Racial and ethnic disparities in extremes of fetal growth after gestational diabetes mellitus

Xiang, Anny H.; Black, Maureen M.; Li, Bonnie H.; Martinez, Mayra P.; Sacks, David A.; Lawrence, Jean M.; Buchanan, Thomas A.; Jacobsen, Steven J.

doi:10.1007/s00125-014-3420-8

Cited by 25 publications

(13 citation statements)

References 27 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The primary exposure variables were maternal pre‐pregnancy BMI, GDM status, EGWG and breastfeeding status for each child. Maternal pre‐pregnancy BMI and gestational weight gain during the index pregnancy were calculated using maternal height and weight measurements from the EMR . Pre‐pregnancy BMI was classified as normal (BMI < 25 kg m −2 ), overweight (25 ≤ BMI < 30 kg m −2 ) or obese (BMI ≥ 30 kg m −2 ).…”

Section: Methodsmentioning

confidence: 99%

Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years

et al. 2016

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The usual description of a baby born to a mother with gestational diabetes (GDM) includes macrosomia and large for gestational age phenotypes in late pregnancy and at birth. Some studies indicate a stronger association between maternal hyperglycemia and offspring birth weight in ethnic South Asians than in Europeans [ 6 – 8 ]. However, little is known about the fetal growth trajectories in GDM and non-GDM pregnancies, in populations universally screened for GDM, and if this differs between these two ethnic groups.…”

Section: Introductionmentioning

confidence: 99%

Fetal growth trajectories in pregnancies of European and South Asian mothers with and without gestational diabetes, a population-based cohort study

et al. 2017

View full text Add to dashboard Cite

ObjectiveOur aim was to examine the impact of gestational diabetes (GDM), from before the GDM-diagnosis is made, on fetal growth trajectories, and to compare it in Europeans and South Asians; two ethnic groups with dissimilar fetal growth patterns.MethodsWe studied European (n = 349) and South Asian (n = 184) pregnant women, from the population-based STORK-Groruddalen cohort in Oslo, Norway. Mothers were enrolled in early pregnancy, screened for GDM in gestational week 28 ±2, and classified as “non-GDM”, “mild GDM” or “moderate/severe GDM”. We measured fetal head circumference, abdominal circumference and femur length by ultrasound, and estimated fetal weight in gestational week 24, 32 and 37, and performed corresponding measurements at birth.ResultsIn non-GDM pregnancies, South Asian fetuses (n = 156) had a slower growth from gestational week 24, compared with Europeans (n = 310). More than two thirds of the European mothers later diagnosed with GDM were overweight or obese in early pregnancy, while this was not observed in South Asians. Fetuses of GDM mothers tended to be smaller than fetuses of non-GDM mothers in week 24, but thereafter grew faster until birth. This pattern was especially pronounced in fetuses of South Asian mothers with moderate/severe GDM. In week 24 these fetuses had a -0.95 SD (95% CI: -1.53, -0.36) lower estimated fetal weight than their non-GDM counterparts. In contrast, at birth they were 0.45 SD (0.09, 0.81) larger.ConclusionsOffspring of GDM mothers were smaller in mid pregnancy, but subsequently grew faster until birth, compared with offspring of non-GDM mothers. This pattern was most prominent in South Asian mothers with moderate to severe GDM. However, the most remarkable characteristic of these fetuses was not a large size at birth, but the small size in mid pregnancy, before the GDM diagnosis was set.

show abstract

“…Among other factors, this mechanism might account for the higher risk of PCOS and associated clinical/metabolic conditions exhibited by the offspring of mothers with PCOS (Padmanabhan & Veiga-Lopez 2011). Adrenal androgen excess in the maternal circulation occurs in the absence of IUGR (a characteristic that has been shown in animal models) (Zhou et al 2005), and hyperandrogenism might be consequence of obesity, DM, IR (Escobar-Morreale et al Obesity (Chandrasekaran et al 2014), DM, IR and excessive weight gain during pregnancy (Xiang et al 2015) are predictors of large-for-gestational-age (LGA) offspring. Because these conditions may also be associated with hyperandrogenism (Macut et al 2014),…”

Section: Developmental Programming By Androgen Excessmentioning

confidence: 99%

Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause

Melo¹,

Dias²,

Cavalli³

et al. 2015

Reproduction

View full text Add to dashboard Cite

Polycystic ovary syndrome (PCOS) is a multifactorial disorder that arises from interactions between genetic, environmental and intrauterine factors. Small-for-gestational-age (SGA) babies and the daughters of mothers with PCOS represent possible postnatal clinical targets for developmental programming by steroid excess. The presence of excess glucocorticoids and/or androgens during foetal organogenesis and growth might promote changes in gene expression, and these changes might be related to an increase in the risk of PCOS-like reproductive and metabolic disorders in postnatal life, such as rapid growth and weight gain during the first 2 years of life (only in SGA babies), hyperinsulinaemia, adipocyte dysfunction and childhood visceral obesity, premature pubarche and adrenarche (only in SGA babies) and PCOS. In the fourth decade of life, women who have PCOS may be at higher risk for type 2 diabetes mellitus, dyslipidaemia and systemic arterial hypertension, which suggests that these women are also at higher risk for cardiovascular disease during menopause. However, PCOS can also occur in women who were born at appropriate weight for GA or in newborns of women without PCOS, which suggests that genetic variation and environmental factors play important roles in the development and maintenance of PCOS in a population. Genome-wide association studies based on adequate population samples have shown a higher frequency of genetic polymorphisms of the LHCGR, THADA and DENND1A genes in women with PCOS. Genetic studies of PCOS have also included analyses of structural changes in the chromosome based on an assessment of telomere length in single, cross-sectional evaluations, and these studies have produced controversial results. The present narrative review assesses the multifactorial origins of PCOS (including environmental, genetic and intra-uterine factors) and the development of conditions associated with this disorder. It is concluded that although PCOS might originate in the intra-uterine environment through developmental programming by steroid excess, the interaction between genetic and environmental factors is crucial for its appearance. Follow-up studies should be conducted to assess the same populations over their entire lifespans while taking into account different aspects of the pathogenesis of PCOS.Reproduction (2015) 150 R11-R24

show abstract

Racial and ethnic disparities in extremes of fetal growth after gestational diabetes mellitus

Cited by 25 publications

References 27 publications

Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years

Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years

Fetal growth trajectories in pregnancies of European and South Asian mothers with and without gestational diabetes, a population-based cohort study

Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause

Contact Info

Product

Resources

About