Maternal Glycemia during pregnancy and Early Offspring Development: A Prospective Birth Cohort Study

Maternal Glycemia during pregnancy and Early Offspring Development: A Prospective Birth Cohort Study

Highlight：孕期高血糖血症与子代12月龄婴儿神经发育障碍呈显著关联,且这种关联可能由脐血C肽水平介导的。

Abstract

Context: The association of maternal gestational diabetes mellitus (GDM) with neurodevelopmental outcomes remains controversial and evidence that maternal increasing levels of glucose during pregnancy associated with the risk for impaired neurodevelopment were limited.

Objective: To identify the continuous association of increasing maternal glucose levels with neurodevelopmental disorders in offspring and explore the potential contribution of cord metabolites to this association.

Methods: The prospective birth cohort study included 1036 mother-child pairs. Primary predictors were maternal exposure GDM and maternal glucose values at a 75-g oral-glucose-tolerance test (OGTT) at 24–28 weeks during pregnancy. Primary neurodevelopmental outcomes at 12 mo in offspring were assessed by the ASQ-3.

Results: Maternal GDM was associated with failing the communication domain in offspring in the adjusted models [RR with 95% CI: 1.97(1.11, 3.52)]. Increasing levels of fasting plasma glucose (FPG), 1 h plasma glucose (1-h PG) and 2 h plasma glucose (2-h PG) with one SD change were at higher risks in failing the personal social domain of ASQ [RRs with 95% CI for FPG: 1.49(1.09, 2.04); for 1-h PG: 1.70(1.27, 2.29); for 2-h PG: 1.36(1.01, 1.84)]. The linear association was also demonstrated. Compared with girls, boys exposed to higher maternal glucose levels were inclined to the failure of the personal social domain. Mediation analysis showed the contribution of maternal GDM to failure of communication domain mediated by C-peptide.

Conclusions: Maternal glucose levels below those diagnostic of diabetes are continuously associated with impaired neurodevelopment in offspring at 12 mo.

Wang P, Xie J, Jiao XC, Ma SS, Liu Y, Yin WJ, Tao RX, Hu HL, Zhang Y, Chen XX, Tao FB, Zhu P*. Maternal Glycemia during pregnancy and Early Offspring Development: A Prospective Birth Cohort Study. J Clin Endocrinol Metab. 2021 May 13:dgab331.