The long-term impact of maternal glucose abnormalities on offspring obesity risk has remained uncertain. A large retrospective cohort study, published in The Journal of Clinical Endocrinology & Metabolism, investigated the association between gestational glucose intolerance (GGI) and gestational diabetes mellitus (GDM) with obesity outcomes in childhood and adolescence. The analysis included 27,876 offspring: 23,334 (83.7%) born to mothers with normal glucose tolerance (NGT), 3,413 (12.2%) exposed to GGI, and 1,129 (4.1%) exposed to GDM.

Obesity prevalence increased with age, affecting 13.5% of children at 2–5 years, 20.3% at 6–10 years, and 23.4% at 11–18 years. Children exposed to GDM had a 21% higher risk of obesity at ages 6–10 (OR 1.21; 95% CI 1.01–1.46). In adolescence, the risk remained elevated in those exposed to mild glucose intolerance (GGI-1: OR 1.44; 95% CI 1.14–1.81) and GDM (OR 1.28; 95% CI 1.03–1.59). Adjusting for maternal BMI reduced but did not eliminate these associations.

The study confirms that both GGI and GDM exposure independently increase obesity risk later in life. Recognition of gestational glycemia as a predictor of offspring obesity could inform preventive strategies in cardiometabolic health.