BACKGROUND: An increased prevalence of cleft lip and/or palate (CL/P), a major congenital anomaly, has been observed in the offspring of women with elevated body mass index (BMI) before pregnancy. Likewise, gestational comorbidities, such as hypertension and diabetes mellitus, also increase the risk of CL/P; however, the risk linked to the coexistence of these conditions in women with higher BMI on birth prevalence of CL/P remains unclear. This study focused on the combined effects of a high BMI before pregnancy and gestational comorbidities on the birth prevalence of CL/P. METHODS: Among 98,373 live births from the Japan Environment and Children's Study (JECS), a nationwide birth cohort, 255 mothers of infants with CL/P (74, 112, and 69 infants born with cleft lip, cleft lip and palate, and isolated cleft palate, respectively) were included in the analyses. The association of CL/P birth prevalence with pre-pregnancy BMI and gestational comorbidities (hypertension and diabetes) was examined using multivariate logistic regression analyses after multiple imputations, with adjustments for several maternal (age at delivery, smoking habits, and alcohol intake) and child-related (sex and prevalence of other congenital diseases) variables, obtained through medical record transcriptions and self-reports on JECS transcription forms. RESULTS: Higher prevalence rates of overweight, gestational hypertension, and gestational diabetes mellitus were found in mothers of infants with CL/P (16.1%, 6.3%, and 4.7%, respectively) than in the control group (10.4%, 3.1%, and 3.1%, respectively). The odds ratio [95% confidence interval] for childbirth with CL/P was increased in mothers with high BMI before pregnancy (1.58 [1.11-2.24]). Furthermore, gestational hypertension and diabetes coexisting with high BMI additionally increased the odds ratios for childbirth with CL/P (2.91 [1.28-6.61] and 2.12 [0.87-5.19], respectively). CONCLUSION High maternal BMI, particularly when accompanied by gestational hypertension, was significantly associated with an increased prevalence of childbirth with CL/P.
Humans ; Female ; Cleft Lip/etiology* ; Cleft Palate/etiology* ; Pregnancy ; Japan/epidemiology* ; Prevalence ; Body Mass Index ; Adult ; Male ; Infant, Newborn ; Comorbidity ; Diabetes, Gestational/epidemiology* ; Risk Factors ; Young Adult ; Birth Cohort

Objective:To analyze the hearing outcomes of high-risk children of diabetic mothers, especially in the subtypes of pre-pregnancy diabetes and gestational diabetes, in order to provide some reference for clinical practice. Methods:The basic characteristics and hearing levels of children whose mothers had a history of diabetes during pregnancy and underwent audiological diagnosis and evaluation at our hospital's Children's Hearing Diagnosis Center from January 2003 to June 2024 were analyzed. T-tests, Wilcoxon rank-sum tests, and chi-square tests were used for inter-group comparisons, with a significance level set at P<0.05. Results:A total of 285 children（570 ears） of diabetic mothers were included. Hearing loss was found in 310 ears, and the incidence of hearing loss was 54.39%（310/570）. The mean ABR threshold in the pregestational diabetes group was（50.01±29.29） dB HL, while that in the gestational diabetes group was（44.13±26.19） dB HL. The degree of hearing loss in the pregestational diabetes group was more severe than that in the gestational diabetes group（χ²=10.000, P=0.019）. Conclusion:Maternal history of diabetes may be one of the risk factors for hearing loss in their offspring, and the risk of hearing loss in children whose mothers had diabetes before pregnancy may be higher than that in the gestational diabetes group. It is suggested that the clinical practice should pay attention to the monitoring and follow-up management of the hearing status of such children, so as to improve the auditory outcomes of children born to diabetic mothers.
Humans ; Female ; Pregnancy ; Diabetes, Gestational ; Hearing Loss/etiology* ; Child ; Pregnancy in Diabetics ; Risk Factors ; Child, Preschool ; Mothers ; Male

