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首页> 外文期刊>Clinical Chemistry: Journal of the American Association for Clinical Chemists >Obese Nondiabetic Pregnancies and High Maternal Glycated Hemoglobin at Delivery as an Indicator of Offspring and Maternal Postpartum Risks: The Prospective PEACHES Mother-Child Cohort
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Obese Nondiabetic Pregnancies and High Maternal Glycated Hemoglobin at Delivery as an Indicator of Offspring and Maternal Postpartum Risks: The Prospective PEACHES Mother-Child Cohort

机译：肥胖的非糖尿病孕妇和高产妇糖化血红蛋白在分娩时作为后代和产妇产后风险的指标：准妈妈们的准妈妈队列

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BACKGROUND: We investigated whether obese pregnant women negative for gestational diabetes (GDM) still experience dysglycemia, as indicated by high glycated hemoglobin (Hb A1c) at delivery, and whether this impacts offspring and long-term maternal outcomes.METHODS: Data of 462 mother-child pairs of our prospective Programming of Enhanced Adiposity Risk in Childhood – Early Screening (PEACHES) cohort study were analyzed. Of 885 obese and normal-weight pregnancies prospectively enrolled after GDM testing according to the International Association of Diabetes and Pregnancy Study Groups criteria, 462 GDM-negative mothers and their offspring were investigated. We assessed associations of maternal Hb A1c at delivery with large-for-gestational-age (LGA) birth weights, cord-blood C-peptide, and biomarkers of glucose metabolism and inflammation in obese mothers followed for 2.9 years (median) postpartum (n = 42).RESULTS: Cumulative distribution analysis in GDM-negative normal-weight women (n = 155) revealed that 12% had Hb A1c ≥5.7% at delivery (high Hb A1c). Among obese GDM-negative women (n = 307), 31.9% (95% CI, 26.7%–37.4%) equaled or exceeded this cutoff. In obese GDM-negative women with Hb A1c ≥5.7% (n = 98) vs 5.7% (n = 209) at delivery, newborns were more likely to be born LGA [adjusted odds ratio 3.56 (95% CI, 1.64–8.02)], and mean cordblood serum C-peptide was increased by 0.09 ng/mL (95% CI, 0.01–0.17 ng/mL). In the mothers at follow-up, mean postpartum Hb A1c, fasting glucose, high-sensitivity C-reactive protein, and fibrinogen concentrations were higher by 0.3% (95% CI, 0.1%–0.5%), 6.0 mg/dL (95% CI, 2.4–9.5 mg/dL), 6.8 mg/L (95% CI, 1.4–12.3 mg/L), and 74.9 mg/dL (95% CI, 13.6–136.2 mg/dL), respectively.CONCLUSIONS: Increased Hb A1c in obese GDM-negative women at delivery indicates gestational dysglycemia, potentially conferring offspring and long-term maternal health risks. These findings should raise awareness as to careful monitoring of obese pregnancies. Measurement of Hb A1c at delivery could help select women who may need closer postpartum health checks.
机译：背景：我们调查了分娩时高糖化血红蛋白（Hb A1c）所表明的对妊娠糖尿病（GDM）阴性的肥胖孕妇是否仍存在血糖异常，方法是否影响后代和长期母体结果方法：462名母亲的数据分析了我们对儿童期肥胖风险增加的前瞻性编程的早期儿童对-早期筛查（PEACHES）队列研究。根据国际糖尿病和妊娠研究小组的标准，在GDM测试后预期纳入的885例肥胖和正常体重妊娠中，对462例GDM阴性母亲及其后代进行了调查。我们评估了产后Hb A1c与大胎龄（LGA）出生体重，脐带血C肽以及葡萄糖代谢和炎症的生物标志物在产后2.9年（中位数）的关联（n） = 42）。结果：GDM阴性体重正常女性（n = 155）的累积分布分析显示，有12％的孕妇分娩时Hb A1c≥5.7％（高Hb A1c）。在肥胖的GDM阴性女性（n = 307）中，有31.9％（95％CI，26.7％–37.4％）等于或超过了该临界值。在分娩时Hb A1c≥5.7％（n = 98）vs <5.7％（n = 209）的肥胖GDM阴性妇女中，新生儿更有可能出生LGA [校正后的优势比3.56（95％CI，1.64-8.02） ）]，平均脐带血血清C​​肽增加0.09 ng / mL（95％CI，0.01-0.17 ng / mL）。接受随访的母亲的平均产后Hb A1c，空腹血糖，高敏C反应蛋白和血纤蛋白原浓度分别升高0.3％（95％CI，0.1％-0.5％），6.0 mg / dL（95 CI百分比，2.4–9.5 mg / dL），6.8 mg / L（95％CI，1.4–12.3 mg / L）和74.9 mg / dL（95％CI，13.6–136.2 mg / dL）。结论：肥胖的GDM阴性妇女在分娩时Hb A1c升高表示妊娠血糖异常，可能给后代和长期孕产妇健康带来危险。这些发现应提高人们对肥胖妊娠进行认真监测的意识。分娩时测量Hb A1c可以帮助选择可能需要更详细的产后健康检查的女性。

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