SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Ann Hum Biol. 2021 Mar;48(2):81-92. doi: 10.1080/03014460.2021.1918245. Epub 2021 May 6.
Understanding the association between maternal metabolic conditions in pregnancy and the risk of childhood overweight, a growing concern in sub-Saharan Africa (SSA), helps to identify opportunities for childhood obesity prevention.
To assess the association between hyperglycaemia first detected in pregnancy (HFDP) (gestational diabetes mellitus [GDM] and diabetes in pregnancy [DIP]) and child obesity and adiposity in pre-school-aged children in South Africa, independently of maternal BMI.
Measurement of anthropometry and fat mass index (FMI) by the deuterium dilution method was done for 102 3-6-year-old children born to mothers with HFDP and 102 HFDP-unexposed children. Hierarchical regression analysis and generalised structural equation modelling (GSEM) were performed.
The prevalence of overweight/obesity was 10.5% and 11.1% in children exposed to GDM and DIP, respectively, and 3.9% in the HFDP-unexposed group. Log-transformed FMI was significantly higher in the DIP-exposed group ( = 0.166, 95% CI = 0.014-0.217 = .026), but not when adjusting for maternal pregnancy BMI ( = 0.226, 95% CI = 0.003-0.015, = .004). GSEM showed significant total effects of maternal BMI and birth weight on FMI/BMI.
Maternal pregnancy BMI seems to play a greater role in the development of childhood adiposity than maternal hyperglycaemia, requiring further research and identifying maternal BMI as a relevant prevention target in our setting.
了解妊娠期间母体代谢状况与儿童超重风险之间的关系，对于解决撒哈拉以南非洲（SSA）日益严重的儿童超重问题至关重要，这有助于确定儿童肥胖预防的机会。
评估妊娠期间首次发现的高血糖（HFDP）（妊娠期糖尿病[GDM]和妊娠糖尿病[DIP]）与南非学龄前儿童肥胖和肥胖症的相关性，该研究独立于母体 BMI。
对 102 名 3-6 岁儿童进行了人体测量学和脂肪量指数（FMI）的测量，这些儿童的母亲患有 HFDP，另外还招募了 102 名 HFDP 未暴露的儿童。进行了分层回归分析和广义结构方程模型（GSEM）分析。
超重/肥胖的患病率在 GDM 暴露组和 DIP 暴露组中分别为 10.5%和 11.1%，在 HFDP 未暴露组中为 3.9%。DIP 暴露组的 log 转化 FMI 显著更高（ = 0.166，95% CI = 0.014-0.217， = .026），但在校正母体妊娠 BMI 后无显著差异（ = 0.226，95% CI = 0.003-0.015， = .004）。GSEM 显示出母体 BMI 和出生体重对 FMI/BMI 的显著总效应。
妊娠期间母体 BMI 似乎比母体高血糖在儿童肥胖症的发展中起着更大的作用，这需要进一步的研究，并确定母体 BMI 为我们研究环境中的一个相关预防目标。
