Endocr Pract. 2020 Jun 2;26(6):619-626. doi: 10.4158/EP-2019-0415. Epub 2020 Feb 11.
Using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria to diagnose gestational diabetes mellitus (GDM), the association between GDM and offspring body mass index (BMI) gains in early childhood in China remains unclear. We aimed to assess the association between GDM diagnosed by the IADPSG criteria and BMI gain and the risk for overweight/obesity in offspring from 1 to 4 years. This prospective cohort study was based on the healthcare records data from the Medical Birth Registry in Xiamen, China. We included 10,412 mother-child pairs tested for GDM using IADPSG criteria. A total of 1,786 (17.2%) offspring were exposed to GDM. The offspring exposed to GDM had higher mean BMI Z-score (difference, 0.07; 95% confidence interval [CI], 0.02 to 0.12) and risk for overweight/obesity (odds ratio [OR], 1.22; 95% CI, 1.06 to 1.40) compared to those unexposed to GDM from 1 to 4 years of age. However, after adjustment for maternal pre-pregnancy BMI (Model 2), these associations attenuated towards the null (difference in BMI Z-score, 0.02; 95% CI, -0.03 to 0.07; OR for overweight/obesity, 1.09; 95% CI, 0.95 to 1.25). The associations between GDM diagnosed using IADPSG criteria and BMI Z-score and the risk for overweight/obesity in offspring at the age of 1 to 4 years were largely explained by maternal pre-pregnancy BMI. Reducing the prevalence of childhood overweight and obesity in China should focus on maternal weight status before pregnancy, in addition to glycemia during pregnancy. = body mass index; = confidence interval; = gestational diabetes mellitus; = International Association of Diabetes and Pregnancy Study Groups; = large for gestational age; = Medical Birth Registry in Xiamen; = oral glucose tolerance test; = odds ratio.
采用国际妊娠合并糖尿病研究组织（IADPSG）标准诊断妊娠期糖尿病（GDM），但在中国，GDM 与儿童早期体质量指数（BMI）增长之间的关系尚不清楚。我们旨在评估根据 IADPSG 标准诊断的 GDM 与 1 至 4 岁后代 BMI 增长和超重/肥胖风险之间的关系。本前瞻性队列研究基于中国厦门医疗生育登记数据库中的医疗记录数据。我们纳入了 10412 例采用 IADPSG 标准检测 GDM 的母婴对子。共有 1786 例（17.2%）后代暴露于 GDM。与未暴露于 GDM 的后代相比，暴露于 GDM 的后代的平均 BMI Z 评分更高（差值，0.07；95%置信区间[CI]，0.02 至 0.12），超重/肥胖的风险更高（比值比[OR]，1.22；95% CI，1.06 至 1.40）。然而，在校正了母亲孕前 BMI（模型 2）后，这些关联趋近于零（BMI Z 评分差值，0.02；95% CI，-0.03 至 0.07；OR 超重/肥胖，1.09；95% CI，0.95 至 1.25）。采用 IADPSG 标准诊断的 GDM 与后代 1 至 4 岁时 BMI Z 评分和超重/肥胖风险之间的关联，在很大程度上可由母亲孕前 BMI 解释。在中国，要降低儿童超重和肥胖的发生率，除了妊娠期间的血糖水平外，还应关注孕前的母亲体重状况。
