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Fujikawa Shingu K, Waguri M, Takahara M, Piedvache A, Katakami N, Shimomura I. Association between infant birth weight and gestational weight gain in Japanese women with diabetes mellitus. J Diabetes Investig 2024. [PMID: 38445817 DOI: 10.1111/jdi.14177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
AIMS/INTRODUCTION In 2021, the guidelines on gestational weight gain (GWG) were revised and increased by 2-3 kg in Japan. This study aimed to investigate whether the revised guidelines would increase the incidence of babies with excessive birth weight in mothers with diabetes. MATERIALS AND METHODS This retrospective study included 369 deliveries of women with diabetes whose pre-pregnancy body mass index was below 30 kg/m2 between 1982 and 2021. The primary outcome measure was large for gestational age (LGA). We compared the incidence of LGA between women who gained weight within the previous guidelines and women who gained weight within the revised guidelines. We also compared the incidence of macrosomia, preeclampsia, small for gestational age (SGA), and low birth weight. RESULTS The incidence of LGA was not significantly different between women who gained weight within the revised guidelines and those within the previous guidelines (34.6% [95% confidence interval 25.6-44.6%] for the revised guidelines vs 28.9% [21.6-37.1%] for the previous guidelines; P = 0.246). Neither was the incidence of macrosomia or preeclampsia significantly different (8.7% [4.0-15.8%] vs 5.6% [2.5-10.8%] and 5.8% [2.1-12.1%] vs 6.3% [2.9-11.7%]; P = 0.264 and 0.824, respectively), while women who gained weight within the revised guidelines had a lower incidence of SGA (1.9% [0.2-6.8%] vs 10.6% [6.0-16.8%]; P = 0.001) and low birth weight (1.0% [0.02-5.2%] vs 7.0% [3.4-12.6%]; P = 0.023). CONCLUSIONS The revised GWG guidelines could be beneficial in women with diabetes in terms of delivering babies with appropriate birth weight.
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Affiliation(s)
- Kei Fujikawa Shingu
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Obstetric Medicine, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Masako Waguri
- Department of Obstetric Medicine, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Aurélie Piedvache
- Department of Social Medicine, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Berge V, Thyen U. [Effects of High Birth Weight on the Development of Preschoolers]. Z Geburtshilfe Neonatol 2023; 227:448-465. [PMID: 37758195 DOI: 10.1055/a-2160-0584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
BACKGROUND A high birth weight above 4,000 g may lead to risks in the development of affected children. The association is less studied than the effects of very low birth weight and is the subject of this study. METHODS The retrospective study design used data from school entry surveys in Schleswig-Holstein (Germany) collected in 2014-2017 and included 88,858 children aged 5-6 years. End points examined were language, motor skills, cognition, and behavior; use of support measures; and recommendation for special educational needs. Logistic regression models were used to estimate the association between birth weight and the outcome measures, adjusting for sociodemographic factors. RESULTS After accounting for sociodemographic factors, high birth weight is not associated with impaired child development, whereas low birth weight emerges as a significant predictor. Across all birth weights, sociodemographic factors explain most of the variance in multivariate models of the influence of birth weight on child development. CONCLUSIONS Very high birth weight does not justify a general recommendation for support measures. Therefore, individual developmental trajectories should be monitored. Growing up in disadvantaged circumstances may represent a significant risk and should be a reason for early intervention.
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Affiliation(s)
- Valerie Berge
- UKSH Campus Lübeck, Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
- Institut für Humangenetik, Universität zu Lübeck, Lübeck, Germany
| | - Ute Thyen
- UKSH Campus Lübeck, Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
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Okui T. Analysis of the Incidence of Macrosomia in Japan by Parental Nationalities at 5-year Intervals From 1995 to 2020. J Prev Med Public Health 2023; 56:348-356. [PMID: 37551073 PMCID: PMC10415649 DOI: 10.3961/jpmph.23.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/26/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES We investigated trends in the incidence rate of macrosomia and its association with parental nationalities using Vital Statistics data in Japan. METHODS We used singleton birth data every 5 years from 1995 to 2020. The incidence rate of macrosomia was calculated according to specific attributes (maternal age, infant's sex, parental nationalities, parity, and household occupation) over time (years). In addition, a log-binomial model was used to investigate the relationship between the incidence of macrosomia and the attributes. This study compared Korea, China, the Philippines, Brazil, and other countries with Japan in terms of parental nationalities. "Other countries" indicates countries except for Japan, Korea, China, the Philippines, and Brazil. RESULTS The study included 6 180 787 births. The rate of macrosomia in Japan decreased from 1.43% in 1995 to 0.88% in 2020, and the decrease was observed across all parental nationalities. The rates for Japanese parents were the lowest values among parental nationalities during the timespan investigated. Multivariate regression analysis showed that mothers from Korea, China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.91, 2.82, 1.59, 1.74, and 1.64, respectively). Furthermore, fathers from China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.66, 1.38, 1.88, and 3.02, respectively). CONCLUSIONS The rate of macrosomia decreased from 1995 to 2020 in Japan for parents of all nationalities, and the risk of macrosomia incidence was associated with parental nationality.