Prenatal exposure to gestational diabetes mellitus increases developmental defects of enamel in offspring: a retrospective cohort study in China

Abstract Objectives Gestational diabetes mellitus (GDM) is increasingly prevalent in China, yet its impact on offspring dental development remains unclear. This cohort study examined whether maternal GDM is associated with developmental defects of enamel (DDE) in primary teeth and assessed the role of glycemic control during pregnancy. Materials and methods We retrospectively analyzed 136 mother-child pairs from China-Japan Friendship Hospital in Beijing, including 27 GDM-exposed and 109 normoglycemic controls. Data were obtained from medical records and structured interviews. Pediatric dentists calibrated in the Modified DDE Index performed all dental examinations. Logistic regression evaluated associations between GDM exposure and DDE outcomes. Results DDE prevalence was significantly higher in GDM-exposed children than controls (48.1% vs. 11.0%; OR = 7.51, 95% CI: 2.86–19.69, P < 0.001). Elevated odds were observed for primary central incisors (OR = 5.32, P = 0.003), primary lateral incisors (OR = 6.01, P = 0.003), primary canines (OR = 4.57, P = 0.041), and primary first molars (OR = 6.15, P = 0.023). Both demarcated (OR = 4.68, P = 0.005) and diffuse opacities (OR = 13.50, P = 0.027) occurred more frequently in exposed children. Within the GDM group, glycemic parameters showed no significant differences between DDE-positive and DDE-negative subgroups. Conclusions Maternal GDM confers a 7.5-fold increased risk for enamel defects in offspring primary dentition, supporting early dental screening for children of diabetic pregnancies. Clinical relevance This first Chinese report quantifies the impact of maternal GDM on offspring enamel development, providing evidence for early dental referral (by age 12 months) in this at-risk population and highlighting opportunities for interdisciplinary perinatal care.