The Association Of Gestational Metabolic Disorders And Early Adiposity Rebound Timing In Children: A Birth Cohort Study

Objective To describe the detection situation of gestational metabolic diseases(GMD)during pregnancy(such as gestational hypertension(GHTN),preeclampsia(PE),gestational diabetes mellitus(GDM)and gestational overweight/obesity)and children’s adiposity rebound(AR)in Ma’anshan City,which is to clarify the correlation between GMD and its index level with children’s AR and its correlation strength,providing an evidence-based basis for preventing children’s early adiposity rebound timing.MethodsBased on the Ma’anshan Birth Cohort(MABC)built from May 2013 to September2014,this paper has included a total of 3474 pregnant women who met the criteria as the baseline,and they were followed up until delivery,and their children were followed up to the age of 6.The general demographic characteristics of pregnant women,pre-pregnancy height and weight,smoking and drinking during pregnancy and other information were collected by the uniformly trained investigators through the "Maternal and Child Health Registration Form during Pregnancy and Childbirth";the GMD prevalence was collected through medical records;the fetus information was collected through the delivery records.Obstetric doctors measure the height,weight,fasting blood sugar and blood pressure of the pregnant women during the early,middle and late physical examinations.The children were followed up at 42 days,3 months,6 months,9 months,1 year and every six months thereafter,measuring their length/height,weight and other information and collecting the feeding status by asking the main caregivers.Excluded twins,adverse pregnancy outcomes,mothers missing pre-pregnancy weight or weight gain during pregnancy,pre-gestational diabetes or hypertension,and children with BMI measurements < 8times or BMI measurements < 2 times at 0-9 months,1-3 years old,and 3.5-6 years old(a total of 869 mother-child pairs),2605 mother-child pairs were finally included in the analysis.Finally,the minimum was calculated(AR).The linear regression model was adopted to analyze the relationship between the levels of metabolic indexes and AR during pregnancy.The logistic regression model was taken to analyze the effect of single or combined GMD and AR phase advance.ResultsThe overall detection rate of GMD among the pregnant women was 68.6%,among which the detection rate of GHTN was 3.9%,PE 1.8%,GDM 12.6%,and overweight/obesity during pregnancy 63.9%.the AR timing was 52.60 ± 14.36 months age,and this paper defines early AR timing as ≤ 4 years old,and the detection rate was 39.2%.The linear regression model had indicated that there’s an obvious negative linear correlation among blood pressure during pregnancy,fasting blood glucose in the first and second trimesters,and weight gain in the first trimester and offspring AR(P < 0.05).Further analysis had revealed that GHTN,PE,GDM,and overweight/obesity during pregnancy all increases the risk of early AR timing in offspring.After adjusting for the mother’s age,birth rate,education level,alcohol consumption,smoking,and family monthly income per capita,the OR(95%CI)values were 1.80(1.18-2.73),3.61(1.92-6.78),1.57(1.20-2.05)and 1.29(1.09-1.53)respectively.The early AR timing risks of the gestation period low-risk metabolic group(OR = 1.20,95%CI: 1.00-1.44),intermediate-risk metabolic group(OR=1.57,95%CI: 1.22-2.03)and offspring of the high-risk metabolic group(OR = 2.62,95%CI:1.73-3.96)were significantly higher than those without GMD.In the sensitivity analysis stage,the above results still hold when low birth weight infants,high birth weight infants,premature infants and additional adjustments for birth outcomes and6-month-old breastfeeding were excluded.ConclusionsThe overall detection rate of GMD in pregnant women in the Ma’anshan area was high,and the AR timing of children in Ma’anshan area was at an early level.Compared with children without GMD,single or combined GMD could increase the risk of early AR timing in children,and the risk of clustering of multiple metabolic abnormalities was higher than that of single GMD or without GMD.The metabolic level of pregnant women must be attended to and it must be controlled within a reasonable range,and prevent the occurrence of GMD or take treatment early,delaying the occurrence of AR timing in offspring and promoting the healthy development of children.