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母亲患有糖尿病的晚期早产儿的生长模式。

Growth patterns among late preterm infants of mothers with diabetes.

机构信息

Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.

出版信息

J Matern Fetal Neonatal Med. 2022 Dec;35(25):10116-10123. doi: 10.1080/14767058.2022.2119125. Epub 2022 Sep 8.

DOI:10.1080/14767058.2022.2119125
PMID:36075588
Abstract

OBJECTIVE

Exposure to diabetes mellitus during pregnancy increases the risk of offspring obesity and cardiometabolic disease. Limited information exists regarding growth patterns among preterm infants exposed to maternal diabetes. This study describes growth differences during early childhood among late preterm infants of mothers with and without diabetes during pregnancy.

MATERIALS AND METHODS

In a retrospective longitudinal analysis, weight trajectories from birth to age 2 years were compared between diabetes exposure groups ( = 1554) using mixed effects modeling and adjusting for maternal and infant demographic covariates.

RESULTS

Overall, 134 (9%) infants were exposed to diabetes (DM-group). DM-group had higher average weight (adjusted difference 300 g [95% CI: 228, 371]) and weight -score (adjusted difference 0.67 standard deviation scores (SDS) [95% CI: 0.50, 0.84]) compared with unexposed infants. DM-group infants had accelerated weight gain from birth to discharge (adjusted weight difference 31.8 g [95% CI: 12.5, 51.1], adjusted weight -score difference 0.07 SDS [95% CI: 0.02, 0.11]) compared with unexposed infants, including in the first postnatal week (adjusted weight gain velocity difference, day 0-3: 6.07 g/day [95% CI: 0.88, 11.25]; day 3-7: 8.37 g/day [95% CI: 1.60, 15.13]). Through age two, infants in the DM-group maintained higher average weight (adjusted difference 185.7 g [95% CI: 37.2, 334.3]) and weight -score (adjusted difference 0.32 SDS [95% CI: 0.09, 0.55]) than unexposed infants, with greater weight gain between 18 and 24 months (adjusted difference 28.5 g/week [95% CI: 2.6, 54.4]).

CONCLUSIONS

Maternal diabetes exposed late preterm infants had higher weight from birth to age two and greater weight gain in the first postnatal week than unexposed infants. Long term risk associated with weight trajectories in this population requires further study.

摘要

目的

孕期暴露于糖尿病会增加后代肥胖和心脏代谢疾病的风险。关于患有糖尿病的母亲所生的早产儿的生长模式,目前相关信息有限。本研究描述了孕期患有和未患有糖尿病的母亲所生的晚期早产儿在幼儿早期的生长差异。

材料和方法

在回顾性纵向分析中,通过混合效应模型比较了糖尿病暴露组(n=1554)在出生至 2 岁期间的体重轨迹,并调整了母亲和婴儿人口统计学协变量。

结果

总体而言,有 134 名(9%)婴儿暴露于糖尿病(DM 组)。与未暴露组相比,DM 组的平均体重(调整后的差异为 300g[95%CI:228,371])和体重评分(调整后的差异为 0.67 个标准差评分(SDS)[95%CI:0.50,0.84])更高。与未暴露组相比,DM 组婴儿从出生到出院时的体重增长更快(调整后的体重差异为 31.8g[95%CI:12.5,51.1],调整后的体重评分差异为 0.07 SDS[95%CI:0.02,0.11]),包括在出生后的第一周(调整后的体重增加速度差异,第 0-3 天:6.07g/天[95%CI:0.88,11.25];第 3-7 天:8.37g/天[95%CI:1.60,15.13])。到 2 岁时,DM 组婴儿的平均体重(调整后的差异为 185.7g[95%CI:37.2,334.3])和体重评分(调整后的差异为 0.32 SDS[95%CI:0.09,0.55])仍高于未暴露组,18 至 24 个月期间体重增加更多(调整后的差异为 28.5g/周[95%CI:2.6,54.4])。

结论

患有糖尿病的母亲所生的晚期早产儿出生时体重较高,且出生后第一周体重增长更快,这与未暴露组相比。需要进一步研究该人群体重轨迹与长期风险的关系。

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