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Luo S, Hsu E, Lawrence KE, Adise S, Pickering TA, Herting MM, Buchanan T, Page KA, Thompson PM. Associations among prenatal exposure to gestational diabetes mellitus, brain structure, and child adiposity markers. Obesity (Silver Spring) 2023; 31:2699-2708. [PMID: 37840377 PMCID: PMC11025497 DOI: 10.1002/oby.23901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/22/2023] [Accepted: 04/04/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the mediating role of child brain structure in the relationship between prenatal gestational diabetes mellitus (GDM) exposure and child adiposity. METHODS This was a cross-sectional study of 9- to 10-year-old participants and siblings across the US. Data were obtained from the baseline assessment of the Adolescent Brain Cognitive Development (ABCD) Study®. Brain structure was evaluated by magnetic resonance imaging. GDM exposure was self-reported, and discordance for GDM exposure within biological siblings was identified. Mixed effects and mediation models were used to examine associations among prenatal GDM exposure, brain structure, and adiposity markers with sociodemographic covariates. RESULTS The sample included 8521 children (7% GDM-exposed), among whom there were 28 sibling pairs discordant for GDM exposure. Across the entire study sample, prenatal exposure to GDM was associated with lower global and regional cortical gray matter volume (GMV) in the bilateral rostral middle frontal gyrus and superior temporal gyrus. GDM-exposed siblings also demonstrated lower global cortical GMV than unexposed siblings. Global cortical GMV partially mediated the associations between prenatal GDM exposure and child adiposity markers. CONCLUSIONS The results identify brain markers of prenatal GDM exposure and suggest that low cortical GMV may explain increased obesity risk for offspring prenatally exposed to GDM.
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Affiliation(s)
- Shan Luo
- Division of Endocrinology and Diabetes, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
- Center for Endocrinology, Diabetes and Metabolism, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Eustace Hsu
- Division of Endocrinology and Diabetes, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Katherine E. Lawrence
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Shana Adise
- Center for Endocrinology, Diabetes and Metabolism, Children’s Hospital Los Angeles, Los Angeles, California, USA
- Division of Research on Children, Youth, and Families, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Trevor A. Pickering
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Megan M. Herting
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Department of Pediatrics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
- Neuroscience Graduate Program, University of Southern California, Los Angeles, California, USA
| | - Thomas Buchanan
- Division of Endocrinology and Diabetes, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Kathleen A. Page
- Division of Endocrinology and Diabetes, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Neuroscience Graduate Program, University of Southern California, Los Angeles, California, USA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Neuroscience Graduate Program, University of Southern California, Los Angeles, California, USA
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Hoodbhoy Z, Mohammed N, Nathani KR, Sattar S, Chowdhury D, Maskatia S, Tierney S, Hasan B, Das JK. The Impact of Maternal Preeclampsia and Hyperglycemia on the Cardiovascular Health of the Offspring: A Systematic Review and Meta-analysis. Am J Perinatol 2023; 40:363-374. [PMID: 33940650 DOI: 10.1055/s-0041-1728823] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The objective of this review was to assess the impact of maternal preeclampsia or hyperglycemia on the body composition and cardiovascular health in the offspring. STUDY DESIGN We conducted a systematic review utilizing PubMed, EBSCO, CINAHLPlus, Cochrane Library, and Web of Science to include all studies assessing the impact of preeclampsia/eclampsia and/or gestational/pregestational diabetes mellitus on the health of the offspring (children <10 years of age). The health measures included anthropometry, cardiac dimensions and function, and vascular function. We performed a meta-analysis using Review Manager software and computed net risk ratio (RR) with 95% confidence interval (CI) for dichotomous data and mean difference (MD) with 95% CI for continuous data. RESULTS There were 6,376 studies in total, of which 45 were included in the review and 40 in the meta-analysis. The results demonstrated higher birth weight (MD: 0.12 kg; 95% CI: 0.06-0.18) and systolic and diastolic blood pressure (BP; MD: 5.98 mm Hg; 95% CI: 5.64-6.32 and MD: 3.27 mm Hg; 95% CI: 0.65-5.89, respectively) in the offspring of mothers with gestational diabetes compared to controls. In contrast, the offspring of mothers with preeclampsia had lower birth weight (MD: -0.41 kg; 95% CI: -0.7 to -0.11); however, they had increased systolic (MD: 2.2 mm Hg; 95% CI: 1.28-3.12) and diastolic BP (MD: 1.41 mm Hg; 95% CI: 0.3-2.52) compared to controls. There is lack of data to conduct a meta-analysis of cardiac morphology, functional, and vascular imaging parameters. CONCLUSION These findings suggest that the in-utero milieu can have a permanent impact on the body composition and vascular health of the offspring. Future work warrants multicenter prospective studies to understand the mechanism and the actual effect of exposure to maternal hyperglycemia and high BP on the cardiovascular health of the offspring and long-term outcomes. KEY POINTS · Adverse in-utero exposures may have an impact on cardiovascular risk in children.. · Maternal hyperglycemia/preeclampsia lead to changes in birthweight and BP.. · Limited echocardiographic and vascular imaging data in these cohorts necessitates future work..
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Affiliation(s)
- Zahra Hoodbhoy
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Nuruddin Mohammed
- Department of Obstetrics and Gynecology, The Aga Khan University, Karachi, Pakistan
| | | | - Saima Sattar
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Shiraz Maskatia
- Department of Paediatrics, Stanford University, Stanford, California
| | - Seda Tierney
- Department of Paediatrics, Stanford University, Stanford, California
| | - Babar Hasan
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, The Aga Khan University, Karachi, Pakistan
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Yu DQ, Xu GX, Teng XY, Xu JW, Tang LF, Feng C, Rao JP, Jin M, Wang LQ. Glycemic control and neonatal outcomes in women with gestational diabetes mellitus treated using glyburide, metformin, or insulin: a pairwise and network meta-analysis. BMC Endocr Disord 2021; 21:199. [PMID: 34641848 PMCID: PMC8513183 DOI: 10.1186/s12902-021-00865-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 09/24/2021] [Indexed: 02/06/2023] Open
Abstract
AIMS We aimed to assess the comparative efficiency and safety of the use of glyburide, metformin, and insulin in gestational diabetes mellitus (GDM). METHODS We searched for randomized controlled trials that compared glyburide, metformin, and insulin in GDM. Data regarding glycemic control and neonatal safety were collected and analyzed in pairwise and network meta-analyses. RESULTS A total of 4533 individuals from 23 trials were included. Compared with glyburide, metformin reduced 2-h postprandial blood glucose (2HPG) to a greater extent (standard mean difference (SMD) 0.18; 95% credible interval (CI) 0.01, 0.34). There were significantly lower prevalence of neonatal hypoglycemia (risk difference (RD) - 0.07; 95%CI - 0.11, - 0.02) and preeclampsia (RD - 0.03; 95%CI - 0.06, 0) in the metformin group than in the insulin group. The metformin group had significantly lower birth weight (SMD - 0.17; 95%CI - 0.25, - 0.08) and maternal weight gain (SMD - 0.61; 95%CI - 0.86,- 0.35) compared with the insulin group. Network meta-analysis suggested that metformin had the highest probability of successfully controlling glycemia and preventing neonatal complications. CONCLUSIONS The present meta-analysis suggests that metformin may be as effective as insulin for glycemic control and is the most promising drug for the prevention of neonatal and maternal complications.
