| 0bjective: The objective of this study was to investigate the factors of gestational diabetes mellitus and related factors on neonatal body fat mass, to provide reference for the management of GDM and their children.Methods: The study population was recruited from women who wanted to receive prenatal examination and gave birth at the Tongling Medical Center Department of Obstetrics in Anhui between May 2014 and May 2015. Exclusion criterions were: floating population; multiple pregnancies; severe chronic diseases or genetic disease; known pre-gestational diabetes; not want to offer blood samples. Written informed consents were collected from all participants at the first appointment. Meanwhile, the study had been approved by the local ethics committee. We established a prospective cohort study. Each woman who gave written informed consent was given a 75-gram, OGTT between 24 th and 28 th weeks gestation. The diagnosis of GDM was defined according to the IADPSG criterion : fasting glucose ≥ 5.1 mmol/L,1 h glucose≥ 10.0 mmol/L, 2 h glucose≥8.5 mmol/L. If at least one of the thresholds was met or exceeded, GDM was diagnosed. Radial vein blood samples were obtained. Neonatal cord blood was collected immediately after delivery from umbilical cord vein. Free fatty acids were measured using GC-MS. To investigate the effect of gestational diabetes mellitus related factors on neonatal body fat mass. Neonatal body fat mass was calculated by Dauncey’s method.Results:(1)General demographic characteristics: There were 632 participants in our study, and 189 cases in the GDM group, and 443 cases in the control group. The age was varied from 17 to 43 years old. The average age was 27.1±4.0 years old. GDM group had older age but lower height versus control(27.8±4.0y vs. 26.8±4.0y),( 160.8±4.4cm vs. 160.8±4.4cm). Pre-pregnancy BMI and placental weight in GDM group were higher than control group, the difference was statistically significant.Gestational weight gain was lower in GDM group than control group, the difference has statistically significant.(2)Comparisons of neonatal anthropometric characteristics in two groups: GDM group in neonatal weight, height, crown-rump length, head circumference, chest circumference, biceps circumference, thigh circumference and calf circumference were measured 3397.1±500.8g, 50.1±2.0 cm,32.1±1.9 cm,34.7±1.7 cm,34.0±1.8 cm,11.9±1.0 cm,15.9±1.3 cm,11.7±1.1cm, respectively. There were no significantly differences in these measures between two groups. The neonates in GDM group had higher arm length, TSF and SSF versus control group, the difference was statistically significant. Neonatal arm length、TSF and SSF GDM group in were measured 15.3±1.3cm, 6.4±1.5mm, 6.0±1.4mm, respectively. There were no significant differences in neonatal gender and birth weight between two groups. The neonatal in GDM group had higher total fat mass and Body fat percentage content versus control group 0.65±0.29 kg vs. 0.53±0.22 kg, 18.37±5.92% vs.15.45±4.89%, respectively, the difference has statistically significant.(3) The comparisons of maternal blood glucose/blood lipid and fatty acids between two groups: I There were significant difference in FPG, TG, HDL and LDL between two groups(P<0.05). Values of FPG, TG, HDL and LDL in GDM group were higher than normal group(5.16±0.48 mmol/L, 1.57±0.68 mmol/L, 1.61±0.39 mmol/L, 2.20±0.46 mmol/L, respectively). II GDM group had higher fasting glucose, 1 h glucose and 2 h glucose Versus normal group(5.19±0.46 mmol/L vs. 5.19±0.46mmol/L,9.84±1.74 mmol/L vs. 7.74±1.50 mmol/L, 7.51±1.43 vs. 6.28±4.06mmol/L, respectively). There were significant difference in glucose values at each time point between two groups(P<0.001). III At third trimester, values of FPG and TG in GDM group were higher than normal group(5.03±0.54 mmol/L, 3.94±1.52 mmol/L, respectively), the difference was statistically significant(P<0.05). IV There were no significantly difference in third trimester serum SOD,MDA,GSH-Px and 8-isoprostane between two groups.(4)I Comparisons between two groups in maternal serum fatty acids and cord blood serum fatty acids:GDM group had decreased C20:2,n-6 but increased the count of MUFA and C18:1,n-9 versus control group(0.37±0.06% vs. 0.39±0.07%, 21.97± 2.50% vs. 21.04±2.45%, 18.09±2.40% vs. 17.10±2.19%, respectively), the difference had statistically significant(P<0.05). However, there were no significantly difference in cord blood serum fatty acids between two groups. II GDM group in maternal serum had higher LC-PUFA count, C18:3,n-3, C20:5,n-3, n-6 PUFA count, C18:2,n-6, C20:2,n-6, MUFA count, C18:1,n-9, C24:1,n-9, C14:0 and omega-6:omega-3 than cord blood, the difference was statistically significant. Cord blood serum had higher n-3 PUFA count, DHA, C20:4,n-6, C18:3,n-6, C20:3,n-6, C20:4,n-6, C22:4,n-6, C16:1,n-7, SFA count, C18:0,C20:0,C22:0,C24:0, index of omega-3 and AA:EPA versus maternal serum. There were no significant difference in C22:5,n-3, C20:1,n-9 and C16:0 between maternal serum fatty acids and cord blood serum fatty acids(P>0.05).(5) Multiple linear regression analysis was performed to determine influencing factors independently associated with neonatal body fat mass. GDM, Gestational age, C18: 1,n-9, pre-pregnancy BMI and DHA correlated significantly with neonatal body fat mass(β=3.509,P<0.001; β=1.505,P<0.001; β=1.259,P=0.001; β=0.259,P=0.019; β=0.980,P=0.031, respectively). However, total MUFA negatively correlated with neonatal body fat mass(β =-0.713, P = 0.039).Conclusions: Neonatal body fat mass of gestational diabetes mellitus increases. Gestational diabetes mellitus because of glucose and lipid disorders lead to abnormal intrauterine environment, thereby causing neonatal body fat mass accumulation. |
PDF Full Text Request