Gestational diabetes and ultrasound-assessed fetal growth in South Asian and White European women: findings from a prospective pregnancy cohort.
Gestational diabetes and ultrasound-assessed fetal growth in South Asian and White European women: findings from a prospective pregnancy cohort.
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DOI：
10.1186/s12916-018-1191-7
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发表时间：
2018-11-06
期刊：
影响因子：
9.3
通讯作者：
Lawlor DA
中科院分区：
文献类型：
--
作者：
Brand JS;West J;Tuffnell D;Bird PK;Wright J;Tilling K;Lawlor DA
妊娠期糖尿病（GDM）是一个既定的危险因素，在出生时大的，但其对宫内胎儿生长的影响，在不同的种族人群还不太清楚。在这里，我们研究联合协会GDM和种族与纵向胎儿生长在南亚和白色欧洲血统的妇女。这项研究包括10,705名来自英格兰北部布拉德福德产前诊所的前瞻性队列妇女的单胎（4747名白色欧洲人和5958名南亚人）。所有妇女在妊娠26-28周时完成75克口服葡萄糖耐量试验。超声测量胎儿头围（HC），股骨长度（FL），腹围（AC），估计胎儿体重（EFW），并在出生时相应的人体测量结果被用来推导胎儿生长轨迹。GDM和种族与这些轨迹的关联使用多级分数多项式模型进行评估。832例妊娠（7.8%）受GDM影响：南亚人10.4%，白色欧洲人4.4%。妊娠期糖尿病与妊娠早期较小的胎儿尺寸相关[暴露于妊娠期糖尿病的胎儿与未暴露的胎儿相比，12周时平均HC和16周时平均AC和EFW的差异（95% CI（参考）= − 1.8 mm（− 2.6; − 1.0）、− 1.7毫米（-2.5;-0.9），和-6 g（− 10;-2）]和从妊娠24周至足月的胎儿尺寸较大[平均HC，AC，暴露于GDM的胎儿与未暴露的胎儿的EFW比较= 0.9 mm（0.3; 1.4）、0.9 mm（0.2; 1.7）和7 g（0; 13）（24周）]。在两个种族中，GDM与胎儿生长的关系具有相似的程度。然而，增长轨迹不同的种族与南亚人小于白色欧洲人，无论GDM的状态。因此，在整个妊娠期，暴露于GDM的南亚胎儿比没有GDM的白色欧洲人的胎儿更小。在这两个种族中，GDM与GDM诊断前的早期胎儿大小偏差有关，这突出了比现有方法更早诊断妊娠高血糖症的新策略的必要性。我们的研究结果还表明，种族特异性的胎儿生长标准是重要的，在确定高血糖症相关的病理影响。本文的在线版本（10.1186/s12916-018-1191-7）包含补充材料，可供授权用户使用。
Maternal gestational diabetes (GDM) is an established risk factor for large size at birth, but its influence on intrauterine fetal growth in different ethnic populations is less well understood. Here, we examine the joint associations of GDM and ethnicity with longitudinal fetal growth in South Asian and White European origin women. This study included 10,705 singletons (4747 White European and 5958 South Asian) from a prospective cohort of women attending an antenatal clinic in Bradford, in the North of England. All women completed a 75-g oral glucose tolerance test at 26–28 weeks’ gestation. Ultrasound measurements of fetal head circumference (HC), femur length (FL) abdominal circumference (AC), and estimated fetal weight (EFW), and corresponding anthropometric measurements at birth were used to derive fetal growth trajectories. Associations of GDM and ethnicity with these trajectories were assessed using multilevel fractional polynomial models. Eight hundred thirty-two pregnancies (7.8%) were affected by GDM: 10.4% of South Asians and 4.4% of White Europeans. GDM was associated with a smaller fetal size in early pregnancy [differences (95% CI) in mean HC at 12 weeks and mean AC and EFW at 16 weeks comparing fetuses exposed to GDM to fetuses unexposed (reference) = − 1.8 mm (− 2.6; − 1.0), − 1.7 mm (− 2.5; − 0.9), and − 6 g (− 10; − 2)] and a greater fetal size from 24 weeks’ gestation through to term [differences (95% CI) in mean HC, AC, and EFW comparing fetuses exposed to GDM to those unexposed = 0.9 mm (0.3; 1.4), 0.9 mm (0.2; 1.7), and 7 g (0; 13) at 24 weeks]. Associations of GDM with fetal growth were of similar magnitude in both ethnic groups. Growth trajectories, however, differed by ethnicity with South Asians being smaller than White Europeans irrespective of GDM status. Consequently, South Asian fetuses exposed to GDM were smaller across gestation than fetuses of White Europeans without GDM. In both ethnic groups, GDM is associated with early fetal size deviations prior to GDM diagnosis, highlighting the need for novel strategies to diagnose pregnancy hyperglycemia earlier than current methods. Our findings also suggest that ethnic-specific fetal growth criteria are important in identifying hyperglycemia-associated pathological effects. The online version of this article (10.1186/s12916-018-1191-7) contains supplementary material, which is available to authorized users.
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影响因子：
8
作者：
Boney, CM;Verma, A;Vohr, BR
通讯作者：
Vohr, BR
DOI：
10.1016/s0002-9378(03)00828-7
发表时间：
2003-12-01
影响因子：
9.8
作者：
Catalano, PM;Thomas, A;Amini, SB
通讯作者：
Amini, SB
影响因子：
9.8
作者：
Buck Louis GM;Grewal J;Albert PS;Sciscione A;Wing DA;Grobman WA;Newman RB;Wapner R;D'Alton ME;Skupski D;Nageotte MP;Ranzini AC;Owen J;Chien EK;Craigo S;Hediger ML;Kim S;Zhang C;Grantz KL
通讯作者：
Grantz KL
世界卫生组织胎儿生长图：超声生物识别测量和估计胎儿体重的跨国纵向研究。
影响因子：
15.8
作者：
Kiserud T;Piaggio G;Carroli G;Widmer M;Carvalho J;Neerup Jensen L;Giordano D;Cecatti JG;Abdel Aleem H;Talegawkar SA;Benachi A;Diemert A;Tshefu Kitoto A;Thinkhamrop J;Lumbiganon P;Tabor A;Kriplani A;Gonzalez Perez R;Hecher K;Hanson MA;Gülmezoglu AM;Platt LD
通讯作者：
Platt LD
DOI：
10.1111/dme.12381
发表时间：
2014-03
期刊：
Diabetic medicine : a journal of the British Diabetic Association
影响因子：
--
作者：
Catalano PM
通讯作者：
Catalano PM