Search

Aims: To examine the independent and interactive effects of maternal gestational diabetes mellitus (GDM) and high pre‐pregnancy body mass index (BMI) on the risk of offspring adverse growth patterns. Materials and Methods: One thousand six hundred and eighty one mother‐child pairs were followed for 8 years in Tianjin, China. Group‐based trajectory modelling was used to identify offspring growth patterns. Logistic regression was performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs) of GDM and high pre‐pregnancy BMI for offspring adverse growth patterns. Restricted cubic spline was used to identify cut‐off points. Additive interactions and multiplicative interactions were used to test interactive effects between GDM and high pre‐pregnancy BMI for adverse growth patterns. Results: Four distinct growth patterns were identified in offspring, including normal growth pattern, persistent lean growth pattern, late obesity growth pattern (LOGP), and persistent obesity growth pattern (POGP). Maternal high pre‐pregnancy BMI was associated with LOGP and POGP (adjusted OR, 95% CI: 2.38, 1.74–3.25 & 4.92, 2.26–10.73). GDM greatly enhanced the adjusted OR of high pre‐pregnancy BMI for LOGP up to 3.48 (95% CI: 2.25–5.38). Additive interactions and multiplicative interactions between both risk factors were significant for LOGP but not for POGP. Conclusions: Maternal high pre‐pregnancy BMI was associated with increased risk of LOGP and POGP, whereas GDM greatly enhanced the risk of high pre‐pregnancy BMI for LOGP. [ABSTRACT FROM AUTHOR]

To evaluate the independent association of seasonal variation with GDM incidence in Tianjin, China, and to test whether there is an additive interaction between seasonal variation and pre-pregnancy body mass index (BMI) on GDM incidence. A population-based observational cohort study was conducted using the healthcare records data from Tianjin, China. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Additive interaction between pre-pregnancy BMI groups and seasons was estimated by using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S). Among the 112,639 pregnant women, 20.8% developed GDM at 24–28 weeks of gestation. The multivariable adjusted ORs and 95% CIs were 1.00, 1.00 (0.96–1.05), 1.15 (1.09–1.20) and 1.22 (1.16–1.29) respectively based on seasons (spring, summer, autumn and winter). Compared with the spring/summer and pre-pregnant BMI < 24 kg/m2 group, co-presence of autumn/winter and pre-pregnancy BMI ≥ 24 kg/m2 increased the OR from 1.00 to 2.70 (95% CI 2.28–3.20), with a significant additive interaction: RERI (0.32, 95% CI 0.19–0.45), S (1.21, 95% CI 1.12–1.31) and AP (0.11, 95% CI 0.07–0.16). Autumn/winter is an independent risk factor for GDM incidence, and can significantly amplify the obesity-associated risk for GDM incidence. The underlying mechanism warrants further investigations. We suggest that seasonality is an additional factor when interpreting OGTT results for the diagnosis of GDM. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to explore associations of aromatic amino acids (AAA) in early pregnancy with gestational diabetes mellitus (GDM), and whether high AAA and gut microbiota-related metabolites had interactive effects on GDM risk. Methods: We conducted a 1:1 case-control study (n = 486) nested in a prospective cohort of pregnant women from 2010 to 2012. According to the International Association of Diabetes and Pregnancy Study Group's criteria, 243 women were diagnosed with GDM. Binary conditional logistic regression was performed to examine associations of AAA with GDM risk. Interactions between AAA and gut microbiota-related metabolites for GDM were examined using additive interaction measures. Results: High phenylalanine and tryptophan were associated with increased GDM risk (OR: 1.72, 95% CI: 1.07–2.78 and 1.66, 1.02–2.71). The presence of high trimethylamine (TMA) markedly increased the OR of high phenylalanine alone up to 7.95 (2.79–22.71), while the presence of low glycoursodeoxycholic acid (GUDCA) markedly increased the OR of high tryptophan alone up to 22.88 (5.28–99.26), both with significant additive interactions. Furthermore, high lysophosphatidylcholines (LPC18:0) mediated both interactive effects. Conclusions: High phenylalanine may have an additive interaction with high TMA, while high tryptophan may have an additive interaction with low GUDCA toward increased risk of GDM, both being mediated via LPC18:0. [ABSTRACT FROM AUTHOR]

