Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China.
Fujian Medical University, Fuzhou, China.
Sci Rep. 2020 Jan 31;10(1):1549. doi: 10.1038/s41598-020-58423-7.
The growth trajectory of Chinese preschoolers still remains unclear. Our objective was to determine whether there was an association between adverse pregnancy outcomes and overweight offspring. We analyzed population-based retrospective cohort data from the Medical Birth Registry of Xiamen, which comprised 33,157 children examined from 1 to 6 years of age. Longitudinal analyses were used to evaluate the growth trajectories of offspring body mass index (BMI). Multivariate logistic regression was used to assess the effects of two adverse pregnancy outcomes, gestational diabetes mellitus (GDM) and being large-for-gestational age (LGA), on childhood overweight. Offspring of mothers with GDM and LGA has a higher annual BMI z-score from 1 to 6 years of age (all P < 0.05). But, a higher annual BMI z-score was only observed in children aged 1-5 years in models 1-3. Overall BMI z-score of offspring aged 1-6 who were born to mothers with GDM and LGA were also higher in models 1-3 (all P < 0.05). Additionally, offspring of mothers with GDM and LGA had a higher risk for overweight in model 1, from 1 to 6 years of age (odds ratio (OR), 1.814; 95% confidence interval (CI), 1.657-1.985; P < 0.0001). However, this association was attenuated after adjusting for maternal pre-pregnancy BMI (OR, 1.270; 95% CI, 0.961-1.679; P = 0.0930). Offspring of mothers with GDM and LGA had a higher BMI z-score and increased risk for overweight. Indeed, intrauterine exposure to maternal GDM and LGA could bias offspring to overweight, whereas maternal pre-pregnancy BMI may play a key role in offspring overweight for children born to mothers with GDM and LGA.
中国学龄前儿童的生长轨迹仍不清楚。我们的目的是确定不良妊娠结局与超重后代之间是否存在关联。我们分析了来自厦门医学出生登记处的基于人群的回顾性队列数据，该数据包括 33157 名 1 至 6 岁的儿童。使用纵向分析来评估后代体重指数（BMI）的生长轨迹。使用多变量逻辑回归评估两种不良妊娠结局，即妊娠糖尿病（GDM）和胎儿过大（LGA），对儿童超重的影响。患有 GDM 和 LGA 的母亲的后代在 1 至 6 岁时的 BMI 年龄别 z 评分每年都更高（均 P<0.05）。但是，在模型 1-3 中仅观察到 1-5 岁儿童的 BMI 年龄别 z 评分每年更高。在模型 1-3 中，患有 GDM 和 LGA 的母亲所生的 1-6 岁儿童的整体 BMI 年龄别 z 评分也更高（均 P<0.05）。此外，患有 GDM 和 LGA 的母亲的后代在模型 1 中，从 1 岁到 6 岁超重的风险更高（比值比（OR），1.814；95%置信区间（CI），1.657-1.985；P<0.0001）。但是，在调整了母亲的孕前 BMI 后，这种关联减弱了（OR，1.270；95%CI，0.961-1.679；P=0.0930）。患有 GDM 和 LGA 的母亲的后代的 BMI 年龄别 z 评分更高，超重的风险增加。实际上，子宫内暴露于母亲的 GDM 和 LGA 可能使后代偏向超重，而母亲的孕前 BMI 可能在患有 GDM 和 LGA 的母亲所生孩子的超重中起关键作用。
