The overarching goal of this study is to establish a large offspring cohort to investigate the long-term intergenerational impacts of gestational diabetes (GDM) and maternal obesity on the metabolic, vascular, and reproductive health of the offspring. The proposed data collection will also create opportunities to evaluate many other health outcomes, such as neurodevelopment, lung function, kidney function, immune function, and bone development.
Accumulating evidence from animal and human studies suggests that adverse intrauterine exposures may lead to permanent fetal adaptations in anatomy and physiology, which may be beneficial for short term fetal survival, but may result in an altered long-term risk of disease later in life. Maternal obesity and pregnancy complications such as GDM are exposures of interest given that a very high proportion of U.S. women (~45%) are overweight or obese when becoming pregnant. Moreover, GDM is a common pregnancy complication, impacting 7-10% pregnancies. These in utero exposures create a vicious cycle for the offspring as they are at greater risk of developing cardiometabolic dysfunction and subsequent diabetes themselves, leading to similar problems for their own offspring, and hence perpetuating the cycle of adverse outcomes for subsequent generations.
Study Design & Progress
In the present study, we will apply a hybrid design which combines maternal and offspring data that have been prospectively and longitudinally collected with newly collected data. This study will leverage ongoing mother-offspring cohorts, the Nurses' Health Study II (NHS-II; mothers) and the Growing Up Today Study (GUTS; offspring) in the United States and the mother-offspring pairs in the Danish National Birth Cohort (DNBC) in Denmark. Both studies have collected data covering the lifespan, from pre-pregnancy through young adulthood, and will be augmented with new collection of data and biological specimens. The current study aims to collect data at a single time point on 4,700 offspring, their parents, and 200 of their siblings. Offspring will be oversampled on the exposures of GDM and overweight/obesity in utero. Data collection is expected to begin in Fall 2017.