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Affiliation(s)
- Dan-Qing Yu
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Rd, Zhejiang, 310009, Hangzhou, China
| | - Guan-Xin Xu
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Rd, Zhejiang, 310009, Hangzhou, China
| | - Xin-Yuan Teng
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Rd, Zhejiang, 310009, Hangzhou, China
| | - Jing-Wei Xu
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Rd, Zhejiang, 310009, Hangzhou, China
| | - Liang-Fang Tang
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Rd, Zhejiang, 310009, Hangzhou, China
| | - Chun Feng
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Rd, Zhejiang, 310009, Hangzhou, China
| | - Jin-Peng Rao
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Rd, Zhejiang, 310009, Hangzhou, China
| | - Min Jin
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Rd, Zhejiang, 310009, Hangzhou, China
| | - Li-Quan Wang
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Rd, Zhejiang, 310009, Hangzhou, China.
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Chen YL, Han LL, Shi XL, Su WJ, Liu W, Wang LY, Huang PY, Lin MZ, Song HQ, Li XJ. Adverse pregnancy outcomes on the risk of overweight offspring: a population-based retrospective study in Xiamen, China. Sci Rep 2020; 10:1549. [PMID: 32005877 PMCID: PMC6994466 DOI: 10.1038/s41598-020-58423-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/14/2020] [Indexed: 11/09/2022] Open
Abstract
The growth trajectory of Chinese preschoolers still remains unclear. Our objective was to determine whether there was an association between adverse pregnancy outcomes and overweight offspring. We analyzed population-based retrospective cohort data from the Medical Birth Registry of Xiamen, which comprised 33,157 children examined from 1 to 6 years of age. Longitudinal analyses were used to evaluate the growth trajectories of offspring body mass index (BMI). Multivariate logistic regression was used to assess the effects of two adverse pregnancy outcomes, gestational diabetes mellitus (GDM) and being large-for-gestational age (LGA), on childhood overweight. Offspring of mothers with GDM and LGA has a higher annual BMI z-score from 1 to 6 years of age (all P < 0.05). But, a higher annual BMI z-score was only observed in children aged 1-5 years in models 1-3. Overall BMI z-score of offspring aged 1-6 who were born to mothers with GDM and LGA were also higher in models 1-3 (all P < 0.05). Additionally, offspring of mothers with GDM and LGA had a higher risk for overweight in model 1, from 1 to 6 years of age (odds ratio (OR), 1.814; 95% confidence interval (CI), 1.657-1.985; P < 0.0001). However, this association was attenuated after adjusting for maternal pre-pregnancy BMI (OR, 1.270; 95% CI, 0.961-1.679; P = 0.0930). Offspring of mothers with GDM and LGA had a higher BMI z-score and increased risk for overweight. Indeed, intrauterine exposure to maternal GDM and LGA could bias offspring to overweight, whereas maternal pre-pregnancy BMI may play a key role in offspring overweight for children born to mothers with GDM and LGA.
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Affiliation(s)
- Yin-Ling Chen
- Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Li-Li Han
- Fujian Medical University, Fuzhou, China
| | - Xiu-Lin Shi
- Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Wei-Juan Su
- Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Wei Liu
- Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Li-Ying Wang
- Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Pei-Ying Huang
- Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Ming-Zhu Lin
- Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Hai-Qu Song
- Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Xue-Jun Li
- Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China.
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Herath HP, Herath RP, Wickremasinghe R. Hyperglycaemia in Pregnancy and Anthropometric Parameters in the Offspring at 10 Years: A Community-Based Retrospective Cohort Study in Sri Lanka. J Obes 2020; 2020:2735148. [PMID: 32670637 PMCID: PMC7350072 DOI: 10.1155/2020/2735148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 05/02/2020] [Accepted: 06/01/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Studies of developmental origins of health and disease have highlighted the possible role of intrauterine hyperglycaemia, increasing the future risk of obesity, diabetes, and cardiovascular diseases in the offspring. There is limited evidence from South Asian populations for risk estimates for childhood obesity that are attributable to maternal diabetes in utero. OBJECTIVE The aim of this study was to determine the association between hyperglycaemia in pregnancy (HIP) and anthropometric parameters in the offspring at 10-11 years of age. METHODS A community-based retrospective cohort study was conducted in Colombo district, Sri Lanka. In the first stage, children born in 2005 were identified, and the availability of antenatal records was assessed. In the second stage, the exposure status of participants was ascertained based on antenatal records and predefined criteria. In the third stage, height, weight, waist circumference, and triceps skinfold thickness (TSFT) of eligible participants were measured to ascertain the outcome status. Background characteristics were collected by interviewing mothers. A 24-hour dietary recall and a 3-day diet diary were recorded. RESULTS 159 children of mothers with HIP (exposed) and 253 children of mothers with no HIP (nonexposed) participated. Mean ages (SD) of exposed and unexposed groups were 10.9 (0.3) and 10.8 (0.3) years, respectively. The median BMI (17.6 vs 16.1, p < 0.001), waist circumference (63 cm vs 59.3 cm, p < 0.001), and triceps skinfold thickness (13.7 mm vs 11.2 mm, p < 0.001) were significantly higher in the exposed group. Offspring of women with HIP were more likely to be overweight (aOR = 2.6, 95% CI 1.4-4.9) and have abdominal obesity (aOR = 2.7, 95% CI 1.1-6.5) and high TSFT (aOR = 2.2, 95% CI 1.06-4.7) at 10-11 years than children who were not exposed after adjusting for maternal BMI, maternal age at delivery, and birth order. CONCLUSIONS Intrauterine exposure to HIP is a significant determinant of overweight, high TSFT, and abdominal obesity in the offspring.
