Associations Between Maternal Obesity and Pregnancy Hyperglycemia and Timing of Puberty Onset in Adolescent Girls: A Population-Based Study
Associations Between Maternal Obesity and Pregnancy Hyperglycemia and Timing of Puberty Onset in Adolescent Girls: A Population-Based Study
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DOI：
10.1093/aje/kwy040
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发表时间：
2018-07-01
影响因子：
5
通讯作者：
Kushi, Lawrence H.
中科院分区：
文献类型：
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作者：
Kubo, Ai;Deardorff, Julianna;Kushi, Lawrence H.
青春期提前与不良的健康结果有关。我们使用15，267名6-11岁的种族/民族多样的Kaiser Permanente北方加州成员，研究了子宫内暴露于母亲肥胖是否与女儿的青春期时间相关，这些成员具有儿科医生评估的坦纳分期（2003-2017年）。我们根据电子健康记录数据计算了孕妇怀孕期间的体重指数（BMI;体重（kg）/身高（m）（2））。使用比例风险模型与区间删失，我们研究了母亲肥胖和女孩的青春期时间之间的关联，以及种族/民族的影响修改和调解青春期前BMI。母体肥胖（BMI >= 30）和超重（BMI 25-29.9）与女孩乳房发育的早期发生有关（风险比（HR）= 1.39（95%置信区间（CI）：1.30，1.49）和HR = 1.21（95% CI：1.13，1.29）），调整后的女孩的种族/民族，母亲的年龄，教育，产次，并在怀孕期间吸烟。母亲肥胖和女孩阴毛开始之间的关联存在种族/民族的相互作用：亚洲和非西班牙裔白色女孩的关联最强（HR = 1.53（95% CI：1.24，1.90）和HR = 1.34（95% CI：1.18，1.52）），非洲裔美国女孩不存在。调整女孩青春期前的BMI仅略微减弱了相关性。我们的研究结果表明，怀孕期间母体代谢因素对女孩青春期发育的重要性，以及种族/民族之间的潜在差异。
Early puberty is associated with adverse health outcomes. We investigated whether in utero exposure to maternal obesity is associated with daughters' pubertal timing using 15,267 racially/ethnically diverse Kaiser Permanente Northern California members aged 6-11 years with pediatrician-assessed Tanner staging (2003-2017). We calculated maternal body mass index (BMI; weight (kg)/height (m)(2)) during pregnancy from the electronic health record data. Using a proportional hazards model with interval censoring, we examined the associations between maternal obesity and girls' pubertal timing, as well as effect modification by race/ethnicity and mediation by prepubertal BMI. Maternal obesity (BMI >= 30) and overweight (BMI 25-29.9) were associated with earlier onset of breast development in girls (hazard ratio (HR) = 1.39 (95% confidence interval (CI): 1.30, 1.49) and HR = 1.21 (95% CI: 1.13, 1.29), respectively), after adjustment for girl's race/ethnicity, maternal age, education, parity, and smoking during pregnancy. There was interaction by race/ethnicity for associations between maternal obesity and girls' pubic hair onset: Associations were strongest among Asian and non-Hispanic white girls (HR = 1.53 (95% CI: 1.24, 1.90) and HR = 1.34 (95% CI: 1.18, 1.52), respectively) and absent for African-American girls. Adjustment for girl's prepubertal BMI only slightly attenuated associations. Our results suggest the importance of maternal metabolic factors during pregnancy in the timing of girls' puberty and potential differences in the associations by race/ethnicity.