Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
Eur J Endocrinol. 2021 Jan;184(1):51-64. doi: 10.1530/EJE-20-0296.
The incidence of gestational diabetes mellitus (GDM) has been on the rise, driven by maternal obesity. In parallel, pubertal tempo has increased in the general population, driven by childhood obesity.
To evaluate the available evidence on pubertal timing of boys and girls born to mothers with GDM.
We searched MEDLINE, EMBASE, CINAHL Plus, Cochrane library and grey literature for observational studies up to October 2019.
Two reviewers independently selected studies, collected data and appraised the studies for risk of bias. Results were tabulated and narratively described as reported in the primary studies.
Seven articles (six for girls and four for boys) were included. Study quality score was mostly moderate (ranging from 4 to 10 out of 11). In girls born to mothers with GDM, estimates suggest earlier timing of pubarche, thelarche and menarche although for each of these outcomes only one study each showed a statistically significant association. In boys, there was some association between maternal GDM and earlier pubarche, but inconsistency in the direction of shift of age at onset of genital and testicular development and first ejaculation. Only a single study analysed growth patterns in children of mothers with GDM, describing a 3-month advancement in the age of attainment of peak height velocity and a slight increase in pubertal tempo.
Pubertal timing may be influenced by the presence of maternal GDM, though current evidence is sparse and of limited quality. Prospective cohort studies should be conducted, ideally coupled with objective biochemical tests.
由于母亲肥胖，妊娠糖尿病（GDM）的发病率一直在上升。与此同时，由于儿童肥胖，普通人群的青春期提前。
评估 GDM 母亲所生孩子的青春期启动时间的现有证据。
我们检索了 MEDLINE、EMBASE、CINAHL Plus、 Cochrane 图书馆和灰色文献，以获取截至 2019 年 10 月的观察性研究。
两名审查员独立选择研究、收集数据并评估研究的偏倚风险。结果以原始研究报告的方式进行制表和叙述性描述。
共纳入 7 篇文章（6 篇针对女孩，4 篇针对男孩）。研究质量评分大多为中等（范围为 11 分中的 4 至 10 分）。在 GDM 母亲所生的女孩中，估计青春期启动时间更早，包括阴毛早现、乳房早现和月经初潮，但对于这些结果中的每一个，只有一项研究显示出统计学上的显著关联。对于男孩，母亲 GDM 与阴毛早现之间存在一定关联，但在生殖器和睾丸发育以及首次射精的起始年龄变化的方向上存在不一致。只有一项研究分析了 GDM 母亲所生孩子的生长模式，描述了身高生长速度峰值年龄提前 3 个月，青春期速度略有增加。
青春期启动时间可能受到母亲 GDM 的影响，尽管目前的证据有限且质量有限。应进行前瞻性队列研究，理想情况下结合客观的生化测试。