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Affiliation(s)
- Himali P. Herath
- Department of Nutrition, Medical Research Institute, Colombo 00800, Sri Lanka
| | - Rasika P. Herath
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Rajitha Wickremasinghe
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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Mak JKL, Lee AH, Pham NM, Pan XF, Tang L, Binns CW, Sun X. Gestational diabetes incidence and delivery outcomes in Western China: A prospective cohort study. Birth 2019; 46:166-172. [PMID: 30216525 DOI: 10.1111/birt.12397] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Few studies have examined the age-standardized incidence of gestational diabetes mellitus (GDM) for comparison between populations. Information on delivery outcomes is also lacking for Chinese women with GDM. Therefore, the present study aimed to determine age-standardized GDM incidence and assess its association with maternal and neonatal outcomes. METHODS A total of 1901 pregnant women were recruited in Chengdu, Sichuan Province. GDM was diagnosed between 24 and 28 weeks' gestation using oral glucose tolerance tests. Age-standardized incidence rates of GDM were calculated using the direct method. Delivery outcomes were extracted from medical records and compared between the GDM and non-GDM groups. RESULTS The age-standardized GDM incidence was 18.3% (95% CI 15.6-21.1) and increased with maternal age and prepregnancy body mass index (BMI). Women with GDM experienced longer length of stay in hospital, shorter gestation at delivery, and a higher risk of cesarean delivery. Their newborns were more likely to be macrosomic or small for gestational age, and to require neonatal intensive care. CONCLUSIONS The incidence of GDM was high in Western China, especially among older and overweight women. Moreover, women with GDM had higher rates of adverse delivery outcomes. The findings lend further support for the screening, prevention, and management of GDM in Chinese women.
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Affiliation(s)
- Jonathan K L Mak
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Ngoc Minh Pham
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Tang
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Colin W Binns
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Xin Sun
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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Yu DQ, Lv PP, Yan YS, Xu GX, Sadhukhan A, Dong S, Shen Y, Ren J, Zhang XY, Feng C, Huang YT, Tian S, Zhou Y, Cai YT, Ming ZH, Ding GL, Zhu H, Sheng JZ, Jin M, Huang HF. Intrauterine exposure to hyperglycemia retards the development of brown adipose tissue. FASEB J 2019; 33:5425-5439. [PMID: 30759346 DOI: 10.1096/fj.201801818r] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Brown adipose tissue (BAT) is an exclusive tissue of nonshivering thermogenesis. It is fueled by lipids and glucose and involved in energy and metabolic homeostasis. Intrauterine exposure to hyperglycemia during gestational diabetes mellitus may result in abnormal fetal development and metabolic phenotypes in adulthood. However, whether intrauterine hyperglycemia influences the development of BAT is unknown. In this study, mouse embryos were exposed to the intrauterine hyperglycemia environment by injecting streptozocin into pregnant mice at 1 d post coitum (dpc). The structure of BAT was examined by hematoxylin and eosin staining and immunohistochemical analysis. The glucose uptake in BAT was measured in vivo by [18F]-fluoro-2-deoxyglucose-micro-positron emission tomography. The gene expression in BAT was determined by real-time PCR, and the 5'-C-phosphate-G-3' site-specific methylation was quantitatively analyzed. Intrauterine hyperglycemia exposure resulted in the impaired structure of BAT and decreased glucose uptake function in BAT in adulthood. The expressions of the genes involved in thermogenesis and mitochondrial respiratory chain in BAT, such as Ucp1, Cox5b, and Elovl3, were down-regulated by intrauterine hyperglycemia exposure at 18.5 dpc and at 16 wk of age. Furthermore, higher methylation levels of Ucp1, Cox5b, and Elovl3 were found in offspring of mothers with streptozotocin-induced diabetes. Our results provide the evidence for enduring inhibitory effects of intrauterine hyperglycemia on BAT development in offspring. Intrauterine hyperglycemia is associated with increased DNA methylation of the BAT specific genes in offspring, which support an epigenetic involvement.-Yu, D.-Q., Lv, P.-P., Yan, Y.-S., Xu, G.-X., Sadhukhan, A., Dong, S., Shen, Y., Ren, J., Zhang, X.-Y., Feng, C., Huang, Y.-T., Tian, S., Zhou, Y., Cai, Y.-T., Ming, Z.-H., Ding, G.-L., Zhu, H., Sheng, J.-Z., Jin, M., Huang, H.-F. Intrauterine exposure to hyperglycemia retards the development of brown adipose tissue.
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Affiliation(s)
- Dan-Qing Yu
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Ping-Ping Lv
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China.,Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yi-Shang Yan
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Guan-Xin Xu
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Annapurna Sadhukhan
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shan Dong
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China.,Qilu Hospital of Shandong University, Jinan, China
| | - Yan Shen
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China.,Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Jun Ren
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China.,Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xue-Ying Zhang
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chun Feng
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Yi-Ting Huang
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Shen Tian
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Yin Zhou
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Yi-Ting Cai
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhen-Hua Ming
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Guo-Lian Ding
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Zhu
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Jian-Zhong Sheng
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China.,Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Hangzhou, China; and
| | - Min Jin
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - He-Feng Huang
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China.,Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
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8
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Hammoud NM, Visser GHA, van Rossem L, Biesma DH, Wit JM, de Valk HW. Long-term BMI and growth profiles in offspring of women with gestational diabetes. Diabetologia 2018; 61:1037-1045. [PMID: 29492638 PMCID: PMC6448978 DOI: 10.1007/s00125-018-4584-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/02/2018] [Indexed: 01/27/2023]
Abstract
AIMS/HYPOTHESIS Gestational diabetes mellitus (GDM) is reported to be associated with childhood obesity, however the magnitude of this association and relation to intrauterine growth is uncertain. We, therefore, aimed to assess whether the growth trajectories of large for gestational age (LGA) and non-LGA offspring of mothers with GDM (OGDM) are different until early adolescence. We also aimed to explore whether growth trajectories of OGDM differ from those of offspring of mothers with type 1 or 2 diabetes (ODM1, ODM2). METHODS We studied height and BMI standard deviation score (SDS) of the OGDM group, up to the age of 14 years, with subgroup analysis comparing LGA with non-LGA at birth as a reflection of the intrauterine environment. All mothers with GDM who delivered at the University Medical Center Utrecht between 1990 and 2006 were contacted to participate; informed consent was received for 104 OGDM of 93 mothers. Offspring data were collected through Dutch infant welfare centres. Recorded height and weight were converted to BMI and age- and sex-specific SDS values for Dutch children. Additionally, we compared the OGDM group with ODM1 and ODM2 groups in order to identify those offspring with the highest risk of becoming overweight. Growth trajectories were compared between non-LGA and LGA OGDM and between OGDM, ODM1 and ODM2, using a random-effects model. In the longitudinal follow-up a mean of 7.4 ± 2 measurements per infant were available. RESULTS Mothers had a prepregnancy BMI of 25.8 kg/m2 and 24% of their infants were LGA at birth. Heights of OGDM were no different from those of the Dutch Growth Study. Non-LGA OGDM showed a BMI SDS comparable with that of the reference population, with a slight increase in early adolescence. LGA OGDM had a higher BMI SDS trajectory than non-LGA OGDM and the reference population, which plateaued at around 10 years of age. Comparison of growth trajectories of OGDM, ODM1 and ODM2 showed ODM2 to have the highest trajectory followed by ODM1 and OGDM, with the LGA counterparts of all three offspring groups in the highest BMI SDS ranges. CONCLUSIONS/INTERPRETATION Until early adolescence, OGDM have a BMI that is 0.5 SDS higher than that of the Dutch background population. LGA OGDM appear to be at particularly higher risk of being overweight in adolescence compared with non-LGA OGDM, putting them also at a higher lifetime risk of being overweight and developing obesity. ODM2 showed the highest BMI SDS values and had an average BMI SDS of +1.6 until the age of 14, when it became +2 SD. These results emphasize the importance of adequate recognition and timely treatment of maternal gestational diabetes to prevent fetal macrosomia in obstetrics.
