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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >The mediating effects of gestational diabetes on fetal growth and adiposity in women who are overweight and obese: secondary analysis of the LIMIT LIMIT randomised trial
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The mediating effects of gestational diabetes on fetal growth and adiposity in women who are overweight and obese: secondary analysis of the LIMIT LIMIT randomised trial

机译：妊娠期糖尿病对超重和肥胖妇女胎儿生长和肥胖的调解作用：极限限制随机试验的二次分析

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Objective To describe the mediating effect of maternal gestational diabetes on fetal biometry and adiposity measures among overweight or obese pregnant women. Design Secondary analysis of the LIMIT randomised trial. Setting Public hospitals, metropolitan Adelaide, South Australia. Population Pregnant women with body mass index ( BMI ) ≥25 kg/m 2 and singleton gestation. Methods Fetal ultrasound measures at 36 weeks of gestation and baseline BMI from women randomised to the LIMIT trial Standard Care group ( n = 912 women) were used to conduct causal mediation analyses using regression‐based methods. Main outcomes measures Ultrasound measures of fetal biometry and adiposity at 36 weeks of gestation. Results Increased maternal BMI was associated with increased measures of fetal head circumference [direct (unmediated) effect 0.18 (95% CI : 0.05–0.31), P = 0.005; total effect 0.17 (95% CI : 0.02–0.31), P = 0.018], abdominal circumference [direct effect 0.26 (95% CI : 0.11–0.41), P = 0.001; total effect 0.26 (95% CI : 0.11–0.42), P = 0.001] and estimated fetal weight [direct effect 0.22 (95% CI : 0.08–0.35), P = 0.002; total effect 0.22 (95% CI : 0.08–0.35), P = 0.002], with no evidence of mediation by treated gestational diabetes. There was no apparent association between maternal BMI and fetal adiposity measures, or mediation by treated gestational diabetes. Conclusions We show an important association between increased maternal BMI and fetal growth, not mediated by treated gestational diabetes. There was no association between increased maternal BMI and fetal adiposity measures, or mediation by treated gestational diabetes. Whether these findings represent ‘saturation’ in the effect of maternal BMI on fetal growth or the effect of treatment of GDM is unclear. Funding This project was funded by a 4‐year project grant from the National Health and Medical Research Council ( NHMRC ), Australia ( ID 519240); The Channel 7 Children's Research Foundation, South Australia; and the US National Institutes of Health (R01 HL 094235‐01). Tweetable abstract Increased fetal growth associated with maternal obesity is not mediated by gestational diabetes.
机译：目的描述母体妊娠糖尿病对超重或肥胖孕妇胎儿生物生物生物生物生物生物生物生物生物生物生物生物生物生物生物生物生物生物学和肥胖措施的介质效果。设计极限随机试验的二次分析。设定公立医院，大都会阿德莱德，南澳大利亚。人口孕妇体重指数（BMI）≥25公斤/平方米和单身妊娠。方法采用胎儿超声测量36周的妊娠和基线BMI从随机分配到极限试验标准护理组（n = 912名女性）进行因果转换方法进行因果调解分析。主要结果测量胎儿生物学和妊娠36周的胎儿生物学和肥胖的超声测量。结果母体BMI的增加与胎儿圆周圆周的增加的措施相关[直接（未介导）0.18（95％CI：0.05-0.31），P = 0.005;总效果0.17（95％CI：0.02-0.31），P = 0.018]，腹部圆周[直接效果0.26（95％CI：0.11-0.41），P = 0.001;总效果0.26（95％CI：0.11-0.42），P = 0.001]和估计胎儿重量[直接效果0.22（95％CI：0.08-0.35），P = 0.002;总效果0.22（95％CI：0.08-0.35），p = 0.002]，没有治疗的妊娠期糖尿病的调解证据。母体BMI和胎儿肥胖度量之间没有明显关联，或通过治疗的妊娠期糖尿病调解。结论我们表现出母体BMI和胎儿生长增加的重要关联，而不是由治疗的妊娠期糖尿病介导的。母体BMI和胎儿肥胖措施之间没有关联，或通过治疗的妊娠期糖尿病调解。这些发现是否代表母体BMI对胎儿生长的影响或治疗GDM的效果不清楚。资助该项目由国家卫生和医学研究委员会（NHMRC），澳大利亚（ID 519240）提供的4年项目授予资金;南澳大利亚渠道7儿童研究基金会;和美国国家卫生研究院（R01 HL 094235-01）。 Twelable摘要增加了与孕产妇肥胖相关的胎儿生长未被妊娠期糖尿病介导。

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