Akinola Ibironke J, Ubuane Peter O, Dada Adeyemi O, Chionuma Joy O, Kuku-Kuye Taiwo O, Olalere Folasade D
Department of Paediatrics and Child Health, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Lagos, Nigeria.
Department of Paediatrics, Lagos State University Teaching Hospital, Lagos, Nigeria.
Ann Pediatr Endocrinol Metab. 2024 Feb;29(1):19-28. doi: 10.6065/apem.2346136.068. Epub 2024 Feb 29.
We prospectively evaluated the association of the insulin resistance of third-trimester Nigerian pregnant women with their newborn infants' insulin resistance and birth size. Pregnancy-associated insulin resistance (IR), often assessed with homeostatic model assessment of IR (HOMA-IR), is associated, especially among women with gestational diabetes (GDM), with abnormal neonatal birth size and body composition, predisposing the baby to metabolic disorders like diabetes and obesity. The associations of maternal IR with neonatal IR, birth size and body composition are less studied in nondiabetic pregnant women, especially in sub-Saharan settings like Nigeria.
We originally recruited 401 third trimester, nondiabetic pregnant women to a prospective cohort study, followed up until birth. Blood samples of mothers and babies were obtained, respectively, at recruitment and within 24 hours postbirth for fasting serum glucose (FSG) and insulin (FSI) assays, and HOMA-IR was calculated as [(FSI × FSG)/22.5)].
Complete data for 150 mother-baby dyads was analysed: the mothers, with a mean (standard deviation [SD]) age of 31.6 (4.5) years, had live births at a mean (SD) gestational age of 39.2 weeks. The proportions of infants with wasting, stunting, impaired fetal growth (either wasting or stunted), small-for-gestation-age, large-for-gestational-age, low birthweight, and macrosomia were 4.2% (95% confidence interval, 1.1-10.3), 19.7% (12.9-28.0), 23.1% (15.8-31.8), 10.1% (5.3-17.0), 12.6% (7.2-19.9), 0.8% (0.02-4.5), and 5.0% (1.8-10.5), respectively. Maternal HOMA-IR was not associated with neonatal HOMA-IR (p=0.837), birth weight (p=0.416) or body composition measured with weight-length ratio (p=0.524), but birth weight was independently predicted by maternal weight (p=0.006), body mass index (p=0.001), and parity (p=0.012).
In this nondiabetic/non-GDM cohort, maternal HOMA-IR was not associated with neonatal IR, body size or body composition. Larger studies are required to confirm these findings, with addi-tional inclusion of mothers with hyperglycaemia for comparison.
我们前瞻性地评估了尼日利亚孕晚期孕妇的胰岛素抵抗与其新生儿胰岛素抵抗及出生体重之间的关联。妊娠相关胰岛素抵抗（IR）通常采用胰岛素抵抗稳态模型评估（HOMA-IR）来评估，尤其在患有妊娠期糖尿病（GDM）的女性中，它与新生儿出生体重异常和身体组成有关，使婴儿易患糖尿病和肥胖等代谢紊乱疾病。在非糖尿病孕妇中，尤其是在尼日利亚这样的撒哈拉以南地区，母体IR与新生儿IR、出生体重和身体组成之间的关联研究较少。
我们最初招募了401名孕晚期非糖尿病孕妇进行前瞻性队列研究，随访至分娩。分别在招募时和出生后24小时内采集母亲和婴儿的血样，用于检测空腹血清葡萄糖（FSG）和胰岛素（FSI），并计算HOMA-IR为[（FSI×FSG）/22.5]。
分析了150对母婴的完整数据：母亲的平均（标准差[SD]）年龄为31.6（4.5）岁，平均（SD）孕周为39.2周时分娩。消瘦、发育迟缓、胎儿生长受限（消瘦或发育迟缓）、小于胎龄儿、大于胎龄儿、低出生体重和巨大儿的婴儿比例分别为4.2%（95%置信区间，1.1-10.3）、19.
