OBJECTIVE Gestational diabetes mellitus (GDM) is known to be associated with certain respiratory impairments in offspring. However, the specific association between maternal GDM and childhood lung function remains unclear. We examined the association of maternal glycemia, as measured by oral glucose tolerance test (OGTT) values, with childhood lung function outcomes in a birth cohort. RESEARCH DESIGN AND METHODS A follow-up study was conducted with 889 children aged 6 years whose mothers underwent a 75-g OGTT between 24 and 28 weeks of gestation. After adjusting for prenatal and postnatal factors, multivariable regression models were used to evaluate the relationship between maternal glycemia and offspring lung function. RESULTS In total, 10.7% of the offspring were exposed to maternal GDM. Maternal GDM significantly reduced the z score of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and forced expiratory flow at 25–75% of FVC in children, with more pronounced effects in female offspring. Maternal 1- and 2-h post-OGTT glucose z scores and the sum of those z scores, but not those for fasting glucose, were inversely associated with several measures of children's lung function. Additionally, maternal GDM increased the risk of impaired lung function in children (odds ratio 2.64; 95% CI, 1.10–5.85), defined as an FVC <85% of the predicted value. There were no significant associations with FEV1/FVC. CONCLUSIONS Maternal hyperglycemia was negatively associated with lung function in children, particularly among girls. Further studies are warranted to elucidate the underlying mechanisms of this association and to explore potential interventions to mitigate its effects.

中文翻译：

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妊娠期母体血糖和儿童肺功能：一项前瞻性队列研究


目的 已知妊娠糖尿病 （GDM） 与后代的某些呼吸障碍有关。然而，母体 GDM 与儿童肺功能之间的具体关联仍不清楚。我们检查了通过口服葡萄糖耐量试验 （OGTT） 值测量的母亲血糖与出生队列中儿童肺功能结果的相关性。研究、设计和方法对 889 名 6 岁儿童进行了一项随访研究，这些儿童的母亲在妊娠 24 至 28 周之间接受了 75 克 OGTT。在调整了产前和产后因素后，采用多变量回归模型评估母体血糖与后代肺功能之间的关系。结果 总共有 10.7% 的后代暴露于母体 GDM。母体 GDM 显著降低儿童 1 秒用力呼气量 （FEV1） 的 z 评分 （FEV1）、用力肺活量 （FVC） 和用力呼气流量 25-75%，对女性后代的影响更为明显。母体 OGTT 后 1 小时和 2 小时葡萄糖 z 评分以及这些 z 评分的总和，而不是空腹血糖的总和，与儿童肺功能的几个指标呈负相关。此外，母体 GDM 增加了儿童肺功能受损的风险 （比值比 2.64;95% CI，1.10-5.85），定义为 FVC <85% 的预测值。与 FEV1/FVC 无显著关联。结论 母亲高血糖与儿童肺功能呈负相关，尤其是女孩。需要进一步的研究来阐明这种关联的潜在机制，并探索减轻其影响的潜在干预措施。