How strong is the association between gestational diabetes and long-term health complications?

Gestational diabetes is associated with an increased risk of long-term complications in both the parent and the infant.^[1][2][3] However, this association reflects shared environmental and genetic factors rather than a direct causal relationship to gestational diabetes, and some studies find no conclusive evidence of an association between gestational diabetes and adverse effects in offspring (such as the risk for childhood obesity^[4] and metabolic diseases^[5]). Moreover, even if gestational diabetes does increase the risk for certain conditions in offspring, it is unlikely that complex, multifactorial health conditions (like obesity) can be attributed to gestational diabetes alone.