Department of population medicine, College of medicine, QU Health, Qatar University, Doha, Qatar.
Division of Nursing and Midwifery, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
PLoS One. 2021 Oct 21;16(10):e0258894. doi: 10.1371/journal.pone.0258894. eCollection 2021.
Little is known about the influence of hyperglycemia first detected in pregnancy (HFDP) on weight outcomes in exposed offspring in Africa. We investigated the influence of maternal blood glucose concentrations during pregnancy on offspring weight outcomes at birth and preschool age, in offspring exposed to HFDP, in South Africa.
Women diagnosed with HFDP had data routinely collected during the pregnancy and at delivery, at a referral hospital, and the offspring followed up at preschool age. Maternal fasting, oral glucose tolerance test 1 and 2-hour blood glucose were measured at diagnosis of HFDP and 2-hour postprandial blood glucose during the third trimester. Offspring were classified as either those exposed to diabetes first recognized in pregnancy (DIP) or gestational diabetes (GDM). At birth, neonates were classified into macrosomia, low birth weight (LBW), large for gestational age (LGA), appropriate (AGA) and small for gestational age (SGA)groups. At preschool age, offspring had height and weight measured and Z-scores for weight, height and BMI calculated.
Four hundred and forty-three neonates were included in the study at birth, with 165 exposed to DIP and 278 exposed to GDM. At birth, the prevalence of LGA, macrosomia and LBW were 29.6%, 12.2% and 7.5%, respectively, with a higher prevalence of LGA and macrosomia in neonates exposed to DIP. At pre-school age, the combined prevalence of overweight and obesity was 26.5%. Maternal third trimester 2-hour postprandial blood glucose was significantly associated with z-scores for weight at birth and preschool age, and both SGA and LGA at birth.
In offspring exposed to HFDP, there is a high prevalence of LGA and macrosomia at birth, and overweight and obesity at preschool age, with higher prevalence in those exposed to DIP, compared to GDM. Maternal blood glucose control during the pregnancy influences offspring weight at birth and preschool age.
在非洲，人们对妊娠期间首次发现的高血糖（HFDP）对暴露后代的体重结果的影响知之甚少。我们研究了南非 HFDP 暴露的母亲在怀孕期间的血糖浓度对后代出生时和学龄前体重结果的影响。
在转诊医院，被诊断为 HFDP 的女性在怀孕期间和分娩时常规收集数据，并在学龄前对后代进行随访。在诊断 HFDP 时和妊娠晚期测量空腹、口服葡萄糖耐量试验 1 小时和 2 小时血糖，以及餐后 2 小时血糖。将后代分为糖尿病首次诊断为妊娠（DIP）或妊娠期糖尿病（GDM）的暴露者。出生时，新生儿分为巨大儿、低出生体重（LBW）、大于胎龄儿（LGA）、适当（AGA）和小于胎龄儿（SGA）。在学龄前，测量了后代的身高和体重，并计算了体重、身高和 BMI 的 Z 分数。
在出生时，共有 443 名新生儿纳入研究，其中 165 名暴露于 DIP，278 名暴露于 GDM。出生时，LGA、巨大儿和 LBW 的患病率分别为 29.6%、12.2%和 7.5%，DIP 暴露的新生儿 LGA 和巨大儿的患病率更高。在学龄前，超重和肥胖的综合患病率为 26.5%。母亲妊娠晚期餐后 2 小时血糖与出生和学龄前体重 Z 分数显著相关，与出生时的 SGA 和 LGA 也显著相关。
在 HFDP 暴露的后代中，出生时 LGA 和巨大儿的患病率较高，学龄前超重和肥胖的患病率也较高，与 GDM 相比，DIP 暴露的后代患病率更高。孕期血糖控制会影响后代出生时和学龄前的体重。
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