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Affiliation(s)
- Nurah M Hammoud
- Department of Obstetrics, Division Woman & Baby, the University Medical Center Utrecht, Heidelberglaan 100, Huispostnummer KE.04.123.1, P.O. Box 85090, 3508 AB, Utrecht, the Netherlands.
- Department of Internal Medicine and Infectious Diseases, the University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Gerard H A Visser
- Department of Obstetrics, Division Woman & Baby, the University Medical Center Utrecht, Heidelberglaan 100, Huispostnummer KE.04.123.1, P.O. Box 85090, 3508 AB, Utrecht, the Netherlands
| | - Lenie van Rossem
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Douwe H Biesma
- Department of Internal Medicine and Infectious Diseases, the University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jan M Wit
- Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Harold W de Valk
- Department of Internal Medicine and Infectious Diseases, the University Medical Center Utrecht, Utrecht, the Netherlands
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9
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Liang Z, Zhou M, Xu XK, Qu F, Chen D. Is Chemerin associated with gestational diabetes mellitus? An evidence-based clinical research from Chinese women. J OBSTET GYNAECOL 2018; 38:482-487. [PMID: 29430984 DOI: 10.1080/01443615.2017.1385596] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The present study aimed to explore the association between gestational diabetes mellitus (GDM) and Chemerin, by analysing Chemerin level, clinical data and biochemical parameters among 46 GDM patients and 43 controls. It was found that the Chemerin levels from cord blood, peripheral blood, adipose tissue and placenta tissue were all significantly higher in the GDM group than those in the control group (p < .05 for all). Maternal insulin resistance (IR) index and serum inflammation parameters, including C-reactive protein and white blood cells, were also higher in GDM group (p < .05 for all). Moreover, maternal IR index and circulating insulin level were both positively correlated with maternal circulating Chemerin level (p < .05 for both). Our findings suggest that Chemerin, associated with IR and more expressed in GDM women, might participate in the pathogenesis of GDM. Impact Statement What is already known on this subject: Chemerin, a recently-discovered adipocytokine, has been widely-considered to be involved in metabolic diseases, and several studies have investigated it in gestational diabetes mellitus (GDM), but with no consensus about the level comparison between GDM and controls. What the results of this study add: The present case-control study found that the levels of Chemerin from cord blood, peripheral blood, adipose tissue and placenta tissue were all significantly higher in the GDM group. What the implications are of these findings for clinical practice and/or further research: Also, the circulating Chemerin level was positively correlated with insulin index, which we thought would add to the evidence that Chemerin does be associated with GDM, contributing to elucidating the pathogenesis of GDM.
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Affiliation(s)
- Zhaoxia Liang
- a Obstetrical Department , Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China
| | - Menglin Zhou
- a Obstetrical Department , Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China
| | - Xu-Kang Xu
- b School of Pharmacy and Medical Sciences, Division of Health Science , University of South Australia , Adelaide , Australia
| | - Fan Qu
- a Obstetrical Department , Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China
| | - Danqing Chen
- a Obstetrical Department , Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China
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10
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Dugas C, Perron J, Kearney M, Mercier R, Tchernof A, Marc I, Weisnagel SJ, Robitaille J. Postnatal Prevention of Childhood Obesity in Offspring Prenatally Exposed to Gestational Diabetes mellitus: Where Are We Now? Obes Facts 2017; 10:396-406. [PMID: 28848122 PMCID: PMC5644967 DOI: 10.1159/000477407] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 05/02/2017] [Indexed: 12/15/2022] Open
Abstract
Children exposed to gestational diabetes mellitus (GDM) in utero are at high risk of developing many health problems such as obesity. There is an urgent need to find new strategies to prevent obesity development among high-risk populations such as those children. Accordingly, the aim of this review was to summarize current knowledge on the postnatal prevention of childhood obesity in offspring born from mothers with GDM. Specifically, this review addresses the impact of breastfeeding, complementary feeding practices as well as dietary intake and physical activity during childhood on obesity risk of children exposed to GDM in utero. Furthermore, breast milk composition of diabetic mothers and its potential impact on growth is discussed. According to the available literature, breastfeeding may reduce obesity risk in children exposed to GDM in utero but a longer duration seems necessary to achieve its protective effect against obesity. Detailed analysis of breast milk composition of mothers with GDM will be necessary to fully understand the relationship between breastfeeding and obesity in this specific population. This review highlights the need for more studies addressing the impact of complementary feeding practices and lifestyle habits during childhood on obesity risk of children exposed to GDM in utero.
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Affiliation(s)
- Camille Dugas
- School of Nutrition, Laval University, Quebec City, Quebec City, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec City, Quebec City, Canada
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Quebec City, Quebec City, Canada
| | - Julie Perron
- Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec City, Quebec City, Canada
| | - Michèle Kearney
- School of Nutrition, Laval University, Quebec City, Quebec City, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec City, Quebec City, Canada
| | - Roxanne Mercier
- School of Nutrition, Laval University, Quebec City, Quebec City, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec City, Quebec City, Canada
| | - André Tchernof
- School of Nutrition, Laval University, Quebec City, Quebec City, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec City, Quebec City, Canada
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Quebec City, Quebec City, Canada
| | - Isabelle Marc
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Quebec City, Quebec City, Canada
| | - S. John Weisnagel
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Quebec City, Quebec City, Canada
- Diabetes Research Unit, Laval University Medical Research Center, Quebec City, Quebec City, Canada
| | - Julie Robitaille
- School of Nutrition, Laval University, Quebec City, Quebec City, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec City, Quebec City, Canada
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Quebec City, Quebec City, Canada
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11
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Growth and BMI during the first 14 y of life in offspring from women with type 1 or type 2 diabetes mellitus. Pediatr Res 2017; 81:342-348. [PMID: 27828938 DOI: 10.1038/pr.2016.236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/30/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND Infants of women with pregestational diabetes are at risk for developing obesity in later life. This study aimed to identify subgroups at highest risk, by studying growth profiles of offspring from women with type 1 or 2 diabetes mellitus (ODM1, ODM2) until the age of 14 y. METHODS Information from infant welfare centers was received for 78 ODM1 and 44 ODM2. Mean BMI SD scores (SDS) (based on 1980 nation-wide references) and height SDS (based on 2009 references) were calculated and included in a random-effects model. Values were compared to the 2009 Dutch growth study. RESULTS BMI SDS profiles differed between ODM1 and ODM2, with the highest mean BMI SDS profiles in ODM2. Other factors that affected growth profiles in these infants included the presence of maternal obesity, large for gestational age (LGA) at birth and in ODM2 a Dutch-Mediterranean origin. CONCLUSION Offspring of women with diabetes have higher BMI SDS profiles than observed in the 2009 Dutch growth study, with the highest BMI SDS in ODM2 who are LGA at birth and have obese mothers. Preventive strategies for offspring adiposity may include pursuing lower prepregnancy maternal BMI, prevention of LGA at birth, and prevention of increased weight gain during childhood.
