Is maternal diabetes mellitus (DM) associated with cancer risk in mothers and their offspring? A systematic review and meta-analysis published in Diabetes, Obesity and Metabolism evaluated associations between maternal DM and cancer outcomes across mother-offspring populations.

The analysis included 81 studies involving 44,917,447 mother-offspring pairs. Data were retrieved from PubMed, Embase, and Web of Science through September 30, 2025. The primary outcome was cancer risk in mothers and offspring, reported as risk ratios (RRs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic, which guided the use of random-effects or common-effects models.

Maternal DM was associated with a higher risk of cancers in both mothers and offspring. In analyses adjusted for multiple confounders, offspring showed increased risk of hematologic malignancies (RR 1.37; 95% CI 1.23-1.52; I² = 1.0%), including leukemia (RR 1.34; 95% CI 1.22-1.47; I² = 0.0%). In mothers, the risk of solid tumors was higher (RR 1.17; 95% CI 1.09-1.24; I² = 70.1%). Increased risks were observed for head and neck (RR 1.34; 95% CI 1.23-1.47; I² = 35.1%), respiratory system (RR 1.33; 95% CI 1.05-1.67; I² = 0.0%), gastrointestinal (RR 1.30; 95% CI 1.16-1.45; I² = 45.5%), and gynecologic cancers (RR 1.16; 95% CI 1.04-1.29; I² = 64.1%).

Pre-gestational DM showed a stronger association with offspring cancer risk than gestational DM (RR 1.60 [1.14-2.14] vs 1.10 [1.02-1.18]; subgroup difference p = 0.0046). These findings show that maternal DM was associated with higher cancer risk across generations. Further large-scale studies are needed to clarify potential causal relationships.