孕期前半段的内脏脂肪堆积可预测青春期母亲所生新生儿的体重。

Visceral adiposity in the first half of pregnancy predicts newborn weight among adolescent mothers.

作者信息

Cisneiros Rosangela M, Dutra Luciana P, Silveira Fernando José Carvalho, Souza Alex R, Marques Marcelo, Amorim Melania M, Urquia Marcelo L, Ray Joel G, Alves João G

机构信息

Endocrinology Unit, Universidade Federal do Vale do São Francisco, Petrolina, Brazil.

Department of Nursery Graduation, Universidade Federal do Vale do São Francisco, Petrolina, Brazil.

出版信息

J Obstet Gynaecol Can. 2013 Aug;35(8):704-709. doi: 10.1016/S1701-2163(15)30860-4.

DOI:10.1016/S1701-2163(15)30860-4

PMID:24007705

Abstract

OBJECTIVE

Maternal obesity is a strong risk factor for gestational diabetes mellitus and fetal macrosomia. We assessed the association between maternal visceral adiposity tissue (VAT) depth in the first half of pregnancy and both glucose tolerance in late pregnancy and newborn weight in pregnant adolescents.

METHODS

We completed a prospective cohort study of 73 pregnant adolescents aged 10 to 19 years, without pre-pregnancy diabetes. VAT depth was measured by ultrasound at 12 to 20 weeks' gestation, followed by a two-hour 75-g oral glucose tolerance test at 36 to 39 weeks' gestation, to determine the glucose area under the curve (AUC glucose0-120). The association between VAT depth and newborn weight was evaluated by multiple linear regression analysis, controlling for maternal age, parity, smoking, gestational age at delivery, infant sex, pre-pregnancy BMI, weight gain in pregnancy, and fasting serum glucose at 36 to 39 weeks' gestation. The relation between VAT depth and AUC glucose0-120 was assessed by linear regression analysis, adjusting for maternal age, parity, smoking, pre-pregnancy BMI, and weight gain in pregnancy.

RESULTS

A 1 cm increase in VAT depth was associated with a 206 g (95% CI 101 to 311) adjusted increase in mean birth weight. VAT depth and the other model covariates together explained more of the variance in birth weight (r(2) = 0.282; P < 0.001) than pre-pregnancy BMI with the other covariates in the same model (r(2) = 0.081; P = 0.076). All three glucose tolerance test measures were performed at 36 to 39 weeks' gestation in 51 of the 73 participants. The relationship between VAT depth and AUC glucose0-120 was not significant (P = 0.43).

CONCLUSION

VAT depth in the first half of pregnancy predicts newborn weight better than BMI, but is not associated with glucose tolerance in late pregnancy.

摘要

目的

孕妇肥胖是妊娠期糖尿病和巨大儿的一个重要危险因素。我们评估了妊娠前半期孕妇内脏脂肪组织（VAT）深度与妊娠晚期葡萄糖耐量及妊娠青少年新生儿体重之间的关联。

方法

我们对73名年龄在10至19岁、孕前无糖尿病的妊娠青少年进行了一项前瞻性队列研究。在妊娠12至20周时通过超声测量VAT深度，随后在妊娠36至39周时进行两小时75克口服葡萄糖耐量试验，以确定葡萄糖曲线下面积（AUC glucose0 - 120）。通过多元线性回归分析评估VAT深度与新生儿体重之间的关联，同时控制孕妇年龄、产次、吸烟情况、分娩时的孕周、婴儿性别、孕前体重指数、孕期体重增加以及妊娠36至39周时的空腹血清葡萄糖水平。通过线性回归分析评估VAT深度与AUC glucose0 - 120之间的关系，并对孕妇年龄、产次、吸烟情况、孕前体重指数和孕期体重增加进行校正。

结果

VAT深度每增加1厘米，经校正后平均出生体重增加206克（95%可信区间为101至311克）。与同一模型中包含其他协变量的孕前体重指数相比，VAT深度和其他模型协变量共同解释的出生体重方差更多（r(2) = 0.282；P < 0.001），而孕前体重指数与其他协变量共同解释的方差为r(2) = 0.081；P = 0.076）。73名参与者中有51名在妊娠36至39周时进行了所有三项葡萄糖耐量试验测量。VAT深度与AUC glucose0 - 120之间的关系不显著（P = 0.43）。