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12
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The LIFE Child study: a population-based perinatal and pediatric cohort in Germany. Eur J Epidemiol 2017; 32:145-158. [PMID: 28144813 DOI: 10.1007/s10654-016-0216-9] [Citation(s) in RCA: 128] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 12/02/2016] [Indexed: 12/11/2022]
Abstract
The LIFE Child study is a large population-based longitudinal childhood cohort study conducted in the city of Leipzig, Germany. As a part of LIFE, a research project conducted at the Leipzig Research Center for Civilization Diseases, it aims to monitor healthy child development from birth to adulthood and to understand the development of lifestyle diseases such as obesity. The study consists of three interrelated cohorts; the birth cohort, the health cohort, and the obesity cohort. Depending on age and cohort, the comprehensive study program comprises different medical, psychological, and sociodemographic assessments as well as the collection of biological samples. Optimal data acquisition, process management, and data analysis are guaranteed by a professional team of physicians, certified study assistants, quality managers, scientists and statisticians. Due to the high popularity of the study, more than 3000 children have already participated until the end of 2015, and two-thirds of them participate continuously. The large quantity of acquired data allows LIFE Child to gain profound knowledge on the development of children growing up in the twenty-first century. This article reports the number of available and analyzable data and demonstrates the high relevance and potential of the study.
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13
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Koivunen S, Torkki A, Bloigu A, Gissler M, Pouta A, Kajantie E, Vääräsmäki M. Towards national comprehensive gestational diabetes screening - consequences for neonatal outcome and care. Acta Obstet Gynecol Scand 2016; 96:106-113. [PMID: 27682191 DOI: 10.1111/aogs.13030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 09/21/2016] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The change from risk-factor-based to nearly comprehensive screening of gestational diabetes (GDM) identifies more but milder cases of the disease. The main aim of this study was to evaluate the effect of this screening policy change on neonatal outcomes and care. MATERIAL AND METHODS A population-based register study in Finland. GDM cases during risk-factor-based (year 2006, n = 5179) and comprehensive (2010, n = 6679) screenings were identified through the Medical Birth Register. All singletons without maternal GDM or prepregnancy diabetes served as controls (n = 51 746 and n = 52 386, respectively). The main outcomes were macrosomia, neonatal hypoglycemia and the need for care in a neonatal ward. RESULTS In the GDM group, the mean birthweight decreased between the study years from 3660 g to 3595 g and the prevalence of macrosomia from 5.6 to 4.1% even after adjustment for maternal age, parity and prepregnancy body mass index. The adjusted mean difference in birthweight between GDM and control newborns decreased from 70 to 22 g between the study years. The prevalence of neonatal hypoglycemia increased from 18.0 to 22.1% in the GDM group. However, neonatal hypoglycemia was more often treated without care in a neonatal ward. The proportion of infants treated on a neonatal ward decreased in both the GDM and control groups between the study years. CONCLUSIONS In newborns, comprehensive GDM screening led to decreased mean birthweight and macrosomia rates, but the prevalence of neonatal hypoglycemia increased. This places substantial demands for delivery hospitals and healthcare resources.
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Affiliation(s)
- Sanna Koivunen
- Department of Obstetrics and Gynecology and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Child and Adolescent Health and Wellbeing Unit, National Institute for Health and Welfare, Oulu, Finland
| | - Annukka Torkki
- Department of Obstetrics and Gynecology and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Child and Adolescent Health and Wellbeing Unit, National Institute for Health and Welfare, Oulu, Finland
| | - Aini Bloigu
- Child and Adolescent Health and Wellbeing Unit, National Institute for Health and Welfare, Oulu, Finland
| | - Mika Gissler
- Information Department, National Institute for Health and Welfare, Helsinki, Finland
| | - Anneli Pouta
- Child and Adolescent Health and Wellbeing Unit, National Institute for Health and Welfare, Oulu, Finland
| | - Eero Kajantie
- Department of Obstetrics and Gynecology and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.,Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Marja Vääräsmäki
- Department of Obstetrics and Gynecology and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Child and Adolescent Health and Wellbeing Unit, National Institute for Health and Welfare, Oulu, Finland
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14
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Oza-Frank R, Moreland JJ, McNamara K, Geraghty SR, Keim SA. Early Lactation and Infant Feeding Practices Differ by Maternal Gestational Diabetes History. J Hum Lact 2016; 32:658-665. [PMID: 27550377 PMCID: PMC6322208 DOI: 10.1177/0890334416663196] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Detailed data on lactation practices by gestational diabetes mellitus (GDM) history are lacking, precluding potential explanations and targets for interventions to improve lactation intensity and duration and, ultimately, long-term maternal and child health. OBJECTIVE This study aimed to examine breastfeeding practices through 12 months postpartum by GDM history. METHODS Women who delivered a singleton, liveborn infant at The Ohio State University Wexner Medical Center (Columbus, OH), in 2011 completed a postal questionnaire to assess lactation and infant feeding practices and difficulties. Bivariate and multivariate associations between GDM history and lactation and infant feeding practices were examined. RESULTS The sample included 432 women (62% response rate), including 7.9% who had GDM during the index pregnancy. Women with GDM initiated breastfeeding (at-the-breast or pumping) as often as women without any diabetes but were more likely to report introduction of formula within the first 2 days of life (79.4% vs 53.8%, P < .01; adjusted odds ratio: 3.48; 95% confidence interval, 1.47-8.26). Women with GDM initiated pumping 4 days earlier than women without diabetes ( P < .05), which was confirmed in adjusted analyses. There was no difference in the proportion of women reporting breastfeeding difficulty (odds ratio: 2.08; 95% confidence interval, 0.78-5.52). However, there was a trend toward women with GDM reporting more formula feeding and less at-the-breast feeding as strategies to address difficulty compared with women without diabetes. CONCLUSION Additional research is needed to understand why women with GDM engage in different early lactation and infant feeding practices, and how best to promote and sustain breastfeeding among these women.
