Deepa Ravi, Lewis Melissa Glenda, Van Schayck Onno, Babu Giridhara R
Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Bengaluru, Karnataka, India.
Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Limburg, the Netherlands.
Diabetes Metab Syndr Obes. 2024 Sep 9;17:3365-3378. doi: 10.2147/DMSO.S458238. eCollection 2024.
To assess the association of adverse pregnancy and infant outcomes with different cut-off levels of glucose intolerance during pregnancy in the MAASTHI cohort.
Pregnant women (n = 1470) underwent Oral glucose tolerance test between 24 and 36 weeks using a 75-g oral glucose load, with plasma glucose estimations measured at fasting and two hours later. Follow-up was done within 72 hours of delivery for recording type of delivery, infant weight, mid-upper arm circumference, and skinfold thickness.
The odds of having higher skinfold thickness (>90th percentile) were 43% higher (AOR = 1.43; 95% CI: 1.18, 1.74) and the odds of being overweight at birth was 34% higher (AOR = 1.34; 95% CI: 1.09, 1.62) for every 1 standard deviation (9.9 mg/dL) increase in fasting plasma glucose (FPG) in male infants. The odds of delivering via caesarean section were 45% higher in women with female foetus (1.45,95% CI 1.15,1.82) for every one SD (23.4 mg/dl) increase in 2-h post-load Glucose.
The impact of maternal glucose levels on infant and maternal outcomes differed notably between sex of the child. Compared to female infants, male infants exhibited a stronger association with elevated risks for adverse outcomes, including higher infant weight and increased skinfold thickness.
在MAASTHI队列研究中,评估孕期不同糖耐量临界值与不良妊娠及婴儿结局之间的关联。
1470名孕妇在孕24至36周期间接受了口服葡萄糖耐量试验,口服75克葡萄糖,分别在空腹及两小时后测量血糖水平。在分娩后72小时内进行随访,记录分娩方式、婴儿体重、上臂中段周长和皮褶厚度。
男婴空腹血糖水平每增加1个标准差(9.9毫克/分升),皮褶厚度较高(>第90百分位数)的几率高43%(调整后比值比[AOR]=1.43;95%置信区间[CI]:1.18,1.74),出生时超重的几率高34%(AOR=1.34;95%CI:1.09,1.62)。对于怀有女胎的女性,服糖后2小时血糖每增加1个标准差(23.4毫克/分升),剖宫产的几率高45%(1.45,95%CI 1.15,1.82)。
母亲血糖水平对婴儿和母亲结局的影响在孩子性别之间存在显著差异。与女婴相比,男婴与不良结局风险升高的关联更强,包括更高的婴儿体重和增加的皮褶厚度。