Yuan Zhichao, Su Tao, Yang Li, Xi Lei, Wang Hai-Jun, Ji Yuelong
Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China.
Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing 101101, China.
Nutrients. 2025 Jan 11;17(2):257. doi: 10.3390/nu17020257.
BACKGROUND/OBJECTIVES: This study investigates the impact of maternal glycemic levels during early and late pregnancy on offspring neurodevelopment in China.
Fasting plasma glucose (FPG) and triglyceride (TG) levels were measured in maternal blood during pregnancy, and the TyG index was calculated to assess insulin resistance. Hyperglycemia was defined as FPG > 5.1 mmol/L. Neurodevelopmental outcomes in offspring aged 6-36 months were evaluated using the China Developmental Scale for Children, focusing on developmental delay (DD) and developmental quotient (DQ). Mothers were categorized into four glycemic groups: healthy glycemia group (HGG), early pregnancy hyperglycemia group (EHG), late pregnancy hyperglycemia group (LHG), and full-term hyperglycemia group (FHG). Linear and logistic regression models were applied.
Among 1888 mother-child pairs, hyperglycemia and FPG were associated with an increased risk of overall DD (aOR = 1.68; 95% CI 1.07-2.64) and lower DQ (aBeta = -1.53; 95% CI -2.70 to -0.36). Elevated FPG was linked to DD in fine motor and social behaviors. Compared to HGG, LHG and FHG significantly increased the risk of overall DD (aOR = 2.18; 95% CI 1.26-3.77; aOR = 2.64; 95% CI 1.38-5.05), whereas EHG did not. Male offspring were particularly vulnerable to early pregnancy hyperglycemia (aBeta = -2.80; 95% CI -4.36 to -1.34; aOR = 2.05; 95% CI 1.10-3.80).
Maternal glycemic levels during pregnancy influence offspring neurodevelopment, with persistent hyperglycemia significantly increasing DD risk. Early pregnancy hyperglycemia particularly affects male offspring, underscoring the need for glycemic management during pregnancy.
背景/目的：本研究调查了中国孕期早期和晚期孕妇血糖水平对后代神经发育的影响。
在孕期测量孕妇血液中的空腹血糖（FPG）和甘油三酯（TG）水平，并计算TyG指数以评估胰岛素抵抗。高血糖定义为FPG>5.1 mmol/L。使用中国儿童发育量表评估6至36个月龄后代的神经发育结局，重点关注发育迟缓（DD）和发育商（DQ）。母亲被分为四个血糖组：血糖正常组（HGG）、孕早期高血糖组（EHG）、孕晚期高血糖组（LHG）和足月高血糖组（FHG）。应用线性和逻辑回归模型。
在1888对母婴中，高血糖和FPG与总体DD风险增加（调整后比值比[aOR]=1.68；95%置信区间[CI]1.07-2.64）和较低的DQ（调整后β=-1.53；95%CI -2.70至-0.36）相关。FPG升高与精细运动和社交行为方面的DD有关。与HGG相比，LHG和FHG显著增加了总体DD的风险（aOR=2.18；95%CI 1.26-3.77；aOR=2.64；95%CI 1.38-5.05），而EHG则没有。男性后代尤其易受孕早期高血糖的影响（调整后β=-2.80；95%CI -4.36至-1.34；aOR=2.05；95%CI 1.10-3.80）。
孕期母亲血糖水平影响后代神经发育，持续性高血糖会显著增加DD风险。孕早期高血糖尤其影响男性后代，强调孕期血糖管理的必要性。
