Fan S Q, Yan S Q, Zhu X Z, Li J, Tong C G, Li H, Cao X Y, Wu L L, Xie Z L, Wei F B, Tao Fangbiao
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China.
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/Key Laboratory of Population Health Across Life Cycle, Ministry of Education/Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission, Hefei 230032, China Maternal and Child Health Care Center of Ma'anshan, Ma'anshan 243000, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Oct 10;43(10):1626-1631. doi: 10.3760/cma.j.cn112338-20220429-00364.
To examine the independent and combined effects of pre-pregnancy BMI and gestational diabetes (GDM) on early adiposity rebound (AR) timing in children. Based on the "Ma'anshan Birth Cohort Study", 2 896 eligible maternal and infant pairs were recruited. In the cohort, we collected pre-pregnancy height, weight, 24 to 28 weeks GDM diagnosis, follow-up at 42 days, three months, six months, nine months of age, and every six months after one year of age, and continuously followed up to 6 years old, and obtained the child's length/height, weight, and other data. The intensity of the association between pre-pregnancy BMI, GDM, and early AR timing was analyzed by the multivariate logistic regression model. Multiplication and additive models were used to analyze how pre-pregnancy BMI and GDM influenced early AR timing in children. The prevalence of underweight, average weight, overweight, and obesity before pregnancy were 23.2% (672), 66.4% (1 923), 8.7% (251), and 1.7% (50). The prevalence of GDM was 12.4%. We found that 39.3% of children had AR, and the average age at AR was (4.38±1.08). The results of multifactorial logistic regression analysis showed that pre-pregnancy overweight (=1.67,95%:1.27-2.19), pre-pregnancy obesity (=3.05,95%:1.66-5.56), and maternal GDM (=1.40,95%:1.11-1.76) were risk factors for early AR timing in children. In contrast, pre-pregnancy underweight (=0.60,95%:0.49-0.73) was a protective factor for early AR timing in children. Compared with the different effects of pre-pregnancy overweight/obesity and maternal GDM alone, the combined effect caused a higher risk of early AR timing in children, with values (95%) were 2.03 (1.20-3.44), 3.43 (1.06-11.12), respectively. The multiplication and additive models showed no interaction between pre-pregnancy BMI and GDM-influenced early AR timing in children. Higher pre-pregnancy BMI and maternal GDM are the independent risk factors for the early AR timing in children, and the co-occurrence of the two is higher risks, but there was no statistical interaction.
探讨孕前体重指数(BMI)和妊娠期糖尿病(GDM)对儿童早期肥胖反弹(AR)时间的独立及联合影响。基于“马鞍山出生队列研究”,招募了2896对符合条件的母婴。在该队列中,我们收集了孕前身高、体重、孕24至28周时的GDM诊断情况、出生后42天、3个月、6个月、9个月以及1岁后每6个月的随访数据,并持续随访至6岁,获取了儿童的身长/身高、体重等数据。采用多因素逻辑回归模型分析孕前BMI、GDM与早期AR时间之间的关联强度。运用相乘模型和相加模型分析孕前BMI和GDM如何影响儿童早期AR时间。孕前体重过轻、体重正常、超重和肥胖的患病率分别为23.2%(672例)、66.4%(1923例)、8.7%(251例)和1.7%(50例)。GDM的患病率为12.4%。我们发现39.3%的儿童出现了AR,AR的平均年龄为(4.38±1.08)岁。多因素逻辑回归分析结果显示,孕前超重(比值比=1.67,95%置信区间:1.27 - 2.19)、孕前肥胖(比值比=3.05,95%置信区间:1.66 - 5.56)以及母亲患GDM(比值比=1.40,95%置信区间:1.11 - 1.76)是儿童早期AR时间的危险因素。相比之下,孕前体重过轻(比值比=0.60,95%置信区间:0.49 - 0.73)是儿童早期AR时间的保护因素。与孕前超重/肥胖和母亲患GDM单独产生的不同影响相比,两者共同作用会使儿童早期AR时间的风险更高,相乘模型和相加模型的风险值(95%置信区间)分别为2.03(1.20 - 3.44)、3.43(1.06 - 11.12)。相乘模型和相加模型显示,孕前BMI和GDM对儿童早期AR时间的影响之间不存在交互作用。较高的孕前BMI和母亲患GDM是儿童早期AR时间的独立危险因素,两者同时存在时风险更高,但不存在统计学交互作用。