首页 > 资讯 > 妊娠期糖尿病母亲所产新生儿脐带血皮质醇水平变化及其对子代健康的影响

妊娠期糖尿病母亲所产新生儿脐带血皮质醇水平变化及其对子代健康的影响

泰然健康网
2024-12-10 11:16

摘要：

目的·探讨妊娠期糖尿病（gestational diabetes mellitus，GDM）对新生儿脐带血皮质醇水平的影响，并探索围产期高皮质醇暴露对子代学龄前期健康状况的影响。方法·纳入170例产妇及其足月、单胎分娩新生儿，其中GDM组产妇66例、孕期正常糖耐量（normal glucose tolerance，NGT）组产妇104例。采集新生儿的脐带血，测量其皮质醇及促肾上腺皮质激素（adrenocorticotropic hormone，ACTH）浓度。利用SPSS软件分析GDM对新生儿脐带血皮质醇及ACTH水平的影响。采用多元线性回归模型分析新生儿脐带血皮质醇水平的影响因素。采用Pearson χ2检验分析围产期高皮质醇对子代学龄前期健康状况的影响，并采用二元Logistic回归模型分析子代学龄前期肥胖的影响因素。结果·与NGT组相比，GDM组新生儿的脐带血皮质醇水平较高，ACTH水平较低（均P<0.05）。多元线性回归分析显示，母亲孕次、75 g葡萄糖耐量试验（oral glucose tolerance test，OGTT）服糖后1 h及2 h血糖水平是新生儿脐带血皮质醇水平的独立影响因素（均P<0.05）。随访结果显示，围产期较高水平皮质醇的子代学龄前期肥胖率较高（P=0.009）。二元Logistic回归分析证实新生儿脐带血皮质醇水平≥192.00 ng/mL是学龄前期肥胖的独立危险因素（OR=4.714，P=0.016）。结论·GDM引起新生儿脐带血皮质醇升高，围产期高皮质醇暴露导致子代学龄前期肥胖风险增加，GDM可能通过围产期高皮质醇暴露引起子代远期疾病。

关键词: 妊娠期糖尿病, 脐带血, 糖皮质激素, 产前暴露迟发效应, 肥胖

Abstract:

Objective·To investigate the effect of gestational diabetes mellitus (GDM) on the cortisol level in neonatal umbilical cord blood, and explore the effects of high perinatal cortisol exposure on neonatal health status at preschool-period.Methods·A total of 170 mothers and their full-term neonates were selected, including 66 cases in GDM group and 104 cases in normal glucose tolerance (NGT) group. The umbilical cord blood from the newborns of the two groups was collected to measure the concentrations of cortisol and adrenocorticotropic hormone (ACTH). SPSS software was used to analyze the effect of GDM on cortisol and ACTH levels in the neonatal umbilical cord blood. Multiple linear regression model was used to analyze the influencing factors of cortisol level in the umbilical cord blood. Pearson χ2 method was used to analyze the effects of perinatal high cortisol on the health status of offspring at preschool-period, and binary Logistic regression model was used to analyze the influencing factors of preschool-period obesity.Results·Compared with the NGT group, the cortisol level of neonatal umbilical cord blood in the GDM group was higher and ACTH level was lower (both P<0.05). Multiple linear regression analysis showed that maternal gestational times, and blood glucose at 1 h and 2 h after 75 g oral glucose tolerance test (OGTT) were the independent influencing factors of neonatal umbilical cord blood cortisol level (all P<0.05). The follow-up results showed that the offspring with higher perinatal cortisol level had higher pre-school obesity rate (P=0.009). Binary Logistic regression analysis confirmed that neonatal umbilical cord blood cortisol level ≥ 192.00 ng/mL was an independent risk factor of preschool-period obesity (OR=4.714, P=0.016).Conclusion·Maternal GDM can cause the increase of neonatal umbilical cord blood cortisol level. High perinatal cortisol exposure can increase the risk of preschool-period obesity in the offspring. GDM may cause long-term diseases in the offspring through perinatal high cortisol exposure.

Key words: gestational diabetes mellitus (GDM), umbilical cord blood, glucocorticoid, prenatal exposure delayed effect, obesity

中图分类号:

R714.256