"We Don't Have Any Clue What Will Happen to Them": Perspectives of Women Who Had Gestational Diabetes About Long-Term Child Outcomes

In utero exposure to gestational diabetes mellitus (GDM) is associated with adverse long-term outcomes. Little is known about how mothers perceive these outcomes and the support they need for optimal outcomes for their children. We aimed to explore how women perceive the risk of adverse outcomes for their children exposed to GDM and the support they require for their optimal health. We conducted semistructured interviews with women who experienced GDM in at least one previous pregnancy. Data collection continued until saturation, and analysis followed an iterative thematic approach. Twenty-five mothers participated, and their perceptions about later outcomes for children exposed to GDM varied. Five themes were identified: relating GDM to the offspring's later health; reactions to the potential for poor later outcomes; impact on child growth, development, and behavior; maintaining optimal health from childhood to adulthood; and recommendations for long-term care. Most mothers received no information about potential later child outcomes; some based their views on assumptions. Some mothers who believed their children were at increased risk of poor outcomes expressed fear and worry, while others proactively ensured their children engaged in healthy lifestyle choices. Mothers emphasized the need for support within health facilities (information provision, linking antenatal with child records, and risk assessment) and in the community (social groups, home visits) to ensure optimal health of their children. These findings have potential implications for policy and practice changes to optimize later health outcomes for children exposed to GDM.