International Journal of Clinical Obstetrics and Gynaecology Nexovation

Gestational Diabetes and the Child’s Cardiometabolic Programming: Evidence on Fetal, Neonatal, and Cardiovascular Outcomes

Nathalia Do Prado Dutra Santos1, Nicolly Couto Da Silva2, Lorena Rios Bascoy3, Mateus Soares Santos Araújo4, Joel Eloi Belo Junior5, Nilda Cristina Prates6, Dorvalino Correia Da Silva Júnior7, Yuri Prates Correia Da Silva8, Jhenifer Moura Da Silva9, Aline Cristina Couto Da Silva10, Gabriel Vieira Rodrigues11, Christian Emmanuel Da Silva Pelaes12, Roselene De O Carvalho13, Letícia de Souza Assis14, Regilane da S Batista15, Diego Paulino Mariz16, Délio Tiago Martins Malaquias17, Lisandra Silva Do Amaral18, Isabeli Gomes De Oliveira19, Marina Zorzi Emigliozzi20, Eliane Moreira Da Silva21, Marcos Vinícius Brizola Rafael Botelho22, Ana Clara Ayoroa Freire23, Carlos Henrique B Figueiredo De Mendonça24, Ana Laura Nogueira Ervilha25, Beatriz Trovo Butigno26, Raphaela De Almeida Melo27, Lis Paulino De Oliveira28, Priscilla S D Montalvão29, Rubens R Tudela30, Thalita P M Alineri31, Hadassa Alcantu De Mauro32, Lucas Pereira Sales Porto33, Luiza Benicio Teodoro34, Pamela Ferreira Katanasaka35, Patrick Torres Nascimento36, Alessandra Santos de Freitas37

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Version of record

This is an author-deposited copy. The version of record was originally published elsewhere: Originally published in International Journal of Clinical Obstetrics and Gynaecology Nexovation. ISSN 3051-3367. Volume 2 Issue 3. Pages 01-13. Published 2026-01-01. DOI 10.54660/.IJCOGN.2026.2.3.01-13 . Source: https://www.gynaresearchjournal.com/article/2996/gestational-diabetes-and-the-child-s-cardiometabolic-programming-evidence-on-fetal-neonatal-and

Abstract

Introduction: Gestational diabetes mellitus (GDM) is one of the most common metabolic complications of pregnancy and is associated with significant maternal, fetal, and neonatal consequences. Recent evidence shows that intrauterine exposure to hyperglycemia can trigger cardiometabolic programming mechanisms, increasing the offspring’s susceptibility to developing obesity, insulin resistance, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular diseases throughout life. Objective: To analyze the scientific evidence regarding the relationship between gestational diabetes mellitus and cardiometabolic programming in children, emphasizing the main fetal, neonatal, and cardiovascular outcomes. Methods: A systematic literature review was conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020). Searches were conducted in the following databases: PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, Virtual Health Library (BVS), and SciELO. Studies published between 2016 and 2025, in Portuguese and English, that investigated the association between gestational diabetes and cardiometabolic outcomes in offspring were included. After the selection process, 85 studies met the eligibility criteria and were included in the qualitative synthesis. Results: The studies demonstrated a consistent association between gestational diabetes and a higher incidence of fetal macrosomia, neonatal hypoglycemia, accelerated fetal growth, increased body adiposity, childhood obesity, insulin resistance, metabolic syndrome, hypertension, type 2 diabetes mellitus, and early cardiovascular abnormalities. Epigenetic changes, inflammatory processes, oxidative stress, and endothelial dysfunction were identified as the main mechanisms involved in cardiometabolic programming. The evidence also demonstrated that early diagnosis, adequate glycemic control, and longitudinal follow-up of the child significantly reduce adverse outcomes. Conclusion: Gestational diabetes mellitus is a major factor in the cardiometabolic programming of offspring, with persistent repercussions throughout the life course. Strengthening prenatal screening, maternal metabolic control, and multidisciplinary follow-up of the child represents a fundamental strategy for reducing the intergenerational transmission of cardiometabolic risk and preventing future chronic diseases.

Keywords: Gestational Diabetes MellitusFetal ProgrammingCardiometabolic ProgrammingNeonatal OutcomesFetal MacrosomiaChildhood ObesityInsulin ResistanceCardiovascular Diseases

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