Work

Association between maternal mid-pregnancy glucose levels and offspring wheezing in early childhood: a prospective multicentre birth cohort study in Eastern China

Year: 2026

Type: article

Abstract: Background We examined maternal glucose concentrations and diabetes status in relation to wheeze in early childhood.Methods We analysed 2986 singleton mother–child pairs from a prospective multicentre birth cohort in three centres in Jiangsu Province, China. Participants had recorded wheeze status and complete same-day oral glucose tolerance test (OGTT) measurements at 24–28 gestational weeks. The outcome was a wheeze recorded during early childhood follow-up. The protocol targeted wheezing before age 3, although ascertainment ages were not uniformly available. Adjusted logistic regression estimates were pooled across 50 imputations.Results Wheeze was recorded in 293 children (9.8%). Adjusted ORs per 1 mmol/L higher glucose were 0.98 (95% CI 0.76 to 1.26) for fasting, 1.03 (0.96 to 1.11) for 1 hour and 1.02 (0.94 to 1.11) for 2 hour measurements, with no evidence of nonlinearity. In a secondary analysis, recorded maternal gestational diabetes mellitus (GDM) was associated with higher odds of wheeze than no diabetes (adjusted OR 1.39, 95% CI 1.06 to 1.82; Holm-adjusted p=0.034). Standardised risks were 12.1% and 9.1%, respectively, a difference of 3.0 percentage points (95% CI 0.4 to 5.6).Conclusion Mid-pregnancy glucose concentrations showed no clear association with early-childhood wheeze, with a secondary association between recorded GDM and higher odds of wheeze. Unavailable diagnostic and treatment details and residual confounding limit interpretation. These findings concern wheeze, not subsequent asthma, and do not support changing GDM screening or treatment thresholds.

Source: BMJ Paediatrics Open

DOI: 10.1136/bmjpo-2026-005105