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Interactive effects of prepregnancy overweight and gestational diabetes on macrosomia and large for gestational age: A population-based prospective cohort in Tianjin, China.
Diabetes Res Clin Pract. 2019 Aug; 154:82-89.DR

Abstract

AIMS

Obesity increases risk of gestational diabetes mellitus (GDM) and GDM increases risk of macrosomia but their inter-relations for increased risk of macrosomia remain uncertain. We aimed to examine associations between prepregnancy overweight and macrosomia, and synergistic effects between prepregnancy overweight and GDM on macrosomia.

METHODS

From 2010 to 2012, 19,622 women in urban Tianjin, China, underwent a 50-g 1-h glucose challenge test (GCT) at 24-28 gestational weeks and followed by a 75-g 2-h oral glucose tolerance test (OGTT) if the GCT value was ≥ 7.8 mmol/L. GDM was defined according to International Association of Diabetes and Pregnancy Study Group's criteria. Overweight was defined as body mass index ≥ 24.0 kg/m2. Logistic regression was performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Additive interaction between prepregnancy overweight and GDM was used to test synergistic effects.

RESULTS

In the cohort, 1791 (9.1%) and 1726 (8.8%) of the women delivered a macrosomic infant or a large-for-gestational-age (LGA) infant, respectively. Prepregnancy overweight was associated with increased risk of macrosomia and LGA with adjusted ORs being 2.29 (95%CI: 2.07-2.54) and 2.27 (2.05-2.52), respectively. Copresence of prepregnancy overweight and GDM greatly enhanced the adjusted ORs of overweight alone (ORs for macrosomia and LGA: 2.17, 1.94-2.42 & 2.21,1.98-2.47) and GDM alone (ORs for macrosomia and LGA: 2.01,1.48-2.72 & 2.14, 1.60-2.87) for macrosomia and LGA to 5.29 (4.07-6.87) for macrosomia and 4.72 (3.66-6.10) for LGA, with significant additive interactions.

CONCLUSIONS

Prepregnancy overweight increased the risks of macrosomia and LGA independently and synergistically with GDM.

Authors+Show Affiliations

Department of Epidemiology and Biostatistics, School of Public Health, and Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin Medical University, Tianjin, China.Department of Child Health, Tianjin Women and Children's Health Center, Tianjin, China.Department of Epidemiology and Biostatistics, School of Public Health, and Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin Medical University, Tianjin, China.Department of Epidemiology and Biostatistics, School of Public Health, and Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin Medical University, Tianjin, China.Department of Child Health, Tianjin Women and Children's Health Center, Tianjin, China.Department of Child Health, Tianjin Women and Children's Health Center, Tianjin, China.Department of Child Health, Tianjin Women and Children's Health Center, Tianjin, China.Project Office, Tianjin Women and Children's Health Center, Tianjin, China.Integration in Clinical Medicine, College of Basic Medicine, Tianjin Medical University, Tianjin, China.Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and The Chinese University of Hong Kong-Prince of Wales Hospital-International Diabetes Federation Centre of Education, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.Population Cancer Research Program and Department of Pediatrics, Dalhousie University, Halifax, Canada.Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA.Department of Epidemiology and Biostatistics, School of Public Health, and Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin Medical University, Tianjin, China. Electronic address: yangxilin@tmu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31271809

