Hutcheon Jennifer A, Platt Robert W, Meltzer Sara J, Egeland Grace M
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
Am J Obstet Gynecol. 2006 Aug;195(2):488-94. doi: 10.1016/j.ajog.2006.01.107. Epub 2006 Apr 19.
The purpose of this study was to examine the extent to which blood glucose, obesity, and maternal weight gain explains differences in birth weight using offspring sibling pairs in gestational diabetes mellitus (GDM).
A retrospective analysis of 90 women with at least 2 GDM pregnancies was conducted. A fixed effects model was used to examine differences between siblings of the same mother (within-women), and results were contrasted with a multivariable regression model that compared different mothers (between-women).
Higher maternal weight gain was significantly associated with increased birth weight within mothers, but not between different women. Conversely, overweight status (body mass index [BMI] > or = 25) was significant between-mothers, but not within an individual mother's pregnancies. One-hour postprandial glucose was significant between-mothers, with a weaker association within-mothers. There was no association between fasting glucose and birth weight in either analysis.
Controlling pregnancy weight gain may reduce offspring birth weight in individual women with GDM, while the association between high birth weight and elevated prepregnancy BMI may represent a predisposition to both characteristics.
本研究旨在探讨血糖、肥胖及孕妇体重增加在多大程度上可解释妊娠期糖尿病（GDM）患者子代同胞对出生体重差异的影响。
对90名至少有2次GDM妊娠的女性进行回顾性分析。采用固定效应模型来检验同一母亲的子代同胞（女性内部）之间的差异，并将结果与比较不同母亲（女性之间）的多变量回归模型进行对比。
母亲体重增加较多与母亲内部子代出生体重增加显著相关，但在不同女性之间则不然。相反，超重状态（体重指数[BMI]≥25）在母亲之间具有显著性，但在单个母亲的妊娠中则不然。餐后1小时血糖在母亲之间具有显著性，在母亲内部的关联性较弱。在两种分析中，空腹血糖与出生体重均无关联。
控制妊娠体重增加可能会降低个体GDM女性的子代出生体重，而高出生体重与孕前BMI升高之间的关联可能代表了这两种特征的易感性。