OBJECTIVE: To investigate the association between ABO blood types and gestational diabetes mellitus (GDM) risk. METHODS: A prospective birth cohort study was conducted. ABO blood types were determined using the slide method. GDM diagnosis was based on a 75-g, 2-h oral glucose tolerance test (OGTT) according to the criteria of the International Association of Diabetes and Pregnancy Study Groups. Logistic regression was applied to calculate the odds ratios ( ORs) and 95% confidence intervals ( CIs) between ABO blood types and GDM risk. RESULTS: A total of 30,740 pregnant women with a mean age of 31.81 years were enrolled in this study. The ABO blood types distribution was: type O (30.99%), type A (26.58%), type B (32.20%), and type AB (10.23%). GDM was identified in 14.44% of participants. Using blood type O as a reference, GDM risk was not significantly higher for types A ( OR = 1.05) or B ( OR = 1.04). However, women with type AB had a 19% increased risk of GDM ( OR = 1.19, 95% CI = 1.05-1.34; P < 0.05), even after adjusting for various factors. This increased risk for type AB was consistent across subgroup and sensitivity analyses. CONCLUSION The ABO blood types may influence GDM risk, with type AB associated with a higher risk. Incorporating it-either as a single risk factor or in combination with other known factors-could help identify individuals at risk for GDM before or during early pregnancy.
Humans ; Female ; Pregnancy ; Diabetes, Gestational/etiology* ; ABO Blood-Group System ; Adult ; Prospective Studies ; Risk Factors ; Young Adult

OBJECTIVES: To explore the association between maternal gestational diabetes mellitus (GDM) exposure and the development of autism spectrum disorder (ASD) in offspring. METHODS: A case-control study was conducted, recruiting 221 children with ASD and 400 healthy children as controls. Questionnaires and interviews were used to collect information on general characteristics of the children, socio-economic characteristics of the family, maternal pregnancy history, and maternal disease exposure during pregnancy. Multivariate logistic regression analysis was used to investigate the association between maternal GDM exposure and the development of ASD in offspring. The potential interaction between offspring gender and maternal GDM exposure on the development of ASD in offspring was explored. RESULTS: The proportion of maternal GDM was significantly higher in the ASD group compared to the control group (16.3% vs 9.4%, P=0.014). After adjusting for variables such as gender, gestational age, mode of delivery, parity, and maternal education level, maternal GDM exposure was a risk factor for ASD in offspring (OR=2.18, 95%CI: 1.04-4.54, P=0.038). On the basis of adjusting the above variables, after further adjusting the variables including prenatal intake of multivitamins, folic acid intake in the first three months of pregnancy, and assisted reproduction the result trend did not change, but no statistical significance was observed (OR=1.94, 95%CI: 0.74-5.11, P=0.183). There was an interaction between maternal GDM exposure and offspring gender on the development of ASD in offspring (P<0.001). Gender stratified analysis showed that only in male offspring of mothers with GDM, the risk of ASD was significantly increased (OR=3.67, 95%CI: 1.16-11.65, P=0.027). CONCLUSIONS Maternal GDM exposure might increase the risk of ASD in offspring. There is an interaction between GDM exposure and offspring gender in the development of ASD in offspring.
Child ; Female ; Pregnancy ; Humans ; Male ; Diabetes, Gestational/etiology* ; Autism Spectrum Disorder/etiology* ; Case-Control Studies ; Gestational Age ; Mothers

Children born to mothers with gestational diabetes mellitus (GDM) are more likely to exhibit congenital malformations, high birth weight, and obesity and have an increased risk of developing type 2 diabetes in later life. Children who are exposed to maternal diabetes in utero may be 'programmed' for later development of obesity at a critical period of development. Therefore, the purpose of the present study was to examine the associations among adiposity and systolic blood pressure in children and abnormal maternal glucose levels during pregnancy. A total of 856 mother-child pairs were included in the present retrospective study. Eligible pregnant women underwent a standard 75 g oral glucose tolerance test between 24 and 28 weeks' gestation. Anthropometric characteristics of their children were measured at 6 years of age, including body mass index, the sum of subscapular and tricep skinfold thickness, and systolic blood pressure. The result suggests that children exposed to GDM have higher adiposity; prevention of childhood obesity needs to begin early in life for these children.
Adiposity ; physiology ; Aging ; Child ; China ; epidemiology ; Diabetes, Gestational ; metabolism ; Female ; Humans ; Obesity ; etiology ; Pregnancy ; Prenatal Exposure Delayed Effects ; Risk Factors

BACKGROUNDGestational diabetes mellitus (GDM) is a common complication during pregnancy, and gestational weight gain is one of the major and modifiable risk factors. This study aims to estimate the relationship between the rate of gestational weight gain before diagnosis of GDM and the subsequent risk of GDM.

