Shinohara Satoshi, Kojima Reiji, Otawa Sanae, Kushima Megumi, Miyake Kunio, Yui Hideki, Ooka Tadao, Horiuchi Sayaka, Yokomichi Hiroshi, Yamagata Zentaro, Shinohara Ryoji
Department of Obstetrics and Gynecology, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi 400-8506 Japan.
Department of Epidemiology and Environmental Medicine, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi Japan.
J Diabetes Metab Disord. 2025 Feb 1;24(1):61. doi: 10.1007/s40200-025-01568-x. eCollection 2025 Jun.
To clarify the relationship between maternal 50-g glucose challenge test (GCT) results and neurodevelopment in 3-year-old children and determine if low GCT results are linked to early neurodevelopmental delays in offspring.
In this nationwide prospective cohort study, we extracted data from 104,062 foetal records from the Japan Environment and Children's Study. Outcomes comprised developmental status cut-off values for the domains of the Ages and Stages Questionnaire, Third Edition. The exclusion criteria were gestational diabetes mellitus, diabetes during pregnancy, and GCT results ≥ 140 mg/dL. Based on these criteria, we included 12,472 women who had undergone a GCT between 14 and 27 weeks of gestation and divided the participants into a low-GCT group (cohort specific ≤ 10th percentile, ≤ 81 mg/dL) and a non-low-GCT group (82-139 mg/dL). Multivariable logistic regression analysis was used to investigate the association between low GCT results and early neurodevelopmental delays.
Compared with infants born to women with normal GCT results, those born to women with low GCT results showed a significantly higher incidence of neurodevelopmental delays, particularly in communication, gross motor, fine motor, and problem-solving skills (adjusted odds ratio [OR] 1.35, 95% confidence interval [CI] 1.02-1.78; adjusted OR 1.31, 95% CI 1.01-1.69; adjusted OR 1.26, 95% CI 1.02-1.56; adjusted OR 1.24, 95% CI 1.01-1.54, respectively). No significant increase in the adjusted ORs (95% CIs) was observed for female offspring.
Low maternal GCT results are associated with offspring neurodevelopment at 3 years of age, with the association influenced by offspring sex.
The online version contains supplementary material available at 10.1007/s40200-025-01568-x.
阐明母亲50克葡萄糖耐量试验（GCT）结果与3岁儿童神经发育之间的关系，并确定低GCT结果是否与后代早期神经发育延迟有关。
在这项全国性前瞻性队列研究中，我们从日本环境与儿童研究的104,062份胎儿记录中提取数据。结果包括第三版《年龄与阶段问卷》各领域的发育状况临界值。排除标准为妊娠期糖尿病、孕期糖尿病以及GCT结果≥140mg/dL。基于这些标准，我们纳入了12,472名在妊娠14至27周期间接受过GCT的女性，并将参与者分为低GCT组（队列特定≤第10百分位数，≤81mg/dL）和非低GCT组（82 - 139mg/dL）。采用多变量逻辑回归分析来研究低GCT结果与早期神经发育延迟之间的关联。
与GCT结果正常正常的女性所生婴儿相比，GCT结果低的女性所生婴儿神经发育延迟的发生率显著更高，尤其是在沟通、大运动、精细运动和解决问题的技能方面（调整后的优势比[OR]分别为1.35，95%置信区间[CI]1.02 - 1.78；调整后的OR 1.31，95% CI 1.01 - 1.69；调整后的OR 1.26，95% CI 1.02 - 1.56；调整后的OR 1.24，95% CI 1.01 - 1.54）。在调整后的OR（95% CI）中，未观察到女性后代有显著增加。
母亲GCT结果低与3岁后代的神经发育有关，这种关联受后代性别的影响。
在线版本包含可在10.1007/s40200 - 025 - 01568 - x获取的补充材料。
