Pediatrics · Endocrinology · 3 h ago
Early-life exposures linked to cardiometabolic risk in youth
A systematic review and meta-analysis of 70 studies found associations between several early-life exposures and cardiometabolic outcomes in children and adolescents. Gestational diabetes was associated with more than twice the odds of glucose intolerance, while evidence for breastfeeding was limited and inconclusive.
- GDM exposure was associated with higher odds of glucose intolerance.
- Maternal BMI and infant growth measures tracked with multiple outcomes.
- Breastfeeding evidence was limited and inconclusive.
- Most included studies were observational.
Researchers reviewed longitudinal observational studies, case-control studies and randomized trials examining exposures before conception, during pregnancy and birth, and through infancy up to age 2. The review included 70 studies identified through February 20, 2025: 65 longitudinal observational studies, four case-control studies and one randomized trial. Random-effects models were used to pool estimates; analyses with fewer than five independent studies were considered exploratory.
Gestational diabetes mellitus (GDM) was associated with all assessed cardiometabolic outcomes. In a revised analysis retaining one estimate per source cohort, GDM exposure was associated with higher odds of glucose intolerance in children and adolescents (OR 2.13, 95% CI 1.58–2.86; I²=12.7%). Maternal pregnancy BMI was positively associated with glucose intolerance, dyslipidemia, hypertension and metabolic syndrome. Infant BMI and weight changes were associated with dyslipidemia, hypertension and metabolic syndrome. Evidence for breastfeeding was limited; exploratory findings also suggested higher hypertension odds among children born small for gestational age.
The findings identify early-life exposures associated with later risk, but do not establish causation or show that monitoring or interventions improve outcomes. Much of the evidence came from observational studies, and some analyses were based on few studies. The work was conducted by an expert group collaborating with ILSI Europe; several authors reported affiliations with infant-nutrition companies.
In practice
The review identifies GDM exposure, maternal pregnancy BMI and infant BMI or weight changes as early-life factors associated with cardiometabolic outcomes in children and adolescents. This may help clinicians recognize groups with potentially elevated risk, but the synthesis does not establish that these exposures cause later disease or show that closer monitoring improves outcomes. Most included evidence was observational, and some findings—including those concerning breastfeeding and small-for-gestational-age birth—were limited or exploratory; the findings alone do not justify a change in practice.
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BMC Medicine: Early-life risk factors and cardiometabolic outcomes in children and adolescents: a systematic review and meta-analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.