Maternal circulating metabolic biomarkers and their prediction performance for gestational diabetes mellitus related macrosomia

Yuan, Yingdi; Zhu, Qingyi; Yao, Xiaodie; Shi, Zhonghua; Wen, Juan

doi:10.1186/s12884-023-05440-9

Cited by 5 publications

(5 citation statements)

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“…In line with other studies, we found a positive association between two-hour glucose concentrations following an OGTT and birthweight z-score. This association is especially well-documented in studies of mothers with GDM and obesity (38)(39)(40). Yuan et al found maternal factors such as pre-pregnancy BMI, GWG, glucose values at OGTT, HDL and LDL together with other metabolites predicted macrosomia infants in mothers with GDM (41).…”

Section: Inflammatory Lipid and Metabolic Markers And Birth Outcomesmentioning

confidence: 83%

“…This association is especially well-documented in studies of mothers with GDM and obesity ( 38–40 ). Yuan et al found maternal factors such as pre-pregnancy BMI, GWG, glucose values at OGTT, HDL and LDL together with other metabolites predicted macrosomia infants in mothers with GDM ( 41 ). Although mothers in the present study did not have obesity or GDM, our findings could indicate similar mechanisms occurring across a wider range of maternal weight statuses in our population.…”

Section: Discussionmentioning

confidence: 99%

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Maternal inflammatory, lipid and metabolic markers and associations with birth and breastfeeding outcomes

Christensen,

Rom,

Greve

et al. 2023

Front. Nutr.

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BackgroundConditions in utero influence intrauterine and postnatal infant growth and a few studies indicate that maternal inflammation and insulin resistance might affect birth and breastfeeding outcomes. Furthermore, hormones in human milk (HM) may influence infant appetite-regulation and thereby milk intake, but the associations are less understood.Objective(1) To investigate associations between maternal inflammatory, lipid and metabolic markers and birth and breastfeeding outcomes, and (2) to assess predictors of maternal inflammatory, lipid and metabolic markers in pregnancy.MethodsSeventy-one mother-infant dyads participating in the Mothers, Infants and Lactation Quality (MILQ) study were included in the present study. Fasting blood samples were collected around 28th gestational week, and HM samples at three time points from 1.0 to 8.5 months, where milk intake was assessed using 24-h test weighing. Maternal plasma inflammatory, lipid and metabolic markers included high-sensitive C-reactive protein (hs-CRP), tumor-necrosis factor-α (TNFα), interferon-γ (IFNγ), Interleukin (IL)-6, IL-8, high-, low-, and very-low-density lipoprotein (HDL, LDL, VLDL), total-cholesterol, triglycerides, leptin, adiponectin, insulin, C-peptide, the homeostasis model assessment of insulin resistance (HOMA-IR) and glucose concentration at t = 120 min following an oral glucose tolerance test. Of these, TNFα, IFNγ, IL-6, IL-8, leptin, adiponectin and insulin were also measured in HM samples.ResultsHDL in pregnancy was inversely associated with gestational age (GA) at birth and GA-adjusted birthweight z-score, whereas triglycerides and glucose (t = 120) were positively associated with GA-adjusted birthweight z-score. Higher hs-CRP, VLDL and triglycerides were associated with a higher placental weight. Furthermore, higher HDL, insulin, leptin and HOMA-IR were associated with longer duration of exclusive breastfeeding (EBF). Higher pre-pregnancy BMI was the main predictor of higher levels of hs-CRP, log-TNFα, leptin, insulin, C-peptide, and HOMA-IR.ConclusionMaternal lipid and metabolic markers influenced birthweight z-score and placental weight as well as duration of EBF. Furthermore, pre-pregnancy BMI and maternal age predicted levels of several inflammatory and metabolic markers during pregnancy. Our findings indicate that maternal lipid and metabolic profiles in pregnancy may influence fetal growth and breastfeeding, possibly explained by overweight and/or higher placental weight.Clinical trial registrationhttps://clinicaltrials.gov/, identifier NCT03254329.

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Section: Inflammatory Lipid and Metabolic Markers And Birth Outcomesmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Maternal inflammatory, lipid and metabolic markers and associations with birth and breastfeeding outcomes

Christensen,

Rom,

Greve

et al. 2023

Front. Nutr.

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“…Recently new studies demonstrated even women with normal OGTT show abnormal glycemic fluctuations, based on this point, a new method called CGM (Continuous Glucose Monitoring) to detect dysglycemia in pregnancy, might help to detect glycemic fluctuations in women with normal OGTT, improving their treatment and outcomes [ 25 , 26 ]. Further, various studies already have proposed prediction models that may help to detect women at risk of GDM in the first trimester using ultrasound or biochemical markers [ 27 – 31 ], which may reduce the risk of adverse pregnancy outcomes.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of abnormal glucose values and gestational diabetes mellitus among pregnant women in Xi’an from 2015 to 2021