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Affiliation(s)
- Reena Oza-Frank
- The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | | | - Kelly McNamara
- The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | | | - Sarah A. Keim
- The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
- The Ohio State University College of Public Health, Columbus, OH, USA
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15
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Plasma Markers of Oxidative Stress in Patients with Gestational Diabetes Mellitus in the Second and Third Trimester. Obstet Gynecol Int 2016; 2016:3865454. [PMID: 27803713 PMCID: PMC5075618 DOI: 10.1155/2016/3865454] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 08/04/2016] [Accepted: 08/15/2016] [Indexed: 12/02/2022] Open
Abstract
Objective. To determine plasma markers of oxidative stress during the second and third trimester of pregnancy in patients with gestational diabetes mellitus (GDM). Study Design. We conducted a prospective nested case-control study involving 400 pregnant women, 22 of whom developed GDM. As control group, 30 normal pregnant women were chosen randomly. Plasma samples were analyzed for 8-iso-prostaglandin F2α (8-iso-PGF2α), advanced oxidative protein products (AOPPs), protein carbonyl (PCO), glutathione peroxidase-3 (GPX-3), and paraoxonase-1 (PON1) at 16–20 weeks, 24–28 weeks, and 32–36 weeks of gestation. Results. Compared to control subjects, the plasma levels of PCO, AOPPs, and 8-iso-PGF2α were elevated at 16–20 weeks' and 32–36 weeks' gestation in GDM. There was no significant difference in PCO and 8-iso-PGF2α at 24–28 weeks in GDM. GPX-3 was statistically significantly increased at 16–20 weeks and 32–36 weeks in GDM. PON1 reduced in patients with GDM. No significant differences were found at 24–28 and 32–36 weeks between the GDM and control groups. In GDM, PCO, AOPPs, and 8-iso-PGF2α levels were higher and GPX-3 and PON1 levels were lower in the second than the third trimester. Conclusion. Oxidation status increased in GDM, especially protein oxidation, which may contribute to the pathogenesis of GDM.
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16
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Abstract
PURPOSE OF REVIEW The huge percentages of persons with obesity in many countries constitute a public health crisis. The severe consequences of obesity for physical health and emotional wellbeing already emerge in childhood. Therefore, the acknowledgment of early risk factors is essential to provide recommendations for prevention strategies. This review outlines the current state of research concerning early risk factors for obesity, that is, factors that even contribute to later obesity of the offspring during gestation. In this regard, this review specifically addresses the link between restricted eating behavior of the mother and obesity in her offspring. We systematically searched for articles in PsychINFO, PsychINDEX, MEDLINE, PubMed, MEDPILOT, and Web of Science, and we identified additional studies in bibliographies. RECENT FINDINGS Although some risk factors (e.g., short period of breastfeeding, gestational diabetes, and high maternal BMI) have a vast evidence base, others (e.g., restricted eating behavior and second-hand smoking) are insufficiently studied. SUMMARY Physical activity and diet programs in pregnancy can reduce not only the occurrence of gestational diabetes, but also the risk of inappropriate weight gain. As smoking during pregnancy and inappropriate eating behavior are associated with lower education, psychoeducation, for instance in sex education classes, could be easily conceivable.
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17
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Woo Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk Factors for Childhood Obesity in the First 1,000 Days: A Systematic Review. Am J Prev Med 2016; 50:761-779. [PMID: 26916261 DOI: 10.1016/j.amepre.2015.11.012] [Citation(s) in RCA: 554] [Impact Index Per Article: 69.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 12/27/2022]
Abstract
CONTEXT Mounting evidence suggests that the origins of childhood obesity and related disparities can be found as early as the "first 1,000 days"-the period from conception to age 2 years. The main goal of this study is to systematically review existing evidence for modifiable childhood obesity risk factors present from conception to age 2 years. EVIDENCE ACQUISITION PubMed, Embase, and Web of Science were searched for studies published between January 1, 1980, and December 12, 2014, of childhood obesity risk factors present during the first 1,000 days. Prospective, original human subject, English-language research with exposure occurrence during the first 1,000 days and with the outcome of childhood overweight or obesity (BMI ≥85th percentile for age and sex) collected between age 6 months and 18 years were analyzed between December 13, 2014, and March 15, 2015. EVIDENCE SYNTHESIS Of 5,952 identified citations, 282 studies met inclusion criteria. Several risk factors during the first 1,000 days were consistently associated with later childhood obesity. These included higher maternal pre-pregnancy BMI, prenatal tobacco exposure, maternal excess gestational weight gain, high infant birth weight, and accelerated infant weight gain. Fewer studies also supported gestational diabetes, child care attendance, low strength of maternal-infant relationship, low SES, curtailed infant sleep, inappropriate bottle use, introduction of solid food intake before age 4 months, and infant antibiotic exposure as risk factors for childhood obesity. CONCLUSIONS Modifiable risk factors in the first 1,000 days can inform future research and policy priorities and intervention efforts to prevent childhood obesity.
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Affiliation(s)
- Jennifer A Woo Baidal
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York City, New York
| | - Lindsey M Locks
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Erika R Cheng
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Tiffany L Blake-Lamb
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts; Kraft Center for Community Health Leadership, Partners Healthcare, Boston, Massachusetts
| | - Meghan E Perkins
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
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18
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Zhu Y, Olsen SF, Mendola P, Yeung EH, Vaag A, Bowers K, Liu A, Bao W, Li S, Madsen C, Grunnet LG, Granström C, Hansen S, Martin K, Chavarro JE, Hu FB, Langhoff-Roos J, Damm P, Zhang C. Growth and obesity through the first 7 y of life in association with levels of maternal glycemia during pregnancy: a prospective cohort study. Am J Clin Nutr 2016; 103:794-800. [PMID: 26817507 PMCID: PMC4763496 DOI: 10.3945/ajcn.115.121780] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 12/15/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Given the long-term adverse sequelae of childhood obesity, identification of early life factors related to fetal growth and childhood obesity is warranted. Investigation on growth and obesity in early life in association with intrauterine exposure to maternal hyperglycemia, a common metabolic pregnancy complication, is of public health significance and clinical implications. OBJECTIVE We investigated the association of fasting plasma glucose (FPG) concentrations during pregnancy with offspring growth and risk of overweight/obesity through age 7 y, after adjustment for confounders, including maternal prepregnancy obesity status. DESIGN FPG concentrations at 28 gestational weeks (IQR: 22-32 wk) were extracted from medical records for 661 pregnancies complicated by gestational diabetes mellitus in the Danish National Birth Cohort (1996-2002). Offspring's ponderal index was derived from birth weight and length; age- and sex-specific body mass index (BMI) z scores at 5 mo, 12 mo, and 7 y were calculated based on WHO reference data. Relations between FPG and offspring growth and obesity were assessed by linear and Poisson regression with robust standard errors, adjusting for maternal prepregnancy BMI and sociodemographic and perinatal factors. RESULTS At birth, maternal FPG during pregnancy was significantly associated with offspring ponderal index (β = 0.46; 95% CI: 0.14, 0.78 per 1-mmol/L increase) and risk of macrosomia (birth weight >4000 g) (RR = 1.21; 95% CI: 1.07, 1.38 per 1-mmol/L increase). At 7 y, higher maternal FPG concentrations were significantly associated with increased BMI z scores (β = 0.20; 95% CI: 0.04, 0.36) and elevated risk of overweight/obesity (RR = 1.21; 95% CI: 1.01, 1.50). Additional adjustment for birth weight and childhood lifestyle factors did not appreciably alter results. No associations were observed at 5 or 12 mo. CONCLUSION Among women with gestational diabetes mellitus, maternal FPG concentrations during pregnancy were significantly and positively associated with offspring birth size and overweight/obesity risk at 7 y, adjusting for maternal prepregnancy BMI.
