Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Germany.
Diabet Med. 2013 Dec;30(12):1449-56. doi: 10.1111/dme.12286. Epub 2013 Aug 19.
Gestational diabetes mellitus is believed to be a risk factor for childhood overweight/obesity. We aimed to assess whether this association is either a reflection or independent of confounding by maternal BMI.
Data from 7355 mother-child dyads of the German Perinatal Prevention of Obesity cohort with full anthropometric information on mothers and children, gestational diabetes and confounding factors were obtained at school entry health examination. We calculated crude and adjusted logistic regression models for the association of gestational diabetes and childhood overweight/obesity and abdominal adiposity defined by age- and sex-specific percentiles for BMI and waist circumference.
Among all children (mean age 5.8 years), 8.1% were overweight, 2.6% were obese and 15.5% had abdominal adiposity. The prevalence of overweight (obesity) was 21% (8.2%) in children of mothers with gestational diabetes and 10.4% (2.4%) in children of healthy mothers. Analyses with adjustment for maternal BMI and other potential confounders yielded an odds ratio of 1.81 (95% CI 1.23-2.65) and 2.80 (95% CI 1.58-4.99) for the impact of gestational diabetes on childhood overweight and obesity, respectively. Similar results were obtained for the risk of childhood abdominal adiposity (odds ratio 1.64, 95% CI 1.16-2.33) by maternal gestational diabetes.
The postulated increased risk of overweight and abdominal adiposity in offspring of mothers with gestational diabetes cannot be explained by maternal BMI alone and may be stronger for childhood obesity than for overweight.
妊娠期糖尿病被认为是儿童超重/肥胖的一个危险因素。我们旨在评估这种关联是否是由母体 BMI 混杂因素引起的,或者是否与母体 BMI 混杂因素无关。
我们从德国围产期肥胖预防队列的 7355 对母婴对子中获得了数据,这些母婴对子在入学健康检查时均有完整的母婴人体测量学信息、妊娠期糖尿病和混杂因素。我们计算了粗逻辑回归模型和调整后的逻辑回归模型,以评估妊娠期糖尿病与儿童超重/肥胖和根据 BMI 和腰围的年龄和性别特定百分位数定义的腹部肥胖之间的关联。
在所有儿童(平均年龄 5.8 岁)中,8.1%超重,2.6%肥胖,15.5%腹部肥胖。患有妊娠期糖尿病的母亲的孩子中,超重(肥胖)的患病率为 21%(8.2%),而健康母亲的孩子中为 10.4%(2.4%)。调整母体 BMI 和其他潜在混杂因素后,妊娠期糖尿病对儿童超重和肥胖的影响的优势比分别为 1.81(95%CI 1.23-2.65)和 2.80(95%CI 1.58-4.99)。对于由母体妊娠期糖尿病引起的儿童腹部肥胖风险,也得到了类似的结果(优势比 1.64,95%CI 1.16-2.33)。
母亲患有妊娠期糖尿病的子女超重和腹部肥胖的风险增加不能仅用母体 BMI 来解释,而且与超重相比,妊娠期糖尿病对肥胖的影响可能更强。