Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Curr Med Sci. 2022 Jun;42(3):520-529. doi: 10.1007/s11596-022-2547-y. Epub 2022 Apr 29.
Gestational diabetes mellitus (GDM) and gestational weight gain (GWG) are important risk factors that are known to affect offspring growth, but these outcomes are inconsistent and it remains unknown if both risk factors have a synergetic effect on early childhood growth. The present study aimed to conduct offspring body mass index-for-age Z-scores (BMIZ) trajectories and to evaluate the independent and interactive effect of the status of GDM and excessive GWG on the risks of overweight/obesity from birth to 24 months of age.
A total of 7949 mother-child pairs were enrolled in this study. The weight and length of children were measured at birth, 6, 12, and 24 months of age to calculate BMIZ.
The status of GDM was positively associated with offspring BMIZ and risk of macrosomia at birth but was not associated with offspring BMIZ or the risks of overweight/obesity at 6, 12, and 24 months of age. In contrast, excessive GWG was positively linked to offspring BMIZ, the stable high BMIZ trajectory pattern, and risks of overweight/obesity in the first 24 months of age. These two risk factors also had a significant synergistic effect on macrosomia at birth, but the interactive effect was only significant in boys during the follow-up years in the sex-stratified analyses.
The maternal GWG was a more pronounced predictor than GDM with relation to BMIZ and risk of overweight/obesity in early childhood. The interactive effect between these risk factors on offspring overweight/obesity may vary by sex.
妊娠期糖尿病（GDM）和妊娠体重增加（GWG）是已知的影响后代生长的重要危险因素，但这些结果并不一致，目前尚不清楚这两个危险因素是否对儿童早期生长有协同作用。本研究旨在对后代体重指数-年龄 Z 评分（BMIZ）轨迹进行分析，并评估 GDM 状态和 GWG 过度对从出生到 24 个月龄超重/肥胖风险的独立和交互作用。
本研究共纳入 7949 对母婴对子。在出生、6、12 和 24 个月时测量儿童的体重和长度，以计算 BMIZ。
GDM 状态与后代 BMIZ 和出生时巨大儿的风险呈正相关，但与后代 6、12 和 24 个月时的 BMIZ 或超重/肥胖风险无关。相比之下，GWG 过度与后代 BMIZ、稳定的高 BMIZ 轨迹模式以及出生后 24 个月内的超重/肥胖风险呈正相关。这两个危险因素对出生时巨大儿也有显著的协同作用，但在性别分层分析中，仅在随访期间男孩中存在交互作用。
与 GDM 相比，GWG 与 BMIZ 和儿童早期超重/肥胖的风险关系更为显著。这些危险因素对后代超重/肥胖的交互作用可能因性别而异。
