(219) Association between maternal 50-gram glucose challenge levels within normal range and long term offspring morbidities

The 50‑gram Glucose Challenge Test (GCT) is currently used only to determine whether a 100‑gram Oral Glucose Tolerance Test is required, while the absolute GCT value is often considered negligible. We have previously shown that high‑normal GCT results (126–139 mg/dL) are associated with increased risk of maternal cardiometabolic diseases later in life, compared with low‑normal values. This study evaluated the association between high versus low‑normal 50‑gram GCT results in pregnancy and long‑term pediatric health outcomes

 

Study Design:

This population‑based retrospective cohort included 35,478 children born to 21,304 mothers with documented GCT results and complete follow‑up in a large HMO between 2000–2024. Infants with birth weight < 2,000 g, gestational age < 35 weeks, and multiple births were excluded. Maternal GCT results were grouped as ≤125, 126–139, and ≥140 mg/dL. Pediatric morbidities were assessed over 10 years using Kaplan–Meier time‑to‑event analysis and log‑rank tests. Multivariable Cox models estimated adjusted hazard ratios, controlling for maternal age, socioeconomic status, birth weight, gestational age, and offspring sex

Results:

High‑normal maternal GCT (126–139 mg/dL) was associated with higher 10‑year cumulative incidence of childhood obesity (10.9% vs 12.6% vs 12.9%, p = 0.0011), autism (p = 0.0012), dermatitis (p = 0.0216), congenital anomalies (p = 0.0172), and psychiatric disorders (p = 0.0326). Cox models confirmed that high maternal glucose, male sex, and advanced maternal age increased risk, whereas favorable socioeconomic status was protective

Conclusion:
Maternal high‑normal GCT results, although within the non‑diabetic range, are associated with increased long‑term pediatric morbidities, particularly obesity and neurodevelopmental disorders. These findings indicate that women in the high‑normal GCT group, despite being classified as non‑diabetic, merit specific guidance and follow‑up during pregnancy and underscore the need for more attentive long‑term pediatric care for their children