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We investigated the effect of GDM exposure on offspring morbidity in a population\u2010based cohort, assessed by the utilization of specialized health care services up to 12\u2009years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>This register\u2010based study, part of the Finnish Gestational Diabetes (FinnGeDi) study, included all singleton children born in Finland in 2009, captured from the Medical Birth Registry. Mothers of children in the study cohort underwent comprehensive screening for GDM. The study cohort included 6235 (11.1%) GDM\u2010exposed children and 49\u2009484 unexposed children. Utilization of specialized health care services was measured as the number of outpatient visits and inpatient treatment episodes (including duration in days). Data were obtained from the Finnish Care Register for Health Care up to 12\u2009years of age and were analyzed separately for early childhood (0\u20132\u2009years), preschool age (3\u20136\u2009years), and school age (7\u201312\u2009years) also. Maternal, birth, and child\u2010related factors were considered, including maternal age, pre\u2010pregnancy body mass index (BMI), parity, maternal hypertensive disorders, socioeconomic status (SES), smoking status, mode of delivery, preterm birth, small for gestational age, and child sex in the adjustment model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Children exposed to maternal GDM had a higher incidence of outpatient visits than unexposed children (adjusted incidence rate ratio [IRR] 1.10, 95% confidence interval [CI] 1.07\u20131.13). Among children with multiple outpatient care visits (the highest quartile), GDM\u2010exposed children were overrepresented in early childhood (adjusted odds ratio [aOR] 1.08, 95% CI: 1.00\u20131.15), preschool age (aOR 1.12, 95% CI: 1.05\u20131.19), and school age (aOR 1.11, 95% CI: 1.04\u20131.19). Children exposed to GDM were also more likely to require inpatient treatment than unexposed children (adjusted IRR 1.14, 95% CI: 1.10\u20131.19). The difference was not explained by shorter episodes (adjusted IRR 1.20, 95% CI: 1.16\u20131.24 for inpatient treatment days).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children exposed to maternal GDM required more specialized health care services than unexposed children, with increased utilization of specialized health care observed across all age categories up to 12\u2009years of age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70077","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T05:28:26Z","timestamp":1760333306000},"page":"146-155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gestational diabetes mellitus and offspring health: A 12\u2010year register\u2010based analysis of specialized health care utilization in Finland"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5287-7582","authenticated-orcid":false,"given":"Jenni","family":"Kinnunen","sequence":"first","affiliation":[{"name":"Research Unit of Clinical Medicine, Medical Research Center University of Oulu  Oulu Finland"},{"name":"Department of Obstetrics and Gynecology Oulu University Hospital  Oulu Finland"},{"name":"Welfare Epidemiology and Monitoring Unit, Department of Public Health Finnish Institute for Health and Welfare  Helsinki and Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilkka","family":"Nikkinen","sequence":"additional","affiliation":[{"name":"Research Unit of Clinical Medicine, Medical Research Center University of Oulu  Oulu Finland"},{"name":"Department of Obstetrics and Gynecology Oulu University Hospital  Oulu Finland"},{"name":"Welfare Epidemiology and Monitoring Unit, Department of Public Health Finnish Institute for Health and Welfare  Helsinki and Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elina","family":"Keikkala","sequence":"additional","affiliation":[{"name":"Research Unit of Clinical Medicine, Medical Research Center University of Oulu  Oulu Finland"},{"name":"Department of Obstetrics and Gynecology Oulu University Hospital  Oulu Finland"},{"name":"Welfare Epidemiology and Monitoring Unit, Department of Public Health Finnish Institute for Health and Welfare  Helsinki and Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4483-830X","authenticated-orcid":false,"given":"Sanna","family":"Mustaniemi","sequence":"additional","affiliation":[{"name":"Research Unit of Clinical Medicine, Medical Research Center University of Oulu  Oulu Finland"},{"name":"Department of Obstetrics and Gynecology Oulu University Hospital  Oulu Finland"},{"name":"Welfare Epidemiology and Monitoring Unit, Department of Public Health Finnish Institute for Health and Welfare  Helsinki and Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8254-7525","authenticated-orcid":false,"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Department of Data and Analytics Finnish Institute for Health and Welfare  Helsinki Finland"},{"name":"Academic Primary Health Care Centre Region Stockholm  Stockholm Sweden"},{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3212-7826","authenticated-orcid":false,"given":"Hannele","family":"Laivuori","sequence":"additional","affiliation":[{"name":"Medical and Clinical Genetics University of Helsinki and Helsinki University Hospital  Helsinki Finland"},{"name":"Helsinki Institute of Life Science, Institute for Molecular Medicine Finland University of Helsinki  Helsinki 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