Zilin Chen ^1,2 Xin Liu ¹ Minyi Tao ¹ Meng-Nan Yang ¹ Hua He ¹ Fang Fang ¹ Ting Wu ³ Fengxiu Ouyang ¹ Jun Zhang ¹ Fei Li ^1* Zhong-Cheng Luo ^1,2*

• ¹ Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
• ² Department of Obstetrics and Gynecology, Mount Sinai Hospital, and Institute of Health Policy, Management and Evaluation, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
• ³ Chengdu Women and Children’s Central Hospital, Chengdu, Sichuan Province, China

Gestational diabetes mellitus (GDM) is a common pregnancy complication with potential short-and long-term adverse consequences for both mothers and fetuses. It is unclear whether GDM affects linear growth in the offspring; research data are limited and inconsistent. In a prospective birth cohort in Shanghai (n=2055 children; 369 born to mothers with GDM). We sought to evaluate the impact of GDM on longitudinal linear growth in early childhood. Length/height was measured in children at birth, 6 weeks, 6 months, 1, 2 and 4 years of age. Multivariate linear regression and generalized estimating equation models were employed to assess the impact of GDM on length/height for age Z score (LAZ/HAZ). Average birth length was similar in infants of GDM vs. euglycemic mothers. Adjusting for maternal and child characteristics, the children of mothers with GDM had consistently lower LAZ/HAZ compared to children of mothers without diabetes at ages 6 weeks, 6 months, 1, 2 and 4 years. GDM was associated with a 0.12 (95% confidence intervals 0.04-0.21) deficit in LAZ/HAZ in the growth trajectory from birth to age 4 years after adjusting for maternal and child characteristics. GDM was associated with impaired longitudinal linear growth in early childhood. Further studies are warranted to understand the long-term impact on stature and health.