American journal of perinatology · 2026
Long-Term Effects of Maternal Glycemic Measures in Pregnancy and Offspring Adverse Glycemic Outcomes: Results from the TEAM Study.
СтатьяПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Bowers Katherine, Bhoopathy Krishna, Szczesniak Rhonda, Sawyer Russell P, Shah Amy S, Ehrlich Shelley, Dolan Lawrence M, Summer Suzanne, Smith Emily, Altaye Mekibib, Ollberding Nicholas J, Catalano Patrick, Khoury Jane C
Аннотация
OBJECTIVE: In utero exposure to maternal prepregnancy diabetes is associated with an increased risk for abnormal glycemic outcomes in children, including impaired glucose tolerance, insulin resistance, and type 2 diabetes. Our objective was to evaluate the timing of exposure to maternal dysglycemia and whether the effects persist into adulthood.
STUDY DESIGN: The Transgenerational Effects on Adult Morbidity (TEAM) Study followed offspring of mothers with prepregnancy insulin-dependent diabetes mellitus (IDDM), who participated in a Program Project Grant (PPG) between 1978 and 1995. These women had a detailed characterization of glycemic measures across pregnancy and comprehensive obstetric and delivery data. Offspring participated in a complete clinical exam, which included an oral glucose tolerance test (OGTT). Multiple regression methods were used to identify associations between trimester-specific maternal hemoglobin A1 (HbA1) standard deviation (HbA1SD) and maternal glucose profiles with offspring glycemic outcomes, adjusting for covariates.
RESULTS: Among 161 offspring up to 42 years of age (mean age, 32.3 years), first trimester HbA1SD was associated with increased offspring fasting plasma glucose and HbA1c ≥6.5% after adjusting for maternal age, family history of diabetes, presence of microvascular disease, and body mass index (BMI) at the last menstrual period. Both second- and third-trimester maternal HbA1SD were positively associated with offspring HbA1c and inversely associated with the acute insulin response to glucose (AIRg), defined as the rapid, first-phase release of insulin from pancreatic beta-cells within 10 minutes of the OGTT.
CONCLUSION: Our findings add to the current literature showing that the association between trimester-specific gestational maternal glycemic status and offspring adverse glycemic outcome persists into adulthood in the offspring.
KEY POINTS: · Exposure to maternal IDDM is associated with offspring glycemic outcomes.. · Maternal glycohemoglobin, particularly in the first trimester, is associated with HbA1c and fasting glucose.. · Mid-late pregnancy hyperglycemia was associated with reduced offspring acute insulin response..
STUDY DESIGN: The Transgenerational Effects on Adult Morbidity (TEAM) Study followed offspring of mothers with prepregnancy insulin-dependent diabetes mellitus (IDDM), who participated in a Program Project Grant (PPG) between 1978 and 1995. These women had a detailed characterization of glycemic measures across pregnancy and comprehensive obstetric and delivery data. Offspring participated in a complete clinical exam, which included an oral glucose tolerance test (OGTT). Multiple regression methods were used to identify associations between trimester-specific maternal hemoglobin A1 (HbA1) standard deviation (HbA1SD) and maternal glucose profiles with offspring glycemic outcomes, adjusting for covariates.
RESULTS: Among 161 offspring up to 42 years of age (mean age, 32.3 years), first trimester HbA1SD was associated with increased offspring fasting plasma glucose and HbA1c ≥6.5% after adjusting for maternal age, family history of diabetes, presence of microvascular disease, and body mass index (BMI) at the last menstrual period. Both second- and third-trimester maternal HbA1SD were positively associated with offspring HbA1c and inversely associated with the acute insulin response to glucose (AIRg), defined as the rapid, first-phase release of insulin from pancreatic beta-cells within 10 minutes of the OGTT.
CONCLUSION: Our findings add to the current literature showing that the association between trimester-specific gestational maternal glycemic status and offspring adverse glycemic outcome persists into adulthood in the offspring.
KEY POINTS: · Exposure to maternal IDDM is associated with offspring glycemic outcomes.. · Maternal glycohemoglobin, particularly in the first trimester, is associated with HbA1c and fasting glucose.. · Mid-late pregnancy hyperglycemia was associated with reduced offspring acute insulin response..