{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T23:04:00Z","timestamp":1780009440609,"version":"3.53.1"},"reference-count":46,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We and others have shown that maternal hyperglycemia during pregnancy in women with insulin-dependent diabetes mellitus (IDDM) influences fetal growth. Less is understood regarding how trimester-specific glycemic patterns, particularly glucose variability, shape offspring obesity risk across the life course and whether this is mediated by birthweight. Leveraging data from the Diabetes in Pregnancy Program Grant (PPG; 1978\u20131995) and the Transgenerational Effects on Adult Morbidity (TEAM Study; 2017\u20132023) cohort, we aimed to evaluate whether the association between maternal glycemic control and adult offspring obesity status was mediated in part through infant birthweight.<\/jats:p>\n                  <jats:p>Maternal glycohemoglobinA1 levels were collected monthly during pregnancy and harmonized across laboratories using standard deviation units (HbA1SD). Functional principal component analysis characterized patterns in blood glucose level and variability. TEAM Study participants, adult offspring of PPG women, completed in-person or online assessments (via Zoom) of body anthropometrics. Linear mixed-effects models and generalized estimating equations estimated associations between maternal glycemia and adult offspring outcomes. Classical mediation methods tested whether birthweight mediated observed relationships.<\/jats:p>\n                  <jats:p>Consistent with prior findings, third-trimester HbA1SD demonstrated the most consistent positive associations with adult offspring body mass index (BMI) outcomes, after adjustment for maternal BMI at last menstrual period, maternal education, gestational weight gain, and sex of offspring (for offspring weight only). There was no evidence that birthweight mediated the relationship between maternal glycemic patterns and adult offspring overweight and obesity; however, birthweight exhibited an independent direct effect on adult offspring BMI in fully adjusted models.<\/jats:p>\n                  <jats:p>Infant birthweight was not shown to be a mediator in the association of maternal gestational glycemic control and overweight\/obesity in adult offspring of women with IDDM. Although birthweight does not appear to mediate these long-term associations, the findings underscore the importance of trimester-specific evaluation of blood glucose level and variability, motivating further investigation into transgenerational metabolic risk pathways.<\/jats:p>","DOI":"10.1055\/a-2848-3544","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T22:55:46Z","timestamp":1777416946000},"page":"1031-1044","source":"Crossref","is-referenced-by-count":0,"title":["Maternal Hyperglycemia and Adult Offspring Overweight and Obesity: Is Birthweight a Mediator?"],"prefix":"10.1055","volume":"43","author":[{"given":"Ketrell L.","family":"McWhorter","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, Kentucky, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, Kentucky, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Bowers","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States"},{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Summer","sequence":"additional","affiliation":[{"name":"Schubert Research Clinic, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Dolan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States"},{"name":"Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Catalano","sequence":"additional","affiliation":[{"name":"Department of Reproductive Endocrinology, Massachusetts General Hospital, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda D.","family":"Szczesniak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States"},{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States"},{"name":"Department of Biostatistics, Health Informatics and Data Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mekibib","family":"Altaye","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States"},{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barak","family":"Rosenn","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Jersey City Medical Center, Rutgers New Jersey Medical School, Newark, New Jersey, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane C.","family":"Khoury","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States"},{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States"},{"name":"Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States"},{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States"},{"name":"Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, United 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