Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Israel; Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Israel.
Diabetes Res Clin Pract. 2018 Oct;144:231-235. doi: 10.1016/j.diabres.2018.09.003. Epub 2018 Sep 11.
Gestational diabetes mellitus (GDM) is a worldwide public health problem. Few studies investigated the association of intra uterine exposure to GDM and long-term endocrine morbidity of offspring.
To assess whether in utero exposure to GDM increases the risk for long-term endocrine morbidity of the offspring.
A retrospective cohort study was conducted including all singleton born to women who delivered between 1988 and 2014. All births occurred in a tertiary medical center. Data were collected from the computerized perinatal database of the obstetrics and gynecology department and the computerized hospitalization database. The exposure variables were: diet-controlled GDM (GDMA1) and treated GDM (GDMA2). Multivariate generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders and for maternal clusters.
During the study period 231,271 deliveries met the inclusion criteria, of which 12,642 deliveries (5.4%) were diagnosed with GDM. During the follow-up period, children exposed in utero to GDM had a higher rate of long- term hospitalizations with diagnoses of endocrine morbidity (such as diabetes mellitus and obesity) compared to those unexposed. Using a GEE model, controlling for confounders such as maternal age, follow up-time, obesity and birthweight, in-utero exposure to GDMA1 (adjusted OR = 2.1; 95% CI 1.7-2.7; P < 0.001) and especially to GDMA2 (adjusted OR = 3.1; 95% CI 2.2-4.4, P < 0.001) were found as risk factors for long-term endocrine disease during childhood.
Exposure to GDM is a risk factor for long-term endocrine morbidity in the offspring.
妊娠糖尿病（GDM）是一个全球性的公共卫生问题。很少有研究调查宫内 GDM 暴露与后代长期内分泌疾病的关系。
评估宫内 GDM 暴露是否会增加后代长期内分泌疾病的风险。
本研究采用回顾性队列研究，纳入 1988 年至 2014 年期间所有单胎分娩的妇女所分娩的婴儿。所有分娩均发生在一家三级医疗中心。数据来自妇产科计算机围产数据库和计算机住院数据库。暴露变量为：饮食控制的 GDM（GDMA1）和治疗性 GDM（GDMA2）。采用多变量广义估计方程（GEE）逻辑回归模型分析来控制混杂因素和母亲的聚类。
在研究期间，共有 231271 例分娩符合纳入标准，其中 12642 例（5.4%）被诊断为 GDM。在随访期间，与未暴露的儿童相比，宫内暴露于 GDM 的儿童长期住院的诊断为内分泌疾病（如糖尿病和肥胖症）的发生率更高。使用 GEE 模型，在控制了混杂因素（如母亲年龄、随访时间、肥胖和出生体重）后，GDMA1 的宫内暴露（调整后的 OR=2.1；95%CI 1.7-2.7；P<0.001），特别是 GDMA2 的宫内暴露（调整后的 OR=3.1；95%CI 2.2-4.4，P<0.001），被认为是儿童期长期内分泌疾病的危险因素。
GDM 暴露是后代长期内分泌疾病的危险因素。
