Authors：Xiao-Guang Yin, Peng Wang, Mei-Ting Zhou, De-Qin Li, Rui-Xue Tao, Fang-Biao Tao, Yang Wang, Peng Zhu
Source：BMC Pregnancy Childbirth. 2023 Sep 7;23(1):642.
DOI: 10.1186/s12884-023-05954-2.
Abstract：
Background:The evidence on the associations of the timing of maternal gestational diabetes mellitus (GDM) with the comprehensive growth trajectory from perinatal to early childhood in offspring is limited. The potential mechanism remains elusive. Our aim is to estimate the associations of the timing of GDM diagnosis and gestational weight gains (GWG) with the growth trajectory of children from perinatal to early childhood.
Methods:A total of 7609 participants are included from the Maternal & Infants Health in Hefei cohort study. Primary predictors were the timing of maternal GDM diagnosis and GWG during pregnancy. The main outcomes included fetal ultrasonic measurements, birth size as well as BMI peak indicators during infancy within 48 months.
Results:GDM diagnosed before 26 weeks was associated with increased risks of overgrowth for fetal abdominal circumference (OR 1.19, 95% CI 1.04-1.36) and birth weight (OR 1.51, 95% CI 1.19-1.91) when compared with unexposed. GDM diagnosis < 26 weeks was related to the higher BMI peak (β 0.16, 95%CI 0.03-0.28) within 48 months. The significantly additive impacts of maternal early GDM diagnosis and excessive gestational weight gains (EGWG) on offspring overgrowth were observed. Women in GDM < 26 weeks with early EGWG group had higher levels of hsCRP compared with GDM > 26 weeks (P < 0.001).
Conclusions:Exposure to maternal GDM diagnosed before 26 weeks with early EGWG could lead to shifts and/or disruptions from the typical growth trajectory from perinatal to early childhood in offspring.
Keywords: Gestational diabetes mellitus; Gestational weight gain; Growth trajectory; Obesity; Pregnancy.
摘要：
背景：母体妊娠期糖尿病（GDM）发生时间与后代围产期至幼儿期综合生长轨迹相关性的证据有限。潜在的机制仍然难以捉摸。我们的目的是估计GDM诊断时间和妊娠体重增加（GWG）与围产期到幼儿期儿童生长轨迹的关联。
方法：合肥母婴健康队列研究共纳入7609名受试者。主要预测因素是孕期孕产妇GDM诊断和GWG的时机。主要结局包括胎儿超声测量、出生大小以及48个月内婴儿期的BMI峰值指标。
结果：与未暴露相比，26周前诊断的GDM与胎儿腹围（OR 1.19,95%CI 1.04-1.36）和出生体重（OR 1.51,95%CI 1.19-1.91）过度生长的风险增加有关。GDM诊断<26周与0个月内较高的BMI峰值（β 16.95,0%CI 03.0-28.48）有关。观察到母体早期GDM诊断和妊娠期体重过度增加（EGWG）对后代过度生长的显着附加影响。GDM<26周早期EGWG组女性的hsCRP水平高于GDM>26周（P < 0.001）。
结论：在早期EGWG诊断为26周前诊断的母体GDM暴露可能导致后代从围产期到儿童早期的典型生长轨迹的转变和/或中断。
关键词： 妊娠糖尿病;妊娠期体重增加;增长轨迹;肥胖;怀孕。
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