Longmore Danielle K, Barr Elizabeth L M, Lee I-Lynn, Barzi Federica, Kirkwood Marie, Whitbread Cherie, Hampton Vanya, Graham Sian, Van Dokkum Paula, Connors Christine, Boyle Jacqueline A, Catalano Patrick, Brown Alex D H, O'Dea Kerin, Oats Jeremy, McIntyre H David, Shaw Jonathan E, Maple-Brown Louise J
Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia.
Department of Paediatrics, Western Health, Melbourne, Australia.
Pediatr Obes. 2019 Apr;14(4):e12490. doi: 10.1111/ijpo.12490. Epub 2019 Jan 16.
In-utero exposures likely influence the onset and severity of obesity in youth. With increasing rates of type 2 diabetes mellitus (T2DM) and maternal adiposity in pregnancy globally, it is important to assess the impact of these factors on neonatal adipose measures.
To evaluate the contribution of maternal ethnicity, body mass index (BMI), gestational weight gain, and hyperglycaemia to neonatal adiposity.
Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) is a longitudinal cohort study of Australian mother and neonate pairs. In this analysis, Indigenous (n = 519) and Europid (n = 358) women were included, of whom 644 had hyperglycaemia (type 2 diabetes [T2DM], diabetes in pregnancy [DIP], or gestational diabetes [GDM]). Associations between maternal ethnicity, hyperglycaemia, BMI and gestational weight gain, and the neonatal outcomes of length, head circumference, sum of skinfolds, total body fat, and percentage body fat were examined. Models were adjusted for maternal age, smoking status, parity, education, neonatal gender, and gestational age.
Among those with hyperglycaemia in pregnancy, Indigenous women had a higher proportion of T2DM and DIP (36%, 13%) compared with Europid women (4%, 3%). In multivariate analysis, maternal T2DM (compared with no hyperglycaemia), BMI during pregnancy, and excess compared with appropriate gestational weight gain, were significantly associated with greater neonatal measures. DIP was associated with greater sum of skinfolds, total body fat, and percentage body fat. Indigenous ethnicity was associated with greater sum of skinfolds.
Maternal BMI, excess gestational weight gain, and hyperglycaemia operated as independent factors influencing neonatal adiposity. Interventions addressing these factors are needed to reduce neonatal adiposity.
子宫内暴露可能影响青少年肥胖症的发病及严重程度。鉴于全球2型糖尿病（T2DM）发病率及孕期母亲肥胖率不断上升，评估这些因素对新生儿脂肪测量指标的影响十分重要。
评估母亲种族、体重指数（BMI）、孕期体重增加及高血糖对新生儿肥胖的影响。
澳大利亚偏远地区妊娠与新生儿糖尿病结局（PANDORA）研究是一项针对澳大利亚母婴对的纵向队列研究。本分析纳入了519名原住民和358名欧洲裔女性，其中644名患有高血糖（2型糖尿病 [T2DM]、妊娠期糖尿病 [DIP] 或妊娠糖尿病 [GDM]）。研究了母亲种族、高血糖、BMI和孕期体重增加与新生儿身长、头围、皮褶厚度总和、全身脂肪及体脂百分比等结局之间的关联。模型对母亲年龄、吸烟状况、产次、教育程度、新生儿性别及孕周进行了校正。
在孕期患有高血糖的人群中，与欧洲裔女性（4%，3%）相比，原住民女性的T2DM和DIP比例更高（分别为36%，13%）。多变量分析显示，母亲患T2DM（与无高血糖相比）、孕期BMI以及与适当孕期体重增加相比的体重增加过多，均与更大的新生儿测量指标显著相关。DIP与更大的皮褶厚度总和、全身脂肪及体脂百分比相关。原住民种族与更大的皮褶厚度总和相关。
母亲BMI、孕期体重增加过多及高血糖是影响新生儿肥胖的独立因素。需要针对这些因素进行干预以降低新生儿肥胖。
