| 【Objective】To investigate the concentration of glucose and lipid metabolism-related indicators of third trimester maternal blood and umbilical cord blood and the neonatal birth weight in Shanghai, China, analyze the differences in glucose and lipid metabolismin of fetal body and mother’s body of different birth weight, and explore the correlation between maternal and fetal glucose and lipid metabolism indicators. Furthermore, the infants were followed up to determine the correlation among maternal and fetal blood glucolipid metabolism, birthweight, and infant body proportionality in the first year of life and obtained the main factors of infant physical growth.[Methods]Subjects included950mother-infant pairs from Shanghai International Peace Maternity&Child Health Hospital, Chinese Welfare Association, during Sep2009to Mar2010.Third trimester maternal blood was collected through32to37weeks of pregnancy when they did physical examination in the hospital, the pregnancy and family situation questionnaire was completed at the same time. Birth weight of newborn was measured, birth data was recorded and umbilical cord blood was collected after childbirth. Maternal and umbilical cord blood were detected to evaluate the concentration of glucose, insulin, C-Peptide, triglycerides, total cholesterol, high/low-density lipoprotein. At42days,3,6,9,12months, infants were brought to Children hospital to do anthropometric measurement and to fill questionnaire concerning feeding and disease status.The newborns were classified according to birth weight into LBW group (BW<2500g), NBW group (2500g≤BW≤4000g), and HBW group (BW>4000g). Glucose and lipid metabolism indexes of third trimester maternal blood, umbilical cord blood were compared in three groups by single factor ANOVA. The correlation between maternal and fetal glucose and lipid metabolism indicators were analyzed by Pearson correlation coefficient test.Weight-for-age Z-scores (WAZ), length-for-age Z-scores (LAZ), weight-for-length Z-scores (WLZ) and body mass index Z-scores (zBMI) of infants up to1year of age were calculated using World Health Organization (WHO) standards.45factors related to infant growth such as parents characteristics, pregnancy status, birth status, feeding and disease after birth were analyzed by multiple stepwise regression to obtain the main factors of infant physical growth in each follow-up time point.[Results]1. Birth weight and third trimester maternal blood glucose, lipid metabolismAmong the three groups:LDL-C (F=10.44, P<0.001), Insulin (F=3.09, P=0.046), C-P (F=3.76, P=0.024) concentrations have significant difference; No significant difference of TG, the TC, HDL-C, Glu level among the groups;Between the two groups:Insulin (38.87±4.50vs.29.86±1.03, P=0.015) and C-P (247.96±28.97vs.178.24±7.10, P=0.007) concentrations in HBW group were significantly higher than the NBW group. LDL-C consentration in LBW group was significantly higher than the NBW group (0.99±0.09vs.0.74±0.01, P<0.001) and the HBW group(0.99±0.09vs.0.71±0.03, P<0.001); No significant difference of other indicators between the other two groups.2. Birth weight and umbilical cord blood glucose, lipid metabolismAmong the three groups:LDL-C (F=10.32, P<0.001), C-P (F=4.61, P=0.02) concentrations have significant difference; No significant difference of TG, the TC, HDL-C, Glu level among the groups;Between the two groups:(39.19±4.63vs.29.97±1.03, P=0.022) and C-P (256.37±29.62vs.178.22±7.06, P=0.005) concentrations in HBW group were significantly higher than the NBW group. LDL-C consentration in LBW group was significantly higher than the NBW group (0.98±0.09vs.0.74±0.01, P<0.001) and the HBW group (0.98±0.09vs.0.71±0.03, P<0.001); No significant difference of other indicators between the other two groups.3. Maternal blood and umbilical cord blood glucose, lipid metabolismThere is a significant linear positive correlation between maternal and umbilical cord blood:TG (r=0.997, P<0.001), TC (r=0.992, P<0.001), HDL-C (r=0.987, P<0.001), LDL-C (r=0.991, P <0.001), Glu(r=0.989, P<0.001), Insulin (r=0.974, P<0.001) C-P (r=0.974, P<0.001) concentrations.4. Birth weight and infant physical growthIn the NBW group, there is a significant correlation between birth weight and infant physical growth indicators of0-9months:42d(LAZ, WAZ, zBMI),3m (LAZ, WAZ, zBMI),6m (LAZ, WAZ, WLZ, zBMI),9m (LAZ, WAZ); In the LBW/HBW groups there is not a significant correlation between birth weight and infant physical growth indicators.5. Maternal blood glucose, lipid metabolism and infant physical growthThe correlation among maternal blood glucose, lipid metabolism indicators and infant WAZ, LAZ, WLZ and zBMI at each follow-up point was tested by Pearson correlation test.Indicators which has significant correlation with infant physical growth:TG, has negative correlation with WAZ, zBMI of42days and WAZ, WLZ、zBMI of3,6,9,12months;TC, has negative correlation with LAZ of42days;LDL-C, has negative correlation with LAZ, WAZ of42days and LAZ of3month;C-P, has positive correlation with LAZ of42days and6month. 6. Umbilical cord blood glucose, lipid metabolism and infant physical growthThe correlation among umbilical cord blood glucose and lipid metabolism indicators and infant WAZ, LAZ, WLZ and zBMI at each follow-up point was tested by Pearson correlation test.Indicators which has significant correlation with infant physical growth:TG, has negative correlation with WAZ, zBMI of42days and WAZ,WLZ、zBMI of3,6,9,12months;LDL, has negative correlation with LAZ, WAZ of42days.7. Infant physical growth influencing factorsTaking WAZ, LAZ, WLZ and zBMI as dependent variables, continuously variables (birth weight, maternal and umbilical cord blood glucose and lipid metabolism indicators, etc.) and assigned categorical variables(infant gender, mode of delivery, smoking and drinking, parental education, occupation, and feeding, disease status, etc.) as independent variables, multiple stepwise regression analysis was applied.The top three factors influencing infant physical growth:Maternal pregnancy history of hypothyroidism (β=1.008, P=0.006), father’s occupation (β=0.883, P<0.001), TG of umbilical cord blood (β=0.87, P=0.003)【Conclusions】Infants with low birth weight would have a higher intrauterine LDL-C levels than normal, which influented by their mothers’LDL-C, that prompted LBW children would have a higher risk of cardiovascular disease in their adulthood;Insulin resistance in the the uterus has occurred in macrosomia which prompted the macrosomia’s health troubled increased risk of diabetes; TG, LDL-C level of mather and offspring negatively correlated with infant physical growth;Maternal gestational diabetes histories, father’s occupation, TG consentration of umbilical cord blood were the top three factors which have a significant influence on infant physical growth. |
PDF Full Text Request