文章摘要
樊诗琦,严双琴,朱贝贝,李小真,童娟,李春刚,曹慧,伍晓艳,谢亮亮,魏兆莲,陶芳标.孕前BMI和妊娠期糖尿病对儿童脂肪重积聚时相提前的独立和联合效应[J].中华流行病学杂志,2022,43(10):1626-1631
孕前BMI和妊娠期糖尿病对儿童脂肪重积聚时相提前的独立和联合效应
Independent and combined effects of pre-pregnancy BMI and gestational diabetes on early adiposity rebound timing in children
收稿日期:2022-04-29  出版日期:2022-10-18
DOI:10.3760/cma.j.cn112338-20220429-00364
中文关键词: 妊娠期糖尿病  体质指数  超重  肥胖  脂肪重积聚
英文关键词: Gestational diabetes  Body mass index  Overweight  Obesity  Adiposity rebound
基金项目:安徽省重点研究与开发计划(202104j07020034);国家自然科学基金(82073564)
作者单位E-mail
樊诗琦 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/国家卫生健康委胚子及生殖道异常研究重点实验室, 合肥 230032  
严双琴 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/国家卫生健康委胚子及生殖道异常研究重点实验室, 合肥 230032
马鞍山市妇幼保健院, 马鞍山 243000 
470862302@qq.com 
朱贝贝 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/国家卫生健康委胚子及生殖道异常研究重点实验室, 合肥 230032  
李小真 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/国家卫生健康委胚子及生殖道异常研究重点实验室, 合肥 230032  
童娟 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/国家卫生健康委胚子及生殖道异常研究重点实验室, 合肥 230032  
李春刚 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/国家卫生健康委胚子及生殖道异常研究重点实验室, 合肥 230032  
曹慧 马鞍山市妇幼保健院, 马鞍山 243000  
伍晓艳 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/国家卫生健康委胚子及生殖道异常研究重点实验室, 合肥 230032  
谢亮亮 马鞍山市妇幼保健院, 马鞍山 243000  
魏兆莲 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/国家卫生健康委胚子及生殖道异常研究重点实验室, 合肥 230032  
陶芳标 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/国家卫生健康委胚子及生殖道异常研究重点实验室, 合肥 230032  
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中文摘要:
      目的 探讨孕前BMI、妊娠期糖尿病(GDM)与儿童脂肪重积聚(AR)时相提前的关联。方法 基于已经建立的马鞍山优生优育队列,本研究共纳入2 896对母子对,收集孕妇孕前身高、体重、24~28周GDM情况,在婴儿42天、3月龄、6月龄、9月龄以及1岁后每6个月进行1次随访,连续追踪随访至6岁,获得其身长/高、体重等资料。采用多因素logistic回归分析孕前BMI、GDM与儿童AR时相提前的关联强度,并通过相乘、相加模型分析孕前BMI及GDM对于儿童AR时相提前的发生是否存在交互作用。结果 母亲孕前体重不足、体重正常、超重和肥胖者分别占23.2%(672例)、66.4%(1 923例)、8.7%(251例)和1.7%(50例);GDM患病率为12.4%。儿童AR年龄为(4.38±1.08)岁,AR时相提前的儿童占39.3%。多因素logistic回归结果显示,孕前超重(OR=1.67,95%CI:1.27~2.19)、肥胖(OR=3.05,95%CI:1.66~5.56)以及孕期患有GDM(OR=1.40,95%CI:1.11~1.76)是AR时相提前发生的危险因素,而孕前体重不足(OR=0.60,95%CI:0.49~0.73)是AR时相提前发生的保护因素。与仅孕前超重/肥胖或孕期患有GDM相比,孕前超重/肥胖与孕期患有GDM并存,AR时相提前的发生风险更高,OR值(95%CI)分别为2.03(1.20~3.44)、3.43(1.06~11.12)。相乘模型和相加模型分析显示,孕前BMI和孕期患有GDM对儿童AR时相提前无交互作用。结论 母亲孕前较高的BMI和孕期患有GDM是儿童AR时相提前发生的独立危险因素,两者并存的风险更高,但无统计学交互作用。
英文摘要:
      Objective To examine the independent and combined effects of pre-pregnancy BMI and gestational diabetes (GDM) on early adiposity rebound (AR) timing in children.Methods Based on the "Ma'anshan Birth Cohort Study", 2 896 eligible maternal and infant pairs were recruited. In the cohort, we collected pre-pregnancy height, weight, 24 to 28 weeks GDM diagnosis, follow-up at 42 days, three months, six months, nine months of age, and every six months after one year of age, and continuously followed up to 6 years old, and obtained the child's length/height, weight, and other data. The intensity of the association between pre-pregnancy BMI, GDM, and early AR timing was analyzed by the multivariate logistic regression model. Multiplication and additive models were used to analyze how pre-pregnancy BMI and GDM influenced early AR timing in children.Results The prevalence of underweight, average weight, overweight, and obesity before pregnancy were 23.2% (672), 66.4% (1 923), 8.7% (251), and 1.7% (50). The prevalence of GDM was 12.4%. We found that 39.3% of children had AR, and the average age at AR was (4.38±1.08). The results of multifactorial logistic regression analysis showed that pre-pregnancy overweight (OR=1.67, 95%CI:1.27-2.19), pre-pregnancy obesity (OR=3.05, 95%CI:1.66-5.56), and maternal GDM (OR=1.40, 95%CI:1.11-1.76) were risk factors for early AR timing in children. In contrast, pre-pregnancy underweight (OR=0.60, 95%CI:0.49-0.73) was a protective factor for early AR timing in children. Compared with the different effects of pre-pregnancy overweight/obesity and maternal GDM alone, the combined effect caused a higher risk of early AR timing in children, with OR values (95%CI) were 2.03 (1.20-3.44), 3.43 (1.06-11.12), respectively. The multiplication and additive models showed no interaction between pre-pregnancy BMI and GDM-influenced early AR timing in children.Conclusion Higher pre-pregnancy BMI and maternal GDM are the independent risk factors for the early AR timing in children, and the co-occurrence of the two is higher risks, but there was no statistical interaction.
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