METHODSA case-control study was conducted with 90 GDM cases and 165 women in the control group from May 2012 to August 2012 at Peking University First Affiliated Hospital. GDM was diagnosed according to the standards issued by the Ministry of Health of China in 2011. The plasma glucose levels, weights, and covariate data of the women were obtained based on medical records. Univariate analysis and unconditional Logistic regression model were used to estimate the associations.

RESULTSAfter adjusting for age at delivery, parity, and pre-pregnancy body mass index, the risk of GDM increased with increasing rates of gestational weight gain. Compared with the lower rate of gestational weight gain (less than 0.28 kg per week), a rate of weight gain of 0.28 kg per week or more was associated with increased risk of GDM (odds ratio: 2.03; 95% confidence interval: 1.15 to 3.59). The association between the rate of gestational weight gain and GDM was primarily attributed to the increased weight gain in the first trimester.

CONCLUSIONHigh rates of gestational weight gain, particular during early pregnancy, may increase a woman's risk of GDM.

Adult ; Case-Control Studies ; Diabetes, Gestational ; epidemiology ; etiology ; Female ; Humans ; Pregnancy ; Weight Gain ; physiology

INTRODUCTIONWomen with previous gestational diabetes mellitus (PGDM) are at increased risk of future glucose intolerance. This study aimed to determine the prevalence of prediabetes and type 2 diabetes mellitus (T2DM), and the associated antenatal and historical risk factors among women with PGDM.

METHODSThis was a cross-sectional study conducted at University Malaya Medical Centre, Kuala Lumpur, Malaysia. A 75-g 2-hour oral glucose tolerance test was performed in a cohort of multiethnic women with PGDM. Body mass index, waist and hip circumferences, fasting lipid profile and blood pressure were obtained. Data pertaining to the index gestational diabetes mellitus (GDM) were obtained from medical records and interviews.

RESULTS448 women were enrolled in the study. The prevalence of prediabetes and T2DM was 26.2% and 35.5%, respectively. On multinomial logistic regression analysis, fasting plasma glucose at diagnosis of index GDM and duration lapse after index GDM were shown to be significantly higher in women with isolated impaired fasting glucose (IFG), combined IFG/impaired glucose tolerance and T2DM, as compared to women with normal glucose tolerance (p < 0.05). 2-hour plasma glucose at diagnosis of index GDM was significantly higher only in women who progressed to T2DM when compared to those that remained normal glucose tolerant (p < 0.05).

CONCLUSIONIn this study, duration lapse after index GDM, fasting plasma glucose and 2-hour plasma glucose at diagnosis of index GDM were important risk factors for early identification of women at high risk for future glucose intolerance. These may be useful for developing potential preventive strategies.

Adult ; Blood Glucose ; metabolism ; Body Mass Index ; Cross-Sectional Studies ; Diabetes, Gestational ; blood ; Female ; Glucose Intolerance ; blood ; epidemiology ; etiology ; Glucose Tolerance Test ; Humans ; Malaysia ; epidemiology ; Postpartum Period ; blood ; Prediabetic State ; epidemiology ; etiology ; Pregnancy ; Prevalence ; Risk Factors

No abstract available.
Diabetes Mellitus, Type 2/genetics ; Diabetes, Gestational/*etiology/genetics ; Female ; Humans ; Infant, Newborn ; Korea ; Male ; Pregnancy ; Risk Factors

OBJECTIVEAbnormal glucose metabolism during pregnancy can result in significant adverse outcomes for newborns. This study was designed to investigate the effect of different degrees of impaired glucose tolerance on newborns.