Summary: Objective: To explore associations of maternal insulin resistance and β‐cell dysfunction with offspring overweight before 24 months of age among children of Chinese women with gestational diabetes mellitus (GDM). Methods: Offspring of women with GDM (n = 901) who were enrolled in a lifestyle trial during pregnancy were followed up to 24 months of age in Tianjin, China. Restricted cubic spline analysis was performed to examine full‐range associations of maternal homeostatic model assessment of insulin resistance (HOMA‐IR) and β‐cell function (HOMA‐%β) with childhood overweight. Logistic regression was performed to obtain the odds ratios (ORs) and 95% confidence interval (CI) of maternal high HOMA‐IR and low HOMA‐%β at diagnosis of GDM for offspring overweight within 12 months of age and at 13–24 months of age. Results: Maternal high HOMA‐IR was associated with an increased risk of offspring being overweight within 12 months of age and at 13–24 months of age (OR: 1.71, 95%CI: 1.12–2.62 & 1.89, 1.13–3.17, respectively). Maternal low HOMA‐%β was associated with an increased risk of offspring being overweight at 13–24 months of age (1.64, 1.05–2.55). Conclusions: Both maternal increased insulin resistance and decreased β‐cell function at diagnosis of GDM were associated with elevated risk of offspring overweight in early childhood among Chinese women with GDM. [ABSTRACT FROM AUTHOR]

Background Interactions between genetic and nutritional factors can contribute to the risk of gestational diabetes mellitus (GDM). Objectives We aimed to explore the associations of cyclin-dependent kinase 5 regulatory subunit associated protein 1-like 1 (CDKAL1) single-nucleotide polymorphism (SNP) rs7747752 and serum concentrations of SFAs with the risk of GDM in Chinese women. Methods We conducted a 1:1 case–control study in a prospective cohort of pregnant women in Tianjin, China. Serum SFA data were collected from a total of 243 women with GDM and their controls matched by maternal age (±1 y). Among them, 207 case–control pairs had high-quality sequencing data. P/L and S/P ratios were defined as palmitic acid (16:0)/lauric acid (12:0) and stearic acid (18:0)/palmitic acid, respectively. Conditional logistic regression analysis was performed to estimate associations of CDKAL1 SNP rs7747752 and serum concentrations of SFAs with the risk of GDM. An additive interaction between rs7747752 and palmitic acid was analyzed to test the contribution of their interaction to the risk of GDM. Results Among the 5 tested SFAs, palmitic acid was positively whereas lauric acid was negatively associated with the risk of GDM. A P/L ratio ≥12.2 and an S/P ratio ≤0.71 were independently and synergistically associated with an increased risk of GDM. The CDKAL1 rs7747752 G > C variant was significantly associated with an increased risk of GDM (P  < 0.05). Furthermore, the presence of the rs7747752 G > C variant increased the OR (95% CI) of high palmitic acid concentration from 1.55 (0.61, 3.97) to 4.34 (2.04, 9.23), with a significant additive interaction. Conclusions The interaction between high serum palmitic acid concentration and the CDKAL1 rs7747752 G > C variant played a critical role in GDM. Given that a hypocaloric low-carbohydrate diet can lower palmitic acid concentrations, it is worthwhile to test whether such a diet is effective in reducing the risk of GDM, especially among women who have both risk factors. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between neonatal thyroid function and the formal education of mothers.Study design: Participants came from a population-based congenital hypothyroidism (CH) screening program in Tianjin, China.Methods: Of 66,390 registered births in 2015, 60,568 mothers and newborns had complete data. Mothers were categorized into one of four categories based on their educational attainment: (a) midschool or less; (b) high school or equivalent; (c) university; or (d) post graduate. Newborn thyroid-stimulating hormone (TSH) level was measured on day 3-7. Two neonatal groups were created using cutoffs of TSH > 10 μIU/ml and TSH > 20 μIU/ml. Odds ratios (OR) for CH risk by maternal education were estimated from logistic regression models after adjusting for potential confounders.Results: For TSH > 10 μIU/ml, the screen positive incidence rate for CH was 1:201 or 4.98 per 1000 births; for TSH > 20 μIU/ml, the incidence rate was 1:2222 or 0.45 per 1000 births. Screen positive incidence rates decreased with increasing maternal education level. Compared to mothers with a postgraduate education, the ORs (95% CI) for midschool or less, high school or equivalent, and university were 2.09 (1.08, 4.04), 1.45 (0.73, 2.90), and 1.61 (0.85, 3.06) using a cutoff of TSH > 10 μIU/ml. At the higher cutoff of TSH > 20 μIU/ml ORs (95% CI) for midschool or less and high school or equivalent were 3.05 (1.20,7.74) and 3.34 (1.24, 8.97), when compared to a composite reference category of university and postgraduate level education.Conclusion: Maternal education is inversely related to neonatal thyroid function though the mechanism remains unexplained. [ABSTRACT FROM AUTHOR]

