Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan.
Department of Respiratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan.
Diabetes Care. 2024 Nov 1;47(11):1941-1948. doi: 10.2337/dc24-0865.
Gestational diabetes mellitus (GDM) is known to be associated with certain respiratory impairments in offspring. However, the specific association between maternal GDM and childhood lung function remains unclear. We examined the association of maternal glycemia, as measured by oral glucose tolerance test (OGTT) values, with childhood lung function outcomes in a birth cohort.
A follow-up study was conducted with 889 children aged 6 years whose mothers underwent a 75-g OGTT between 24 and 28 weeks of gestation. After adjusting for prenatal and postnatal factors, multivariable regression models were used to evaluate the relationship between maternal glycemia and offspring lung function.
In total, 10.7% of the offspring were exposed to maternal GDM. Maternal GDM significantly reduced the z score of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and forced expiratory flow at 25-75% of FVC in children, with more pronounced effects in female offspring. Maternal 1- and 2-h post-OGTT glucose z scores and the sum of those z scores, but not those for fasting glucose, were inversely associated with several measures of children's lung function. Additionally, maternal GDM increased the risk of impaired lung function in children (odds ratio 2.64; 95% CI, 1.10-5.85), defined as an FVC <85% of the predicted value. There were no significant associations with FEV1/FVC.
Maternal hyperglycemia was negatively associated with lung function in children, particularly among girls. Further studies are warranted to elucidate the underlying mechanisms of this association and to explore potential interventions to mitigate its effects.
已知妊娠期糖尿病（GDM）与后代某些呼吸损伤有关。然而，母体 GDM 与儿童肺功能之间的具体关联尚不清楚。我们在一个出生队列中检查了母体血糖，通过口服葡萄糖耐量试验（OGTT）值，与儿童肺功能结果的关系。
对 889 名 6 岁儿童进行了一项随访研究，这些儿童的母亲在妊娠 24-28 周期间进行了 75g OGTT。在调整了产前和产后因素后，使用多变量回归模型来评估母体血糖与后代肺功能之间的关系。
共有 10.7%的后代暴露于母体 GDM。母体 GDM 显著降低了儿童的 1 秒用力呼气量（FEV1）、用力肺活量（FVC）和 25-75%用力呼气流量的 z 评分，对女性后代的影响更为明显。母亲 OGTT 后 1 小时和 2 小时的血糖 z 评分以及这些 z 评分的总和，而不是空腹血糖 z 评分，与儿童肺功能的几个指标呈负相关。此外，母体 GDM 增加了儿童肺功能受损的风险（比值比 2.64；95%置信区间，1.10-5.85），定义为 FVC<85%的预测值。FEV1/FVC 与无显著关联。
母体高血糖与儿童肺功能呈负相关，尤其是在女孩中。需要进一步的研究来阐明这种关联的潜在机制，并探索潜在的干预措施来减轻其影响。