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Bai W, Wang H, Fang R, Lin M, Qin Y, Han H, Cui J, Zhang R, Ma Y, Chen D, Zhang W, Wang L, Yu H. Evaluating the effect of gestational diabetes mellitus on macrosomia based on the characteristics of oral glucose tolerance test. Clin Chim Acta 2023; 544:117362. [PMID: 37088117 DOI: 10.1016/j.cca.2023.117362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/31/2023] [Accepted: 04/18/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND GDM is always treated as a homogenous disease ignoring the different metabolic characteristics in oral glucose tolerance test (OGTT). We assessed the effect of GDM on macrosomia based on the different characteristics of OGTT. METHODS We retrospectively divided 998 GDM pregnant women into 7 groups, Group A1: abnormal OGTT0h; Group A2: abnormal OGTT1 h; Group A3: abnormal OGTT2 h; Group B1: abnormal OGTT0h+1 h; Group B2: abnormal OGTT0h+2 h; Group B3: abnormal OGTT1 h+2 h; Group C: abnormal OGTT0h+1 h+2 h; RESULTS: The incidence of macrosomia in group C (21.92%) was higher than other groups. The OR of OGTT0h+1 h+2 h was significant (OGTT1 h: OR=1.577, 95% CI: 0.791, 3.145; OGTT2 h: OR=1.151, 95% CI: 0.572, 2.313; OGTT0h+1 h: OR=1.346, 95% CI: 0.584, 3.101; OGTT0h+2 h: OR=1.327, 95% CI: 0.517, 3.409; OGTT1 h+2 h: OR=0.771, 95% CI: 0.256, 2.322; OGTT0h+1 h+2 h: OR=4.164, 95% CI: 2.095, 8.278) when comparing with OGTT0h. Subgroup analysis showed abnormal OGTT0h+1 h+2 h might contribute more to macrosomia in pre-pregnancy BMI ≥ 24 kg/m2 than those with BMI < 24 kg/m2. CONCLUSION The effect of abnormal OGTT0h+1 h+2 h on macrosomia was significantly greater than other OGTT characteristics, especially for those with pre-pregnancy BMI ≥ 24 kg/m2. Individualized management of GDM based on OGTT characteristics and pre-pregnancy BMI might be needed.
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Affiliation(s)
- Wenlin Bai
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Hui Wang
- Obstetrics Clinic, Changzhi Maternal and Child Health Care Hospital, Changzhi, 046000, China
| | - Ruiling Fang
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Mengwen Lin
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Yao Qin
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Hongjuan Han
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Jing Cui
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Rong Zhang
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Yifei Ma
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Durong Chen
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Wenping Zhang
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Li Wang
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Hongmei Yu
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China.
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Kang YE, Yi HS, Yeo MK, Kim JT, Park D, Jung Y, Kim OS, Lee SE, Kim JM, Joung KH, Lee JH, Ku BJ, Lee M, Kim HJ. Increased Pro-Inflammatory T Cells, Senescent T Cells, and Immune-Check Point Molecules in the Placentas of Patients With Gestational Diabetes Mellitus. J Korean Med Sci 2022; 37:e338. [PMID: 36513052 PMCID: PMC9745681 DOI: 10.3346/jkms.2022.37.e338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/22/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is the most common metabolic complication of pregnancy. To define the altered pathway in GDM placenta, we investigated the transcriptomic profiles from human placenta between GDM and controls. METHODS Clinical parameters and postpartum complications were reviewed in all participants. Differentially expressed canonical pathways were analyzed between the GDM and control groups based on transcriptomic analysis. CD4+ T, CD8+ T, and senescent T cell subsets were determined by flow cytometry based on staining for specific intracellular cytokines. RESULTS Gene ontology analysis revealed that the placenta of GDM revealed upregulation of diverse mitochondria or DNA replication related pathways and downregulation of T-cell immunity related pathways. The maternal placenta of the GDM group had a higher proportion of CD4+ T and CD8+ T cells than the control group. Interestingly, senescent CD4+ T cells tended to increase and CD8+ T cells were significantly increased in GDM compared to controls, along with increased programmed cell death-1 (CD274+) expression. Programmed death-ligand 1 expression in syncytotrophoblasts was also significantly increased in patients with GDM. CONCLUSION This study demonstrated increased proinflammatory T cells, senescent T cells and immune-check point molecules in GDM placentas, suggesting that changes in senescent T cells and immune-escape signaling might be related to the pathophysiology of GDM.
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Affiliation(s)
- Yea Eun Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hyon-Seung Yi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
- Laboratory of Endocrinology and Immune System, Chungnam National University College of Medicine, Daejeon, Korea
| | - Min-Kyung Yeo
- Department of Pathology, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jung Tae Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Danbit Park
- Department of Obstetrics and Gynecology, Chungnam National University Hospital, Daejeon, Korea
| | - Yewon Jung
- Department of Obstetrics and Gynecology, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Ok Soon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Seong Eun Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Ji Min Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kyong Hye Joung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Ju Hee Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Bon Jeong Ku
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Mina Lee
- Department of Obstetrics and Gynecology, Chungnam National University College of Medicine, Daejeon, Korea.
| | - Hyun Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
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