Smoking has been associated with depression in the general population. Whether passive smoking is also associated with postpartum depression (PPD) is uncertain. From 2010 to 2012, we recruited 8,842 pregnant women in Tianjin, China. The mainland Chinese version of the Edinburgh Postnatal Depression Scale was used to evaluate postpartum depressive symptoms after birth, with a score of >9 defining PPD. Data were collected using specially designed questionnaires or data from the electronic database of Tianjin Maternal and Child Health Information System. Odds ratios (OR) and 95 percent confidence intervals (CI) were obtained for the association of smoking status with PPD using binary logistic regression. Passive smoke exposure rates before and during pregnancy were 40.9 percent and 52.1 percent, respectively. A total of 8.5% (n = 747) of participants had PPD. Compared with those not exposed, women passively exposed to smoke before and during pregnancy had higher odds of PPD (before pregnancy: OR: 1.24, 95 percent CI: 1.03-1.50; during pregnancy: OR: 1.43, 95 percent CI: 1.16-1.77) after adjustment for confounding factors. Passive smoking before and during pregnancy were associated with PPD in Chinese women. Reducing passive smoke exposure may reduce PPD in Chinese women; further longitudinal studies are warranted to replicate these findings. [ABSTRACT FROM AUTHOR]

Postpartum depression is associated with adverse consequences for mother and offspring. The heritable ABO blood group has been associated with multiple diseases, including mental illness and diabetes. We explored the association of ABO blood group and postpartum depressive symptoms (PPDS) in a population-based cohort of pregnant Chinese women. From 2010 to August 2012, we recruited 8842 pregnant women with a mean age of 28.5 years (SD: 2.94) and mean body mass index of 22.4kg/m2 (SD: 3.45) in Tianjin, China. We used the Mainland Chinese version of the Edinburgh Postnatal Depression Scale after delivery with a cutoff score of 10 to define PPDS. Odds ratios (ORs) and 95% confidence intervals (CIs) for PPDS were obtained using binary logistic regression. Of 8842 women, 8.5% (n = 747) developed PPDS. Compared to those with blood group B, women with blood groups A, AB or O had a higher odds of PPDS (adjusted ORs: 1.23 (95% CI: 1.13-1.40), 1.31 (95% CI: 0.98-1.74), and 1.30(95% CI:1.03-1.60), respectively). Blood group B was associated with reduced odds of PPDS in pregnant Chinese women. If replicated in other studies, non-blood group B may be a useful risk factors for PPDS in Chinese pregnant women. [ABSTRACT FROM AUTHOR]

Objective. To examine the relative impact of maternal prepregnancy body mass index (BMI) and glucose level at 24–28 gestational weeks on offspring’s overweight status from birth to 3 years of age in China. Methods. Health care records of 21,354 mother-child pairs were collected. The single and joint associations of maternal prepregnancy BMI and glucose level at 24–28 gestational weeks with 0–3-year-old offspring’s overweight status were assessed. Results. The odds ratios (95% confidence intervals) of offspring’s macrosomia at birth and overweight/obesity at the 12th month, 24th month, and 36th month were 1.12 (1.11–1.13), 1.05 (1.04–1.06), 1.07 (1.06–1.08), and 1.11 (1.10–1.12) for each 1-unit increase (km/m2) in maternal prepregnancy BMI and 1.13 (1.10–1.17), 1.01 (0.99–1.03), 0.99 (0.96–1.01), and 1.00 (0.97–1.02) for each 1-unit increase (mmol/L) in maternal glucose level at 24–28 gestational weeks, respectively. The positive association of maternal glucose level with macrosomia at birth was similar between prepregnancy normal weight (BMI < 24 kg/m2) and overweight (BMI ≥ 24 kg/m2); however, the positive association of high maternal glucose level with childhood overweight was only seen among prepregnancy normal weight mothers but not among overweight mothers. Conclusions. The impact of maternal gestational hyperglycemia on offspring’s overweight before 3 years of age can be modified by prepregnancy BMI. [ABSTRACT FROM AUTHOR]

Aims: To investigate the risk of postpartum metabolic syndrome in women with GDM compared with those without GDM in a Chinese population.Methods: Tianjin GDM observational study included 1263 women with a history of GDM and 705 women without GDM. Multivariate logistic regression was used to assess risks of postpartum metabolic syndrome between women with and without GDM. Postpartum metabolic syndrome was diagnosed by two commonly used criteria.Results: During a mean 3.53 years of follow up, 256 cases of metabolic syndrome were identified by using the NCEP ATPIII criteria and 244 cases by using the IDF criteria. Multivariable-adjusted odds ratios of metabolic syndrome in women with GDM compared with those without GDM were 3.66 (95% confidence interval [CI] 2.02-6.63) for NCEP ATPIII criteria and 3.90 (95% CI 2.13-7.14) for IDF criteria. Women with GDM had higher multivariable-adjusted odds ratios of central obesity, hypertriglyceridemia, and high blood pressure than women without GDM. The multivariable-adjusted odds ratios of low HDL cholesterol and hyperglycemia were not significant between women with and without GDM, however, the multivariable-adjusted odds ratio of hyperglycemia became significant when we used the modified criteria.Conclusions: The present study indicated that women with prior GDM had significantly higher risks for postpartum metabolic syndrome, as well as its individual components. [ABSTRACT FROM AUTHOR]