Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
BMC Public Health. 2010 Oct 6;10:590. doi: 10.1186/1471-2458-10-590.
Childhood obesity is on the rise and is a major risk factor for type 2 diabetes later in life. Recent evidence indicates that abnormalities that increase risk for diabetes may be initiated early in infancy. Since the offspring of women with diabetes have an increased long-term risk for obesity and type 2 diabetes, the impact of maternal metabolic abnormalities on early nutrition and infant metabolic trajectories is of considerable interest. Human breast milk, the preferred food during infancy, contains not only nutrients but also an array of bioactive substances including metabolic hormones. Nonetheless, only a few studies have reported concentrations of metabolic hormones in human milk specifically from women with metabolic abnormalities. We aim to investigate the impact of maternal metabolic abnormalities in pregnancy on human milk hormones and subsequently on infant development over the first year of life. The objective of this report is to present the methodology and design of this study.
METHODS/DESIGN: The current investigation is a prospective study conducted within ongoing cohort studies of women and their offspring. Pregnant women attending outpatient obstetrics clinics in Toronto, Canada were recruited. Between April 2009 and July 2010, a total of 216 pregnant women underwent a baseline oral glucose tolerance test and provided medical and lifestyle history. Follow-up visits and telephone interviews are conducted and expected to be completed in October 2011. Upon delivery, infant birth anthropometry measurements and human breast milk samples are collected. At 3 and 12 months postpartum, mothers and infants are invited for follow-up assessments. Interim telephone interviews are conducted during the first year of offspring life to characterize infant feeding and supplementation behaviors.
An improved understanding of the link between maternal metabolic abnormalities in pregnancy and early infant nutrition may assist in the development of optimal prevention and intervention strategies and in the protection of nutritionally vulnerable offspring who are at risk for obesity and diabetes later in life.
儿童肥胖症呈上升趋势，是日后发生 2 型糖尿病的主要危险因素。最近的证据表明，可能会在婴儿期早期就出现增加糖尿病风险的异常情况。由于患有糖尿病的女性的后代肥胖和 2 型糖尿病的长期风险增加，因此母体代谢异常对婴儿早期营养和代谢轨迹的影响引起了相当大的关注。母乳是婴儿期首选的食物，不仅含有营养物质，还含有一系列生物活性物质，包括代谢激素。尽管如此，只有少数研究报告了来自代谢异常女性的母乳中代谢激素的浓度。我们旨在研究母亲在妊娠期间的代谢异常对人乳激素的影响，以及随后对婴儿在生命的头一年的发育的影响。本报告的目的是介绍该研究的方法和设计。
方法/设计：本研究是在针对女性及其后代的正在进行的队列研究中进行的前瞻性研究。在加拿大多伦多的门诊妇产科诊所招募了孕妇。在 2009 年 4 月至 2010 年 7 月期间，共有 216 名孕妇接受了基线口服葡萄糖耐量试验，并提供了医疗和生活方式史。正在进行随访访问和电话访谈，预计将于 2011 年 10 月完成。分娩时，收集婴儿出生人体测量数据和母乳样本。在产后 3 个月和 12 个月时，邀请母亲和婴儿进行随访评估。在婴儿生命的第一年期间进行临时电话访谈，以描述婴儿喂养和补充剂行为。
对妊娠期间母体代谢异常与婴儿早期营养之间的联系有了更深入的了解，可能有助于制定最佳的预防和干预策略，并保护那些在以后的生活中肥胖和糖尿病风险较高的营养脆弱的后代。
