Medical School, University of Western Australia, Perth, WA, Australia.
Nutrition Health Innovation Research Institute, Edith Cowan University, Perth, WA, Australia.
Int J Obes (Lond). 2022 Oct;46(10):1925-1935. doi: 10.1038/s41366-022-01203-2. Epub 2022 Aug 17.
There is now good evidence that events during gestation significantly influence the developmental well-being of an individual in later life. This study aimed to investigate the relationships between intrauterine growth trajectories determined by serial ultrasound and subsequent markers of adiposity and inflammation in the 27-year-old adult offspring from the Raine Study, an Australian longitudinal pregnancy cohort.
Ultrasound fetal biometric measurements including abdominal circumference (AC), femur length (FL), and head circumference (HC) from 1333 mother-fetal pairs (Gen1-Gen2) in the Raine Study were used to develop fetal growth trajectories using group-based trajectory modeling. Linear mixed modeling investigated the relationship between adult body mass index (BMI), waist circumference (WC), and high-sensitivity C-reactive protein (hs-CRP) of Gen2 at 20 (n = 485), 22 (n = 421) and 27 (n = 437) years and the fetal growth trajectory groups, adjusting for age, sex, adult lifestyle factors, and maternal factors during pregnancy.
Seven AC, five FL and five HC growth trajectory groups were identified. Compared to the average-stable (reference) group, a lower adult BMI was observed in two falling AC trajectories: (β = -1.45 kg/m, 95% CI: -2.43 to -0.46, P = 0.004) and (β = -1.01 kg/m, 95% CI: -1.96 to -0.05, P = 0.038). Conversely, higher adult BMI (2.58 kg/m, 95% CI: 0.98 to 4.18, P = 0.002) and hs-CRP (37%, 95% CI: 9-73%, P = 0.008) were observed in a rising FL trajectory compared to the reference group. A high-stable HC trajectory associated with 20% lower adult hs-CRP (95% CI: 5-33%, P = 0.011).
This study highlights the importance of understanding causes of the unique patterns of intrauterine growth. Different fetal growth trajectories from early pregnancy associate with subsequent adult adiposity and inflammation, which predispose to the risk of diabetes and cardiometabolic disease.
有充分证据表明，妊娠期间的事件会显著影响个体日后的发育健康。本研究旨在探讨基于超声的宫内生长轨迹与澳大利亚纵向妊娠队列 Raine 研究中 27 岁成年后代的肥胖和炎症标志物之间的关系。
使用 Raine 研究中 1333 对母婴对（Gen1-Gen2）的胎儿超声生物测量值，包括腹围（AC）、股骨长（FL）和头围（HC），采用基于群组的轨迹建模来建立胎儿生长轨迹。线性混合模型研究了 Gen2 时 20 岁（n=485）、22 岁（n=421）和 27 岁（n=437）时成年体重指数（BMI）、腰围（WC）和高敏 C 反应蛋白（hs-CRP）与胎儿生长轨迹组之间的关系，调整了年龄、性别、成年生活方式因素和妊娠期间的母亲因素。
确定了七个 AC、五个 FL 和五个 HC 生长轨迹组。与平均稳定（参考）组相比，两个下降的 AC 轨迹中观察到成年 BMI 较低：（β=-1.45kg/m，95%CI：-2.43 至-0.46，P=0.004）和（β=-1.01kg/m，95%CI：-1.96 至-0.05，P=0.038）。相反，与参考组相比，上升的 FL 轨迹中观察到较高的成年 BMI（2.58kg/m，95%CI：0.98 至 4.18，P=0.002）和 hs-CRP（37%，95%CI：9-73%，P=0.008）。高稳定的 HC 轨迹与成年 hs-CRP 降低 20%相关（95%CI：5-33%，P=0.011）。
本研究强调了了解导致宫内生长独特模式的原因的重要性。不同的胎儿生长轨迹与日后的肥胖和炎症有关，这增加了患糖尿病和代谢性心血管疾病的风险。
