Relationship Between Osteocalcin And Vitamin D With Macrosomia During Pregnancy

BackgroundMacrosomia usually refers to a birth weight more than or equal to 4000 grams.Current research shows that obesity,older mothers,prolonged pregnancy,weight gain during pregnancy,male fetuses,hypertension of pregnancy,and gestational diabetes are all risk factors for macrosomia.Among them,energy metabolism is closely related to the occurrence of macrosomia.Osteocalcin is an important protein in the bone matrix,and osteocalcin has recently been found to regulate energy metabolism.Therefore,during pregnancy,maternal osteocalcin may affect fetal birth weight by regulating energy metabolism or bone formation process.Up to now,we have not found a study about correlation between maternal serum osteocalcin and macrosomia.The main role of vitamin D is to maintain calcium and phosphate homeostasis and bone and muscle integrity.Existing studies of vitamin D may also be involved in the regulation of other important biological processes,such as cell proliferation and differentiation,immune response,and insulin secretion.Most studies on vitamin D and low birth weight babies or birth weight,there is very little research on its relevance to macrosomia currently,and the conclusion is controversial.Objectives1.To investigate the possible influence factors of the basic situation of pregnant women on macrosomia.2.To explore the changes of serum levels of osteocalcin and 25(OH)D in pregnant women during pregnancy3.To investigate the association between serum osteocalcin and 25(OH)D levels and the risk of macrosomia in maternal women.MethodsThis study was based on the Guangxi birth cohort(GXCS),used all pregnant women who had macrosomia as a case.Pregnant women delivered normal birth weight fetus in the cohort served as controls.After eliminating the deformity,stillbirth and other outcomes,matching was performed according to the ratio of 1:2.The matching conditions were the same region,the same sex as the fetus and the same gestational age.Conditional logistic regression was used to analyze the effects of basic maternal conditions on macrosomia.Gestational age as the x-axis,maternal serum osteocalcin or 25(OH)D levels were plotted on the y-axis for scatter plots and smooth curve fitting analysis was performed.Grouped according to gestational age> 19 weeks and ? 19 weeks,Mann-Whitney U test was used to compare the levels of osteocalcin and25(OH)D between the macrosomia group and the control group,and changes before and after 19 weeks gestation.Osteocalcin and 25(OH)D levels were divided into high and low levels in the control group median and low levels were used as reference.Conditional logistic regression analysis was used to estimate high levels of osteocalcin and 25(OH)D levels with macrosomia,and subgroup analysis using fetal sex and pre-pregnancy BMI.1.The increase in pre-pregnancy BMI and gestational age at delivery may be an independent factor in the increase in the risk of macrosomia,and the higher the degree of education may decrease the risk of macrosomia.2.In the macrosomia group,serum osteocalcin was significantly higher than that of the control group 19 weeks before gestational age.The median(interquartile range)were 11.03(9.41-13.21)ng/ml and 9.96(8.32-13.36)ng/ml,respectively;P=0.047.3.Compared with gestational weeks ? 19 weeks in the control group,osteocalcin was significantly increased in gestational age> 19 weeks,P=0.005.The serum 25(OH)D levels in macrosomia and control groups were significantly higher than those in gestational weeks ?19w at gestational age>19w,and the P values ??were P=0.045 and P=0.013,respectively.4.High levels of serum osteocalcin(>9.96 ng/mL)increase the risk of macrosomia before 19 weeks of gestation compared with low levels of serum osteocalcin(? 9.96 ng/mL)(OR=2.38,95% CI: 1.29,4.41,P=0.006).After adjusting for confounding factors,the results were not statistically significant.When fetus sex were male,high levels of osteocalcin in pregnant women increased the risk of macrosomia after adjusting for confounding factors(OR=2.62,95%CI: 1.09-6.32,P=0.032).When BMI<24 pre-pregnancy,after adjusting for confounding factors,high levels of osteocalcin in pregnant women increased the risk of macrosomia(OR=2.16,95%CI: 1.16-4.03,P=0.016).No findings were found high levels of osteocalcin are associated with macrosomia after 19 weeks.25(OH)D was not found to be associated with the risk of macrosomia.Conclusion1.The increase in pre-pregnancy BMI and childbirth gestational weeks may Resultsbe an independent factor in the increase in the risk of macrosomia,and the higher the degree of education,the greater the risk of a lower risk.2.In healthy pregnant women,maternal osteocalcin decreased first and t reaching the lowest level at 19 weeks of gestation,then rose during pregnant,.3.Osteocalcin levels in the macrosomia group were higher than those in the control group,High serum concentrations of osteocalcin(>9.96 ng/mL)in maternal pregnancies and pre-pregnancy BMI < 24 weeks prior to 19 gestational weeks increase the risk of macrosomia.4.No association was found between maternal vitamin D and macrosomia.