Citation

Yang, Wen, et al. "Interactive Effects of Prepregnancy Overweight and Gestational Diabetes On Macrosomia and Large for Gestational Age: a Population-based Prospective Cohort in Tianjin, China." Diabetes Research and Clinical Practice, vol. 154, 2019, pp. 82-89.
Yang W, Liu J, Li J, et al. Interactive effects of prepregnancy overweight and gestational diabetes on macrosomia and large for gestational age: A population-based prospective cohort in Tianjin, China. Diabetes Res Clin Pract. 2019;154:82-89.
Yang, W., Liu, J., Li, J., Liu, J., Liu, H., Wang, Y., Leng, J., Wang, S., Chen, H., Chan, J. C. N., Yu, Z., Hu, G., & Yang, X. (2019). Interactive effects of prepregnancy overweight and gestational diabetes on macrosomia and large for gestational age: A population-based prospective cohort in Tianjin, China. Diabetes Research and Clinical Practice, 154, 82-89. https://doi.org/10.1016/j.diabres.2019.06.014
Yang W, et al. Interactive Effects of Prepregnancy Overweight and Gestational Diabetes On Macrosomia and Large for Gestational Age: a Population-based Prospective Cohort in Tianjin, China. Diabetes Res Clin Pract. 2019;154:82-89. PubMed PMID: 31271809.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interactive effects of prepregnancy overweight and gestational diabetes on macrosomia and large for gestational age: A population-based prospective cohort in Tianjin, China. AU - Yang,Wen, AU - Liu,Jin, AU - Li,Jing, AU - Liu,Jinnan, AU - Liu,Hongyan, AU - Wang,Yue, AU - Leng,Junhong, AU - Wang,Shuo, AU - Chen,Huaxi, AU - Chan,Juliana C N, AU - Yu,Zhijie, AU - Hu,Gang, AU - Yang,Xilin, Y1 - 2019/07/01/ PY - 2019/05/14/received PY - 2019/06/10/revised PY - 2019/06/25/accepted PY - 2019/7/5/pubmed PY - 2019/11/15/medline PY - 2019/7/5/entrez KW - Chinese KW - Gestational diabetes mellitus KW - Large for gestational age KW - Macrosomia KW - Overweight SP - 82 EP - 89 JF - Diabetes research and clinical practice JO - Diabetes Res Clin Pract VL - 154 N2 - AIMS: Obesity increases risk of gestational diabetes mellitus (GDM) and GDM increases risk of macrosomia but their inter-relations for increased risk of macrosomia remain uncertain. We aimed to examine associations between prepregnancy overweight and macrosomia, and synergistic effects between prepregnancy overweight and GDM on macrosomia. METHODS: From 2010 to 2012, 19,622 women in urban Tianjin, China, underwent a 50-g 1-h glucose challenge test (GCT) at 24-28 gestational weeks and followed by a 75-g 2-h oral glucose tolerance test (OGTT) if the GCT value was ≥ 7.8 mmol/L. GDM was defined according to International Association of Diabetes and Pregnancy Study Group's criteria. Overweight was defined as body mass index ≥ 24.0 kg/m2. Logistic regression was performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Additive interaction between prepregnancy overweight and GDM was used to test synergistic effects. RESULTS: In the cohort, 1791 (9.1%) and 1726 (8.8%) of the women delivered a macrosomic infant or a large-for-gestational-age (LGA) infant, respectively. Prepregnancy overweight was associated with increased risk of macrosomia and LGA with adjusted ORs being 2.29 (95%CI: 2.07-2.54) and 2.27 (2.05-2.52), respectively. Copresence of prepregnancy overweight and GDM greatly enhanced the adjusted ORs of overweight alone (ORs for macrosomia and LGA: 2.17, 1.94-2.42 & 2.21,1.98-2.47) and GDM alone (ORs for macrosomia and LGA: 2.01,1.48-2.72 & 2.14, 1.60-2.87) for macrosomia and LGA to 5.29 (4.07-6.87) for macrosomia and 4.72 (3.66-6.10) for LGA, with significant additive interactions. CONCLUSIONS: Prepregnancy overweight increased the risks of macrosomia and LGA independently and synergistically with GDM. SN - 1872-8227 UR - https://www.unboundmedicine.com/medline/citation/31271809/Interactive_effects_of_prepregnancy_overweight_and_gestational_diabetes_on_macrosomia_and_large_for_gestational_age:_A_population_based_prospective_cohort_in_Tianjin_China_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(19)30647-3 DB - PRIME DP - Unbound Medicine ER -