle modifications alone, 724 had gestational diabetes treated with pharmacologic therapy and 206,013 were the comparison group without gestational diabetes. Median follow-up was 10 years for offspring of participants without gestational diabetes, 12 years for offspring of participants with gestational diabetes treated with lifestyle medication, and 17 years for offspring of participants with gestational diabetes treated with medications.
No significant differences were observed among the groups for hospitalizations for asthma, pneumonitis, emphysema and structural disease, pleural disease or other respiratory morbidities. However, obstructive sleep apnea was more common among offspring of participants with gestational diabetes treated with drugs compared with offspring of participants without gestational diabetes (adjusted HR = 1.88; 95% CI, 1.07-3.23). In the final regression models, all offspring of participants with gestational diabetes were evaluated together because no difference was observed between the two groups for obstructive sleep apnea rates.
Overall, among all participants, there were 10,557 events for any respiratory hospitalization and 1,507 events for obstructive sleep apnea only. Incidence of hospitalizations due to obstructive sleep apnea was higher among offspring of participants with gestational diabetes compared with offspring of participants without gestational diabetes (P = .033).
A significant and independent association was found between childhood obstructive sleep apnea in offspring and gestational diabetes (aHR = 1.26; 95% CI, 1.02-1.55).
“Maternal gestational diabetes may contribute to the development of obstructive sleep apnea in the offspring years thereafter, but is apparently not associated with other forms of respiratory morbidity,” Zamstein told Endocrine Today. “As prevalence of gestational diabetes continues to increase worldwide, effective measures of prevention and treatment may be beneficial for the long-term respiratory health of the offspring. To assess the whole range of implications of gestational diabetes on long-term offspring health, on the basis of which appropriate screening and intervention methods [should] be established.” – by Amber Cox
Omri Zamstein, can be reached at firstname.lastname@example.org.
Disclosures: The authors report no relevant financial disclosures.