Title：Timing of gestational diabetes diagnosis, gestational weight gains and offspring growth trajectory: a prospective birth cohort study

Title：Timing of gestational diabetes diagnosis, gestational weight gains and offspring growth trajectory: a prospective birth cohort study.

Authors：Yin XG, Wang P, Zhou MT, Li DQ, Tao RX, Tao FB, Wang Y, Zhu P.

Source：BMC Pregnancy Childbirth. 2023 Sep 7;23(1):642.

DOI: 10.1186/s12884-023-05954-2.

原文链接：https://doi.org/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)发病时间与子代从围产期到幼儿期的综合生长轨迹之间的关联证据有限。潜在的机制仍然难以捉摸。我们的目的是估计GDM的诊断时间和妊娠期体重增加(GWG)与儿童从围产期到幼儿期的生长轨迹的关系。

方法:合肥市母婴健康队列研究共纳入7609名受试者。主要预测因子为妊娠期母体GDM诊断时间和GWG。主要结果包括48个月内胎儿超声测量、出生尺寸及婴儿期BMI峰值指标。

结果:与未接触GDM的胎儿相比，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48个月内BMI峰值增高相关(β 0.16, 95%CI 0.03 ~ 0.28)。观察到母亲早期GDM诊断和妊娠体重增加过多(EGWG)对后代过度生长的显著叠加影响。GDM < 26周伴早期EGWG组的hsCRP水平高于GDM > 26周组(P < 0.001)。

结论:暴露于26周前诊断为妊娠期早期妊娠期妊娠的母体GDM可能导致子代从围产期到幼儿期典型生长轨迹的改变和/或中断。

关键词:妊娠期糖尿病;妊娠期体重增加;增长轨迹;肥胖;怀孕。