The risk of developing type 2 diabetes and cardiovascular disease in women who had previously been diagnosed with gestational diabetes (GDM) is well established. There is increasing evidence that the offspring of women with GDM are at increased risk for the development of all components of the cardiorenal metabolic syndrome. Overall, it appears that these offspring have an increased risk for overweight/obesity, insulin resistance, higher blood pressure, renal disease, and type 2 diabetes. However, distinct differences in regional populations, lack of routine screening and treatment of GDM worldwide, and long follow-up periods for offspring represent a challenge in assessing the risk for development of these abnormalities in the offspring of women who have had GDM.

1.
WHO fact sheet No. 311. Obesity and Overweight. September 2006. www.who.int/mediacentre/factsheets/fs311 (accessed December 8, 2011).
2.
Ogden CL, Carroll MD, Flegal KM: High body mass index for age among US children and adolescents, 2003–2006. JAMA 2008;299:2401–2405.
3.
Cook S, Weitzman M, Auinger P, Nguyen M, Dietz W: Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 2003;157:821.
4.
Barker DJ: The fetal and infant origins of disease. Eur J Clin Invest 1995;25:457–463.
5.
Miehle K, Stephan H, Fasshauer M: Leptin, adiponectin, and other adipokines in gestational diabetes mellitus and preeclampsia. Clin Endocrinol 2012;76:2–11.
6.
Catalano PM, Kirwan JP, Haugel-de Mouzon S, King J: Gestational diabetes and insulin resistance: role in short- and long-term implications for mother and fetus. J Nutr 2003;133(5 suppl 2):1674S–1683S.
7.
Tsadok MA, Friedlander Y, Paltiel O, Manor O, Meiner V, Hochner H, Sagy Y, Sharon N, Yazdgerdi S, Sisovick D, Elchalal U: Obesity and blood pressure in 17-year-old offspring of mothers with gestational diabetes: insights from the Jerusalem perinatal study. Exp Diabetes Res 2011;2011:906154.
8.
Bunt JC, Tataranni PA, Salbe AD: Intrauterine exposure to diabetes is a determinant of hemoglobin A1c and systolic blood pressure in Pima Indian children. J Clin Endocrinol Metab 2005;90:3225–3229.
9.
Cho NH, Silverman BL, Rizzo TA, Metzger BE: Correlations between the intrauterine metabolic environment and blood pressure in adolescent offspring of diabetic mothers. J Pediatr 2000;136:587–592.
10.
Lawlor DA, Fraser A, Lindsay RS, Ness A, Dabelea D, Catalano P, Smith GD, Sattar N, Nelson SM: Association of existing diabetes, gestational diabetes and glycosuria in pregnancy with macrosomia and offspring body mass index, waist and fat mass in later childhood: findings from a prospective pregnancy cohort. Diabetologia 2010;53:89–97.
11.
Lawlor DA, Lichtenstein P, Langstrom N: Association of maternal diabetes mellitus in pregnancy with offspring adiposity into early adulthood: sibling study in a prospective cohort of 280,866 men from 248,293 families. Circulation 2011;123:258–265.
12.
Petry CL: Gestational diabetes: risk factors and recent advances in its genetics and treatment. Br J Nutr 2010;104:775–787.
13.
Reynolds RM, Osmond C, Phillips DIW, Godfrey KM: Maternal BMI, parity, and pregnancy weight gain: influences on offspring adiposity in young adulthood. J Clin Endocrinol Metab 2010;95:5365–5369.
14.
Drake AJ, Reynolds RM: Impact of maternal obesity on offspring obesity and cardiometabolic disease risk. Reproduction 2010;140:387–398.
15.
Bellamy L, Casas JP, Hingoranie AD, Williams D: Type 2 diabetes after gestational diabetes: a systematic review and meta-analysis. Lancet 2009;373:1773–1779.
16.
Dabelea D, Hanson RL, Lindsay RS, Pettitt DJ, Imperatore G, Gabir MM, Roumain J, Bennett PH, Knowler WC: Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity. Diabetes 2000;49:2208–2211.
17.
Franks PW, Looker HC, Kobes S, Touger L, Tataranni PA, Hanson RL, Knowler WC: Gestational glucose tolerance and risk of type 2 diabetes in young Pima Indian offspring. Diabetes 2006;55:460–465.
18.
Clausen TD, Mathiesen ER, Hansen T, Pedersen O, Jensen DM, Lauenborg J, Damm P: High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia. Diabetes Care 2008;31:340–346.
19.
Nistala R, Hayden MR, DeMarco V, Henriksen E, Lackland D, Sowers J: Prenatal programing and epigenetics in the genesis of the cardiorenal syndrome. Cardiorenal Med 2011;1:243–254.
20.
Fernandez-Morera JL, Rodriguez-Rodero S, Menendez-Torre E, Fraga MF: The possible role of epigenetics in gestational diabetes: cause, consequence or both. Obstet Gynecol Int 2010;2010:605163.
21.
