Infant Temperament and Early Infant Growth and Child Overweight in GDM Offspring

描述（由申请人提供）：妊娠期糖尿病（GDM）母亲的后代更容易患肥胖症、葡萄糖耐受不良、胰岛素抵抗和2型糖尿病，因为宫内暴露于母体糖尿病，尽管产后喂养可能会改变风险。“困难”的气质加上产后喂养习惯，如缺乏母乳喂养，早期补充和含糖食物，可能共同使婴儿易于快速生长和后来肥胖，这是未来代谢疾病的关键风险因素。我们提出了一个次要数据分析的高风险队列的GDM母婴对（71%的少数民族）参加研究的妇女，婴儿喂养和2型糖尿病后GDM妊娠（SWIFT; R 01 HD 050625）。从2008年到2011年，SWIFT招募了1，035名GDM母亲，她们在Kaiser Permanente医院分娩了一个单胎，活产e35周。气质、饮食摄入（例如，对363名婴儿在出生后第一年的母乳喂养、饮食摄入、含糖饮料）和人体测量进行了评估。利用这些现有的数据，拟议的研究将首次阐明婴儿气质和健康行为之间的关系，以及它们对GDM后代婴儿生长的影响。本研究的目的是：目的1：描述“困难”气质（即，对限制的更差的痛苦，以及更少的抚慰性）对婴儿在生命的第一年期间的生长的影响，目的2：评估“困难气质”和婴儿快速生长之间的关联的潜在介质（即，较少的母乳喂养、在瓶中添加谷物、早期引入果汁/食物和高摄入含糖食物/饮料），以及探索性目标3：确定困难婴儿气质是否与2-4岁时的超重相关。一个困难的婴儿气质可能会引入一系列额外的压力源，新的母亲除了妊娠期糖尿病的压力。我们提出的研究解决了关于气质和可改变的风险因素的新假设，这些因素可能为早期肥胖预防策略提供信息。

DESCRIPTION (provided by applicant): Offspring of mothers with gestational diabetes mellitus (GDM) are more likely to develop obesity, glucose intolerance, insulin resistance, and type 2 diabetes because of intrauterine exposure to maternal diabetes, although postnatal feeding may modify risk. A 'difficult' temperament coupled with postnatal feeding practices, such as lack of breastfeeding, early complementary and sugary foods may jointly predispose infants to rapid growth and later obesity which are key risk factors for future metabolic disease. We propose a secondary data analysis of a high-risk cohort of GDM mother-infant pairs (71% minority) enrolled in the Study of Women, Infant Feeding and Type 2 Diabetes after GDM Pregnancy (SWIFT;R01HD050625). From 2008-2011, SWIFT enrolled 1,035 GDM mothers who delivered a singleton, live birth e35 weeks at Kaiser Permanente hospitals. Temperament, dietary intake (e.g., breastfeeding, dietary intake, sugar-sweetened beverages), and anthropometry were assessed among 363 infants in the first year of life. Leveraging these existing data, the proposed research will elucidate, for the first time, relationships between infat temperament and health behaviors, and their impact on infant growth in GDM offspring. The study aims are: Aim 1: To characterize the relation of "difficult" temperament (i.e., poorer distress to limitations, and less soothability) to infant growth during the first year of life, Aim2: To evaluate potential mediators of the association between "difficult temperament" and rapid infant growth (i.e., less breast feeding, cereal added to the bottle, early introduction of juice/foods, and high intake of sugar-sweetened foods/beverages), and Exploratory Aim 3: To determine whether difficult infant temperament is associated with overweight at age 2-4 years. A difficult infant temperament may introduce a host of additional stressors to new mothers in addition to the stress of GDM pregnancy. Our proposed research addresses novel hypotheses about temperament and modifiable risk factors that may inform strategies for early life obesity prevention.