宫内暴露于妊娠期糖尿病与婴儿0~8个月体格生长的关联

The association between intrauterine exposure to gestational diabetes mellitus and anthropometric growth of offsprings from birth to 8 months

目的分析宫内暴露于妊娠期糖尿病(GDM)与子代0~8个月体格生长的关联,为探讨GDM对子代体格生长的影响及其随子代年龄变化的关系提供更多证据。方法研究对象为一个前瞻性队列中的孕妇及其分娩的子代。从孕妇进入队列(孕周小于20周)开始,随访至子代8月龄。通过问卷调查收集孕期信息,通过北京市海淀区妇幼保健院的电子信息系统收集分娩信息和子代信息。采用线性混合模型分析GDM与子代0~8月龄体格生长指标Z评分的关联;采用线性回归模型分析GDM与各月龄体格生长指标Z评分的关联。结果本研究共纳入845个母婴对。子代在42 d、3月龄、5月龄、8月龄随访到的人数分别为:475、304、159、131例。根据子代月龄进行分层分析的结果显示,与非GDM组相比,GDM组子代出生时的年龄别体重高(WAZ;β=0.16,95%CI:0.08~0.36),年龄别身长高(LAZ;β=0.16,95%CI:0.02~0.30),42 d的LAZ高(β=0.24,95%CI:0.03~0.45)。结论宫内暴露于GDM的婴儿,出生时WAZ及出生时和42 d时的LAZ比非GDM组高。

Objective To investigate the association between intrauterine exposure to gestational diabetes mellitus(GDM)and anthropometric growth of infants from birth to 8 months and provide evidence for the impacts of GDM on fetal and infants growth.Methods The subjects were pregnant women and their offspring from a longitudinal cohort.Pregnant women were followed up from recruitment(gestational age less than 20 weeks)until their offspring were 8 months.Information on pregnancy characteristics was collected through questionnaire,and that on delivery and infant growth was extracted from the electronic information system of Beijing Haidian Maternal and Child Health Hospital.The linear mixed model was used to analyze the association between GDM and anthropometric growth z-scores from birth to 8 months.Linear regression models were used to analyze the association between GDM and anthropometric growth indicators at different stages of follow-up.Results A total of 845 mother-infant dyads were included in this study.The number of mother-infant dyads completed the follow-up at 42 days,3 months,5 months and 8 months were 475,304,159 and 131,respectively.Compared with the non-GDM group,the weight for age Z score(WAZ,β=0.16,95%CI 0.08-0.36),and length for age Z score(LAZ,β=0.16,95%CI 0.02-0.30)at birth,LAZ at 42 days after birth(β=0.24,95%CI 0.03-0.45)were higher among infants with intrauterine exposure to GDM.Conclusion GDM was associated with higher WAZ and LAZ at birth and higher LAZ at 42 days after birth.