METHODSGlucose challenge test (GCT) and oral glucose tolerance test (OGTT) were performed in pregnant women at 24-28 weeks of gestation. Based on the results of the two tests, their newborn infants were classified into five groups: gestational diabetes mellitus (GDM, n=182), gestational impaired oral glucose tolerance [GIGT, subdividing into GIGT 1 h (n=57) and GIGT 2-3 h groups (n=156)based on the occurrence time of abnormal blood glucose after glucose load], GCT abnormal but OGTT normal (only GCT abnormal, n=38) and normal glucose tolerance (control, n=1 025). The perinatal outcomes were compared among the five groups.

RESULTSThe incidences of macrosomia, large for gestational age (LGA), small for gestational age (SGA), neonatal hypoglycemia and premature birth in the GIGT (1 h) group were significantly higher than those in the control group, but similar to those in the GDM group. The incidences of macrosomia, SGA, neonatal hypoglycemia and premature birth in the GIGT (2-3 h) and the only GCT abnormal groups significantly decreased as compared with those in the GDM group, and similar to those in the control group. GIGT (1 h ) group showed higher incidence of neonatal hypoglycemia and premature birth than the GIGT (2-3 h) and the only GCT abnormal groups.

CONCLUSIONSDifferent degrees of maternal impaired glucose tolerance have different effects on newborns. As maternal GDM, maternal GIGT (1 h) may increase the risk of macrosomia, LGA, SGA, neonatal hypoglycemia and premature birth.

Diabetes, Gestational ; metabolism ; Female ; Fetal Macrosomia ; etiology ; Glucose ; metabolism ; Glucose Intolerance ; complications ; Glucose Tolerance Test ; Humans ; Hypoglycemia ; etiology ; Infant, Newborn ; Male ; Pregnancy ; Premature Birth ; etiology ; Retrospective Studies

BACKGROUNDWomen with a history of gestational diabetes mellitus (GDM) are at higher risk of future development of diabetes. This study investigated the risk factors associated with early postpartum abnormal glucose regulation (AGR) among Chinese women with a history of GDM.

METHODSA total of 186 women with a history of GDM were screened for early postpartum AGR at 6-8 weeks after delivery. Those with AGR were given lifestyle intervention therapy and reevaluated in 6-12 months. The demographic, anthropometric, prenatal and delivery data were recorded. The plasma high-sensitivity C-reactive protein (HsCRP) and lipid concentration were measured, and insulin secretion were analyzed. Insulinogenic index Deltains30'/DeltaBG30', the homeostasis model assessment index (HOMA)-B, and HOMA-IR were calculated. Multiple regression analysis was performed to identify the risk factors.

RESULTSOf the GDM women 28.0% (52/186) had AGR at 6-8 weeks after delivery; 45.2% (17/40) of these AGR women reminded abnormal after 6-12 month lifestyle intervention. Compared to the women who reverted to normal, women with consistent AGR showed significantly lower fasting insulin concentration, lower Deltains30'/DeltaBG30' as well as lower HOMA-B. No significant differences in age, body mass index (BMI), waist circumference, blood pressure, lipid level, HsCRP and HOMA-IR were observed between the two groups. Pre-pregnancy BMI = 25 kg/m(2), fasting glucose level = 5.6 mmol/L and/or 75 g oral glucose tolerance test (OGTT) 2 hours glucose level = 11.1 mmol/L during pregnancy were predictors for the AGR at 6-8 weeks after delivery. Deltains30'/DeltaBG30 = 1.05 was a significant risk contributor to the consistent early postpartum AGR.

CONCLUSIONThere is a high incidence of early postpartum AGR among Chinese woman with prior GDM. Beta-cell dysfunction, rather than insulin resistance or inflammation, is the predominant contributor to the early onset and consistent AGR after delivery.

Adult ; Asian Continental Ancestry Group ; China ; Diabetes Mellitus, Type 2 ; etiology ; Diabetes, Gestational ; Female ; Humans ; Insulin-Secreting Cells ; physiology ; Pregnancy ; Puerperal Disorders ; etiology ; Risk Factors