{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T18:54:22Z","timestamp":1783104862016,"version":"3.54.6"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK109956"],"award-info":[{"award-number":["R01DK109956"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Limited data are available to describe the long\u2010term implications of pre\u2010pregnancy diabetes on offspring body composition in adulthood. The objective of this study was to examine the association between maternal glucose control and variation throughout pregnancy and long\u2010term obesity in offspring. A second objective was to identify the critical windows of gestational exposure most related to the development of long\u2010term obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Research Design and Methods<\/jats:title><jats:p>This cohort study included offspring of women with insulin\u2010dependent diabetes (IDDM) who participated in the Diabetes in Pregnancy Program Project Grant (PPG) between 1978 and 1995 to evaluate the long\u2010term implications of in utero glucose exposure. Offspring completed a comprehensive study visit which included measures of height and weight, and measures from dual\u2010energy X\u2010ray absorptiometry. The exposure was maternal glucose control as measured by glycohemoglobin A<jats:sub>1<\/jats:sub> concentration (where HbA<jats:sub>1<\/jats:sub> was represented as standard deviation units from the mean for the laboratory HBA<jats:sub>1<\/jats:sub>SD), and blood glucose level and variation across pregnancy, and by trimester, characterized using functional principal components (fPC). Outcomes were adult offspring BMI (kg\/m<jats:sup>2<\/jats:sup>), as well as visceral and whole\u2010body fat.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 161 offspring completed a study visit. Mean offspring age at follow\u2010up was 32.3 years\u00a0(\u00b1\u00a04.6), 50.3% were female and 17.4% identified as Black. After adjustment for covariates (maternal age, education, family history of diabetes, diabetes severity, and BMI at last menstrual period), third\u2010trimester maternal HbA<jats:sub>1<\/jats:sub>SD was significantly associated with offspring adiposity measures including BMI, BMI \u2265 30\u00a0kg\/m<jats:sup>2<\/jats:sup>, and visceral and whole\u2010body fat mass and percentage. The third\u2010trimester fPC representing variability of glucose demonstrated a consistent positive association with obesity outcomes but did not reach statistical significance in adjusted models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings corroborate that the third trimester is a critical window of exposure associated with offspring adiposity. Specifically, higher levels of third\u2010trimester maternal glycohemoglobin A<jats:sub>1<\/jats:sub> is a risk factor for obesity in the adult offspring of IDDM mothers. Additionally, results suggest that glucose variability may increase the risk for obesity in the adult offspring.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmf2.70048","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T06:24:08Z","timestamp":1750227848000},"source":"Crossref","is-referenced-by-count":3,"title":["Timing and Variability of Maternal Hyperglycemia in Insulin\u2010Dependent Diabetes, Long\u2010Term Effects on Offspring Obesity\u2014The TEAM Study"],"prefix":"10.1002","volume":"1","author":[{"given":"Katherine","family":"Bowers","sequence":"first","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna","family":"Bhoopathy","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Division of Biostatistics and Bioinformatics Environmental &amp; Public Health Sciences University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda","family":"Szczesniak","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"},{"name":"Division of Biostatistics and Bioinformatics Environmental &amp; Public Health Sciences University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence M.","family":"Dolan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"},{"name":"Division of Endocrinology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Kalkwarf","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"},{"name":"Division of Gastroenterology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Summer","sequence":"additional","affiliation":[{"name":"Schubert Research Clinic, Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mekibib","family":"Altaye","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Ollberding","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Catalano","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology Unit Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menachem","family":"Miodovnik","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology Inova Health System Fairfax Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane C.","family":"Khoury","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"},{"name":"Division of Endocrinology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Centers for Disease Control (CDC).National Diabetes Statistics Report. 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