Meng

Wang

Kang

et al. 2023

BMC Pregnancy Childbirth

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Background Pregnant women with gestational diabetes mellitus (GDM) often have an increased risk of adverse pregnancy outcomes. The purpose of this study was to explore the prevalence and characteristics of GDM in Xi’an from 2015 to 2021 since the implementation of China’s “Two-Child policy” and to provide a clinical basis for the management of GDM. Methods We analyzed the oral glucose tolerance test (OGTT) results of 152,836 pregnant women who underwent routine prenatal examination at the Northwest Women and Children’s Hospital from 2015 to 2021. Additionally, we analyzed the GDM prevalence and characteristics. Results The prevalence of GDM in the Xi’an urban area was 24.66% and exhibited an increasing trend annually (χ2 for trend = 43.922, p < 0.001) and with age (χ2 for trend = 2527.000, p < 0.001). Consistent with this, the proportion of pregnant women aged 18–25 and 26–30 years decreased significantly with the annual growth (χ2 for trend = 183.279, p < 0.001 and χ2 for trend = 33.192, p < 0.001, respectively). The proportion of pregnant women aged 31–35 and 36–42 years increased gradually annually (χ2 for trend = 134.436, p < 0.001and χ2 for trend = 44.403, p < 0.001, respectively). Of the pregnant women diagnosed with GDM, 71.15% (65.05–74.95%) had abnormal fasting plasma glucose (FPG) values. The highest percentage of patients had a single abnormal OGTT value (68.31%; 65.77–70.61%), followed by two (20.52%; 18.79–22.55%) and three (11.17%; 10.11–11.85%) abnormal values (FPG and 1-h and 2-h plasma glucose (PG). Conclusion The prevalence of GDM among pregnant women in Xi’an region was high, and it had a increasing trend over the period from 2015 to 2021. Notably, the proportion of elder pregnant women, aged 31–42 years, presented a significant rise after the implementation of the universal two-child policy. On the basis of the high incidence of GDM among elder pregnant women and the high rate of abnormal OGTT values (numbe ≥ 2) in pregnant women diagnosed with GDM, the management of GDM should be intensified, and relevant departments should pay more attention to pregnant women of advanced age.

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“…[6] With the improvement of living standards and the implementation of the "Two-Child Policy" in China, there has been an increasing number of pregnant women who are overweight or of advanced maternal age, leading to a sharp rise in the affected population. [7] Excessive weight gain during pregnancy also increases the risks of spontaneous and recurrent miscarriages, macrosomia deliveries, congenital heart and neural tube defects, maternal thromboembolism, depression, and breastfeeding issues. [8][9][10][11][12] Moreover, when pregnant women with gestational diabetes are also obese, the probability of macrosomia delivery signi cantly rises.…”

Section: Introductionmentioning

confidence: 99%

Association between percentage change in gestational weight and macrosomia in a diabetic maternal population

Chen,

Sun,

et al. 2024

Preprint

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Background Numerous clinical studies have investigated the relationship between maternal gestational weight-related parameters and macrosomia in infants. However, research on the association between the percentage change in gestational weight and macrosomia in infants is lacking. Additionally, the existing clinical guidelines do not offer specific recommendations for gestational weight control in pregnant women with diabetes to prevent macrosomia deliveries. Objective This study aimed to investigate the relationship between the percentage change in gestational weight and macrosomia deliveries in pregnant women with diabetes. Study Design: This retrospective cohort study included routine obstetric examination and baseline clinical data of pregnant women with gestational diabetes mellitus who visited the Third Affiliated Hospital of Wenzhou Medical University between January 2019 and December 2020. The diagnosis of gestational diabetes mellitus was based on the criteria outlined by the International Association of Diabetes and Pregnancy Study Groups in 2010. The percentage change in gestational weight was calculated using the following formula: pre-delivery weight–pre-pregnancy weight) / pre-pregnancy weight. Macrosomia was defined as a birth weight greater than or equal to 4000 g. Continuous variables were analyzed using one-way analysis of variance or the Kruskal-Wallis rank-sum test, categorical variables were assessed using Fisher's exact probability test, and univariate analysis was used to evaluate the relationship between each variable and macrosomia deliveries. Results This study included 316 patients diagnosed with gestational diabetes mellitus, of whom 57 delivered infants diagnosed with macrosomia. In the unadjusted, partially, and fully adjusted models, a significant correlation was found between percentage change in gestational weight and macrosomia deliveries (odds ratio = 39.6, 95% confidence interval: 1.8-866.3, P = 0.019; odds ratio = 1344.9, 95% confidence interval: 35.4-51118.2, P < 0.001; odds ratio = 1139.7, 95% confidence interval: 0.9-1523385.0, P = 0.055), respectively. After adjusting for potential confounding factors (age, maternal place of birth, height, pre-pregnancy body mass index, history of macrosomia deliveries, fetal sex, pre-delivery hemoglobin A1c, pre-delivery triglycerides, pre-delivery apolipoprotein B, pre-delivery high-density lipoprotein, pre-delivery glucose, number of full-term deliveries, neonatal birth length, gestational age at delivery), a non-linear relationship was noted between the percentage change in gestational weight and macrosomia, with an inflection point at 0.18. Conclusion Results showed a strong correlation between the percentage change in gestational weight and macrosomia deliveries in our population of women with gestational diabetes mellitus; a non-linear relationship was found between the percentage change in gestational weight and macrosomia delivery. This result suggests a significant increase in the probability of macrosomia delivery when the change in gestational weight exceeds 18%.

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Maternal circulating metabolic biomarkers and their prediction performance for gestational diabetes mellitus related macrosomia

Cited by 5 publications

References 35 publications

Maternal inflammatory, lipid and metabolic markers and associations with birth and breastfeeding outcomes

Maternal inflammatory, lipid and metabolic markers and associations with birth and breastfeeding outcomes

Prevalence of abnormal glucose values and gestational diabetes mellitus among pregnant women in Xi’an from 2015 to 2021

Association between percentage change in gestational weight and macrosomia in a diabetic maternal population

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