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Affiliation(s)
- Yeyi Zhu
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD
| | - Sjurdur F Olsen
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Pauline Mendola
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD
| | - Edwina H Yeung
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD
| | | | - Katherine Bowers
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD
| | - Aiyi Liu
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD
| | - Wei Bao
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD
| | - Shanshan Li
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD
| | | | | | - Charlotta Granström
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Susanne Hansen
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Kelly Martin
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD
| | - Jorge E Chavarro
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and
| | - Frank B Hu
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and
| | - Jens Langhoff-Roos
- Department of Obstetrics, Rigshospitalet University Hospital, Copenhagen, Denmark
| | - Peter Damm
- Center for Pregnant Women With Diabetes, Department of Obstetrics, Rigshospitalet, The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Cuilin Zhang
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD;
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19
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Esposito G, Ambrosio R, Napolitano F, Di Giuseppe G. Women's Knowledge, Attitudes and Behavior about Maternal Risk Factors in Pregnancy. PLoS One 2015; 10:e0145873. [PMID: 26714032 PMCID: PMC4694714 DOI: 10.1371/journal.pone.0145873] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 12/09/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The aims of this study were to assess the levels of knowledge, attitudes and behaviors of women about the main maternal risk factors in pregnancy and to identify the factors linked to the main outcomes of interest. MATERIALS AND METHODS A cross-sectional survey was conducted in 513 pregnant women randomly selected from the gynecological ambulatory services of five hospitals located in Naples, Italy. RESULTS Only 42% of women correctly knew all the main maternal risk factors in pregnancy (alcohol, smoking, passive smoking and obesity). Only 21.7% of women were very worried about causing harm to the fetus or child with their risk behaviors, and 22.3% of women reported smoking during pregnancy. Approximately one-third of women (28.9%) reported regularly drinking alcohol before pregnancy and 74.8% of these women reported stopping drinking alcohol during pregnancy. However, only 27.3% of women who were drinking alcohol during pregnancy had the intention of stopping. Only 43.7% of women indicated that during ambulatory gynecological examinations they received information from physicians about the possible damage resulting from all the main risk factors in pregnancy (alcohol, smoking, passive smoking and obesity). CONCLUSION The results indicate that pregnant women lack knowledge regarding the main maternal risk factors. Pregnant women claim to receive little information during gynecological examinations and, therefore, some continue to smoke and drink alcohol during pregnancy. Our results suggest an urgent need for the design of interventions to improve women's levels of knowledge and to promote appropriate behavior in relation to the major risk factors in pregnancy.
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Affiliation(s)
- Giuseppe Esposito
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
- * E-mail:
| | - Rossella Ambrosio
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
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20
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A retrospective study of maternal and neonatal outcomes in overweight and obese women with gestational diabetes mellitus. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0443-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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21
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Tan HC, Roberts J, Catov J, Krishnamurthy R, Shypailo R, Bacha F. Mother's pre-pregnancy BMI is an important determinant of adverse cardiometabolic risk in childhood. Pediatr Diabetes 2015; 16:419-26. [PMID: 25800542 PMCID: PMC4534350 DOI: 10.1111/pedi.12273] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 02/13/2015] [Accepted: 02/18/2015] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Maternal adiposity is associated with poor offspring cardiometabolic health. We aimed to evaluate the relationship of maternal pre-pregnancy body mass index (BMI) on the BMI, body composition and cardiometabolic characteristics of the offspring. METHODS Forty offspring of overweight/obese mothers (O-OW) and 28 offspring of normal weight mothers (O-NW) underwent evaluation of body composition, abdominal fat distribution, blood pressure measurement, fasting lipids and an oral glucose tolerance test. The anthropometric and cardiometabolic characteristics of O-OW were compared with those of O-NW, and the relationship to maternal BMI was evaluated. RESULTS Subjects (mean age: 12.6 ± 0.4, female: 52.9%) had similar gestational age, birth weight, age, gender, and Tanner stage. However, O-OW had a significantly higher BMI (24.4 ± 1.2 vs. 19.7 ± 0.8 kg/m(2) , p = 0.001), % body fat (31.7 ± 1.6 vs. 24.6 ± 1.1%, p < 0.001), visceral fat (41.9 ± 4.7 vs. 26.1 ± 3.9 cm(2) , p = 0.012) with no difference in lean body mass compared with O-NW. O-OW had lower whole body insulin sensitivity index (WBISI) with an adverse cardiovascular disease risk profile [higher blood pressure (BP), triglycerides to high-density lipoprotein (HDL) ratio, hs-C-reactive protein (CRP) and lower HDL]. In addition to offspring's %body fat (β = -0.60, p < 0.001), maternal pre-pregnancy BMI (β = -0.19, p = 0.046) contributed significantly and independently to the offspring's WBISI (R(2) =0.55, p < 0.001). CONCLUSIONS High pre-pregnancy BMI is an important contributor to excess adiposity, insulin resistance, and cardiometabolic disease risk in the offspring during childhood.