Gluckman PD, Hanson Ma, Buklijas T, Low FM, Beedle AS: Epigenetic mechanisms that underpin metabolic and cardiovascular diseases. Nat Rev Endocrinol 2009;5:401–408.
22.
Ozanne SE, Hales CN: Lifespan: catch-up growth and obesity in male mice. Nature 2004;427:411–412.
23.
Park JH, Stoffers DA, Nicholls RD, Simmons RA: Development of type 2 diabetes following intrauterine growth retardation in rats is associated with progressive epigenetic silencing of Pdx1. J Clin Invest 2008;118:2316–2324.
24.
Bouchard L, Thibault S, Guay SP, Santure M, Monpetit A, St-Pierre J, Perron P, Brisson D: Leptin gene epigenetic adaptation to impaired glucose metabolism during pregnancy. Diabetes Care 2010;33:2436–2441.
25.
Ortega-Senovilla H, Shaefer-Graf U, Meitzner K, Abou-Dakn M, Graf K, Kintscher U, Herrera E: Gestational diabetes mellitus causes changes in the concentrations of adipocyte fatty acid-binding protein and other adipocytokines in cord blood. Diabetes Care 2011;34:2061–2066.
26.
Pettit DJ, Knowler WC: Long term effects of the intrauterine environment, birth weight and breast feeding in Pima Indians. Diabetes Care 1998;21:B138–B141.
27.
Pettit DJ, Knowler WC, Bennett PH, Aleck KA, Baird HR: Obesity in offspring of diabetic Pima Indian women despite normal birth weight. Diabetes Care 1987;10:76–80.
28.
Grissa O, Yessoufou A, Mrisak I, Hichami A, Amoussou-Guenou D, Grissa A, Djrolo F, Moutairou K, Miled A, Khairi H, Zaouali M, Bougmiza I, Zbidi A, Tabka Z, Khan NA: Growth factor concentrations and their placental mRNA expression are modulated in gestational diabetes mellitus: possible interactions with macrosomia. BMC Pregnancy Childbirth 2010;10:7.
29.
Poston L: Developmental programming and diabetes – the human experience and insight from animal models. Best Pract Res Clin Endocrinol Metab 2010;24:541–552.
30.
Samuelsson AM, Matthews PA, Argenton M, Christie MR, McConnell JM, Jansen EH, Piersma AH, Ozanne SE, Twinn DF, Remacle C, Rowlerson A, Poston L, Taylor PD: Diet induced obesity in female mice leads to offspring hyperphagia, adiposity, hypertension, and insulin resistance: a novel murine model of developmental programming. Hypertension 2008;51:383–392.
31.
Plagemann A, Harder T, Janert U, Rake A, Rittel F, Rohde W, Dörner G: Malformations of hypothalamic nuclei in hyperinsulinemic offspring of rats with gestational diabetes. Dev Neurosci 1999;21:58–67.
32.
Schubring C, Englaro P, Siebler T, Blum WF, Demirakca T, Kratzsch J, Kiess W: Longitudinal analysis of the maternal serum leptin levels during pregnancy, at birth and up to six weeks after birth: relation to body mass index, skinfolds, sex steroids and umbilical cord blood leptin levels. Horm Res1998;50:276–283.
33.
Schubring C, Kiess W, Englaro P, Rascher W, Dötsch J, Hanitsch S, Attanasio A, Blum WF: Levels of leptin in maternal serum, amniotic fluid, and arterial and venous cord blood: relation to neonatal and placental weight. J Clin Endocrinol Metab 1997;82:1480–1483.
34.
Forhead AJ, Fowden AL: The hungry fetus? Role of leptin as a nutritional signal before birth. J Pysiol 2009;587:1145–1152.
35.
Pirc LK, Owens JA, Crowther CA, Willson K, De Blasio MJ, Robinson JS: Mild gestational diabetes in pregnancy and the adipoinsular axis in babies born to mothers in the ACHOIS randomized control trial. BMC Pediatr 2007;7:18.
36.
American Diabetes Association: Diagnosis and classification of diabetes mellitus. Diabetes Care 2011;34:S62–S69.
37.
Crowther C, Hiller J, Moss J, McPhee A, Jeffries W, Robinson J: Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. N Engl J Med 2005;352:2477–2486.
38.
Castorino K, Paband R, Zisser H, Jovanovic L: Insulin pumps in pregnancy: using technology to achieve normoglycemia in women with diabetes. Curr Diab Rep 2012;12:53–59.
39.
Ali AT, Ferris WF, Naran NH, Crowther NJ: Insulin resistance in the control of body fat distribution: a new hypothesis. Horm Metab Res 2011;43:77–80.
40.
Rowan JA, Rush EC, Obolonkin V, Batting M, Wouldes T, Hauge WM: Metformin in gestational diabetes: the offspring follow-up (MiG FOFU): body composition at 2 years of age. Diabetes Care 2011;34:2279–2284.
41.
Tzanetakou IP, Mikhailidis DP, Perrea DN: Nutrition during pregnancy and the effect of carbohydrates on the offspring’s metabolic profile: in search of the perfect maternal diet. Open Cardiovasc Med J 2011;5:103–109.
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