Journal
NUTRIENTS
Volume 14, Issue 16, Pages -Publisher
MDPI
DOI: 10.3390/nu14163347
Keywords
overweight; obesity; macrosomia; triglyceride; gestational diabetes mellitus; mediation analysis
Categories
Funding
- Hunan Province Outstanding Youth Fund [2022JJ10087]
- China Postdoctoral Science Foundation [2020M682644]
- National Natural Science Foundation Program of China [82073653, 81803313]
- Natural Science Foundation of Hunan Province [2018JJ2551]
- Hunan Provincial Key Research and Development Program [2018SK2063, 2018SK2062]
- Open Project from NHC Key Laboratory of Birth Defect for Research and Prevention [KF2020006]
- Hunan Provincial Science and Technology Talent Support Project [2020TJ-N07]
- Natural Science Foundation of Hunan Province of China [2022JJ40207]
- Changsha Municipal Natural Science Foundation [kq2202470]
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The study found that gestational diabetes mellitus and high maternal triglyceride levels independently increased the risk of macrosomia, and collectively acted as significant mediators in the relationship between pre-pregnancy overweight/obesity and macrosomia.
The purpose of this study is to investigate whether the link between pre-pregnancy overweight/obesity and risk of macrosomia is mediated by both gestational diabetes mellitus (GDM) and high maternal triglyceride (mTG) levels. This prospective study finally included 29,415 singleton term pregnancies. The outcome of interest was macrosomia (>= 4000 g). High mTG levels were denoted as values >= 90th percentile. GDM was diagnosed using a standard 75 g 2 h oral glucose tolerance test. The mediation analysis was conducted using log-binomial regression while controlling for maternal age, education, parity, gestational weight gain, gestational hypertension, smoking, drinking and infant sex. Overall, 15.9% of pregnant women were diagnosed with GDM, and 4.3% were macrosomia. Mediation analysis suggested that overweight had a total effect of 0.009 (95% CI, 0.006-0.013) on macrosomia, with a direct effect of 0.008 (95% CI, 0.004-0.012) and an indirect effect of 0.001 (95% CI, 0.001-0.002), with an estimated proportion of 11.1% mediated by GDM and high mTG levels together. Furthermore, we also discovered a total effect of obesity on macrosomia of 0.038 (95% CI, 0.030-0.047), consisting of a direct effect of 0.037 (95% CI, 0.028-0.045) and an indirect effect of 0.002 (95% CI, 0.001-0.002), with an estimated proportion of 5.3% mediated by GDM and high mTG levels combined. Both GDM and high mTG levels enhanced the risk of macrosomia independently and served as significant mediators in the relationship between pre-pregnancy overweight/obesity and macrosomia.
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