General Practice Research Unit (AFE), Department of General Practice, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
Akershus University Hospital, Lørenskog, Norway.
Acta Paediatr. 2021 Apr;110(4):1239-1248. doi: 10.1111/apa.15637. Epub 2020 Nov 4.
Independent effects of gestational diabetes (GDM), maternal prepregnant obesity and gestational weight gain on offspring BMI and obesity are scarcely documented. We examined associations between GDM and children's BMI trajectories from birth to 4-5 years age, and effects of prepregnant obesity and gestational weight gain not mediated through GDM.
We included 734 children from a population-based, multi-ethnic cohort of women and their offspring followed from early pregnancy. All women were screened for GDM. Using linear mixed models, we explored associations between maternal factors and children's BMI development through seven serial measurements.
At birth and age 4-5 years, BMI of children exposed to GDM was similar to those not exposed. However, they had slower BMI growth (B = -0.1 BMI units/month (95% CI: -0.17, -0.04)) during first 6 months, and faster BMI growth from 6 months to 4-5 years. Maternal prepregnant obesity was associated with higher child BMI at birth, and thereafter persistently higher BMI. High gestational weight gain was associated with faster BMI growth from 6 months to 4-5 years.
Effects of maternal GDM, prepregnant obesity, and gestational weight gain on children's BMI and BMI trajectories from birth to preschool age differed in relation to effect size, timing and direction.
妊娠糖尿病（GDM）、孕妇孕前肥胖和孕期体重增加对后代体重指数（BMI）和肥胖的独立影响鲜有文献记载。我们研究了 GDM 与儿童从出生到 4-5 岁期间 BMI 轨迹之间的关联，以及不通过 GDM 介导的孕前肥胖和孕期体重增加的影响。
我们纳入了一个基于人群的、多民族的孕妇及其后代队列的 734 名儿童。所有女性均接受 GDM 筛查。使用线性混合模型，我们通过 7 次连续测量来探讨母体因素与儿童 BMI 发育之间的关系。
在出生和 4-5 岁时，暴露于 GDM 的儿童的 BMI 与未暴露于 GDM 的儿童相似。然而，他们在出生后前 6 个月的 BMI 增长较慢（B= -0.1 BMI 单位/月（95%CI：-0.17，-0.04）），而在 6 个月至 4-5 岁之间的 BMI 增长较快。母亲孕前肥胖与儿童出生时的 BMI 较高有关，此后 BMI 一直较高。高孕期体重增加与从 6 个月到 4-5 岁期间的 BMI 增长较快有关。
母体 GDM、孕前肥胖和孕期体重增加对儿童从出生到学龄前 BMI 和 BMI 轨迹的影响在效应大小、时间和方向上存在差异。
