Satkunanathan Piraveena, Allard Catherine, Doyon Myriam, Perron Patrice, Bouchard Luigi, Hivert Marie-France, Peters Tricia M
Division of Experimental Medicine, McGill University, Montreal, Québec, Canada.
Centre for Clinical Epidemiology, Lady Davis Research Institute, Montreal, Québec, Canada.
BMC Pregnancy Childbirth. 2025 Jan 20;25(1):41. doi: 10.1186/s12884-025-07148-4.
Lower maternal insulin sensitivity during pregnancy is associated with greater fetal adiposity. Physical activity can improve insulin sensitivity, but it is not known if physical behaviours influence the known association of maternal insulin sensitivity with offspring adiposity. This study aimed to investigate the moderating impact of physical behaviours on this association.
Pregnant women (n = 812) from the Gen3G cohort were recruited during the first trimester of pregnancy and followed until delivery. At the first (V1) and second trimester (V2) hospital visits, Gen3G staff measured anthropometry, and participants reported sleep duration as well as leisure physical activity and sedentary behaviour via lifestyle questionnaires. We used plasma glucose and insulin values from the 75 g oral glucose tolerance test at V2 to calculate insulin sensitivity using the Matsuda index. We recorded birthweight from electronic medical records. Among a subset of neonates (n = 265), trained research staff measured skinfold thickness using a calibrated skinfold caliper following standardized protocols to estimate neonatal adiposity. Linear regression analyses assessed the association of insulin sensitivity with birthweight z-score and sum of neonatal skinfold thickness, adjusting for maternal age, race/ethnicity, gravidity, smoking, with and without adjustment for maternal body mass index at V1. We evaluated moderation by physical activity, sedentary behaviour, or nighttime sleep duration using interaction terms and stratified analyses for the association of maternal insulin sensitivity with offspring birthweight and with offspring adiposity.
Lower Matsuda index was associated with higher birthweight z-score (ß±SE= -0.180 ± 0.056, p = 0.001) and with higher sum of skinfold thickness (neonatal adiposity) (ß±SE=-0.877 ± 0.383, p = 0.02) in fully adjusted models. The association between Matsuda index and sum of skinfold thickness was weaker in women with higher levels of physical activity at V2 ([high ≥ 1.26 kcal/kg/day] ß±SE=-0.15 ± 0.65) compared to women with lower levels [low < 1.26 kcal/kg/day] ß±SE=-1.36 ± 0.51, P-interaction = 0.01). We also observed potential interactions of sleep and sedentary behaviour at V2 with Matsuda index for the association with birthweight z-score. We did not observe effect modification by levels of physical behaviours assessed at V1.
The association between lower insulin sensitivity and higher neonatal adiposity was attenuated in women with higher physical activity levels in the second trimester, independent of maternal body mass index.
孕期母亲胰岛素敏感性降低与胎儿肥胖程度增加有关。体育活动可改善胰岛素敏感性，但尚不清楚身体行为是否会影响母亲胰岛素敏感性与后代肥胖之间已知的关联。本研究旨在调查身体行为对这种关联的调节作用。
招募了来自Gen3G队列的孕妇（n = 812），在妊娠早期进行入组，并随访至分娩。在第一次（V1）和妊娠中期（V2）的医院就诊时，Gen3G工作人员测量人体测量学指标，参与者通过生活方式问卷报告睡眠时间、休闲体育活动和久坐行为。我们使用V2时75克口服葡萄糖耐量试验的血浆葡萄糖和胰岛素值，通过松田指数计算胰岛素敏感性。我们从电子病历中记录出生体重。在一部分新生儿（n = 265）中，训练有素的研究人员按照标准化方案，使用校准的皮褶厚度计测量皮褶厚度，以估计新生儿肥胖程度。线性回归分析评估胰岛素敏感性与出生体重z评分和新生儿皮褶厚度总和之间的关联，并对母亲年龄、种族/族裔、妊娠次数、吸烟情况进行调整，V1时调整或不调整母亲体重指数。我们使用交互项和分层分析评估体育活动、久坐行为或夜间睡眠时间对母亲胰岛素敏感性与后代出生体重及后代肥胖关联的调节作用。
在完全调整的模型中，较低的松田指数与较高的出生体重z评分（ß±SE = -0.180±0.056，p = 0.001）以及较高的皮褶厚度总和（新生儿肥胖）（ß±SE = -0.877±0.383，p = 0.02）相关。与V2时体育活动水平较低的女性相比，V2时体育活动水平较高的女性（[高≥1.26千卡/千克/天]ß±SE = -0.1±0.65），松田指数与皮褶厚度总和之间的关联较弱[低<1.26千卡/千克/天]ß±SE = -1.36±0.51，P交互作用 = 0.01）。我们还观察到V2时睡眠和久坐行为与松田指数在与出生体重z评分关联方面存在潜在交互作用。我们未观察到V1时评估的身体行为水平的效应修饰作用。
在妊娠中期体育活动水平较高的女性中，较低的胰岛素敏感性与较高的新生儿肥胖之间的关联减弱，且独立于母亲体重指数。