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Affiliation(s)
- Hong Chang Tan
- Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - James Roberts
- Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA,Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Janet Catov
- Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA,Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA
| | | | - Roman Shypailo
- Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Fida Bacha
- Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX
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Nilsson C, Andersson C, Ursing D, Strevens H, Landin-Olsson M. Outcomes of women with gestational diabetes mellitus in Sweden. Eur J Obstet Gynecol Reprod Biol 2015; 193:132-5. [PMID: 26295790 DOI: 10.1016/j.ejogrb.2015.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 06/18/2015] [Accepted: 07/30/2015] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The number of women with gestational diabetes mellitus (GDM) during pregnancy is increasing around the world and in our region in the south Sweden 1.2% of all pregnant women received the GDM diagnosis in the 90s and now it is about 2.2%. The aim of this study was to compare women with GDM 1995-99 against women with GDM 2012-13 regarding eventual differences in demographics and pregnancy outcome. STUDY DESIGN In our region in Sweden, all pregnant women are tested for GDM with a 2-h 75g oral glucose tolerance test and the 2-h cut off value for GDM is ≥10.0mmol/l in capillary plasma glucose. 1995-99 there were 131 women with GDM and their medical journals were compared against the 210 women with GDM during 2012-13. The same screening and diagnostic method was uses during the whole time period. RESULTS In the 2012-13 GDM pregnancies there were more non-Scandinavian women, more women with insulin treatment during pregnancy and a higher frequency of cesarean deliveries compared to 1995. First weight of the women during GDM pregnancy 2012-13 was significantly higher than the weight of women with GDM 1995-99, 71kg (43-138; n=201) and 65kg (43-133; n=125) (p=0.008) respectively. However, there was no significant difference in weight of the mother at delivery. Birth weight of the child in GDM pregnancies 1995-99 was 3722.4g±578.2 (n=109; p=0.009), and in GDM pregnancies 2012-13 3555.6g±465.8 (n=162). CONCLUSION Even though women with GDM 2012-13 weigh more when they start the pregnancy there is no difference in weight at delivery compared to women with GDM 1995-99. This is also reflected on the newborn, that 2012-13 had significantly lower birth weight but with the same gestational length as 1995-1999. We believe that this is due to a more active and intense treatment of women with GDM during pregnancy together with higher frequency of cesarean delivery. Prevention of large infants is crucial to avoid complications during delivery.
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Affiliation(s)
- Charlotta Nilsson
- Department of Pediatrics, Institution of Clinical Science, Helsingborg Hospital, Lund University, Sweden.
| | - Caroline Andersson
- Department of Pediatrics, Institution of Clinical Science, Helsingborg Hospital, Lund University, Sweden
| | - Dag Ursing
- Department of Endocrinology, Institution of Clinical Science, Skåne University Hospital, Lund University, Sweden
| | - Helena Strevens
- Department of Obstetrics and Gynecology, Institution of Clinical Science, Skåne University Hospital, Lund University, Sweden
| | - Mona Landin-Olsson
- Department of Endocrinology, Institution of Clinical Science, Skåne University Hospital, Lund University, Sweden
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Nilsson C, Ursing D, Strevens H, Landin-Olsson M. Towards normalized birthweight in gestational diabetes mellitus. Acta Obstet Gynecol Scand 2015; 94:1090-4. [PMID: 26073567 DOI: 10.1111/aogs.12695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 06/03/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The objective was to describe pregnancy outcomes in gestational diabetes mellitus (GDM) in comparison with general population in Sweden. MATERIAL AND METHODS A population-based retrospective study using University hospital records and Swedish Medical Birth Register was carried out on pregnant women with well-monitored GDM (n = 870) and pregnancies in the Swedish Medical Birth Register (n = 1 553 420). Data from GDM pregnancies was compared to pregnancies in the whole of Sweden during 1995-2010. The main outcome measures were age, first bodyweight in and weight gain during pregnancy, birthweight, gestational length, percentage of cesarean deliveries. RESULTS First maternal bodyweight during the GDM pregnancy was higher than in the general population, 72.4 ± 17.4 kg (n = 837) vs. 67.3 ± 12.6 kg (n = 1 383 000; p < 0.0001). Women with GDM gained less weight during pregnancy 9.9 ± 5.8 kg (n = 703) compared to the general population, 13.2 ± 5.7 kg (n = 482 860; p < 0.0001). Mean birthweight in GDM pregnancies was 3564 ± 500 g (n = 743) compared to 3580 ± 483 g for the general population (n = 1 316 364; p = ns). Gestational length was slightly shorter, 39.4 weeks in the GDM pregnancies (n = 683) vs. 39.5 weeks (n = 1 319 876; p = 0.02) in the general population and the percentage of cesarean deliveries higher in the GDM pregnancies at 18.4% (n = 712) vs. 13.3% (n = 1 322 242; p < 0.0001). CONCLUSIONS Though many studies have shown an increased risk of macrosomia in GDM pregnancies, remaining even after ambitious management programs, we show no difference in birthweight. This may be due to a combination of intense efforts to achieve good metabolic control during pregnancy and shorter pregnancy duration. Preventing unduly large babies is crucial to minimize adverse pregnancy outcomes.
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Affiliation(s)
- Charlotta Nilsson
- Department of Pediatrics, Institution of Clinical Science, Helsingborg Hospital, Lund University, Helsingborg, Sweden
| | - Dag Ursing
- Department of Endocrinology, Institution of Clinical Science, Skåne University Hospital, Lund University, Lund, Sweden
| | - Helena Strevens
- Department of Obstetrics and Gynecology, Institution of Clinical Science, Skåne University Hospital, Lund University, Lund, Sweden
| | - Mona Landin-Olsson
- Department of Endocrinology, Institution of Clinical Science, Skåne University Hospital, Lund University, Lund, Sweden
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Over-nutrient environment during both prenatal and postnatal development increases severity of islet injury, hyperglycemia, and metabolic disorders in the offspring. J Physiol Biochem 2015; 71:391-403. [PMID: 26048534 DOI: 10.1007/s13105-015-0419-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 05/28/2015] [Indexed: 12/18/2022]
Abstract
Prenatal and postnatal over-nutrition has emerged as a new health issue contributing to metabolic disorders in early development of the offspring. Accumulating evidence has suggested that adverse prenatal and postnatal environments gave rise to the predisposition to metabolic syndromes including hyperglycemia, obesity, and diabetes. However, little research has concentrated on the effects of exposures to both adverse conditions before and after birth of the offspring. In this study, we aimed to investigate whether prenatal and postnatal over-nutrition is able to cause metabolic disorders to female mice feed on high-fat/fructose diet (HFFD) as well as their offspring. Female mice were fed on either HFFD or a normal chow diet (NC), while their offspring were divided into four experimental groups as NC/NC, HFFD/NC, NC/HFFD, and HFFD/HFFD (prenatal/postnatal diet order), respectively. Both NC/HFFD and HFFD/HFFD offspring exhibited obvious body weight and fat content gain, hyperglycemia, and severe insulin resistance. Interestingly, when compared to NC/HFFD offspring, the HFFD/HFFD offspring exhibited more severe alterations in their metabolism and dysfunctions on pancreatic β-cells, suggesting a potential impact of prenatal HFFD on the programming of pancreatic β-cell deficiency in the fetus. Meanwhile, the results from HFFD/NC mice indicated that a balance diet after birth partially compensated the adverse prenatal HFFD impact. In conclusion, this study demonstrated that prenatal and postnatal over-nutrition increases severity of islet injury, hyperglycemia, and metabolic disorders in the offspring.
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Li J, Zhu Q, Wang H, Han C, Zhou Q, Huang H, Dong M. Decreased fetal pre-adipocyte factor-1 in pregnancies complicated by gestational diabetes mellitus. Clin Chim Acta 2014; 431:93-5. [DOI: 10.1016/j.cca.2014.01.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 01/17/2014] [Accepted: 01/30/2014] [Indexed: 11/29/2022]
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