Supplementary information files for Relationships between exposure to gestational diabetes treatment and neonatal anthropometry: Evidence from the Born in Bradford (BiB)

© the authors, CC-BY NCSupplementary files for article Relationships between exposure to gestational diabetes treatment and neonatal anthropometry: Evidence from the Born in Bradford (BiB)Objectives To examine the relationships between gestational diabetes mellitus (GDM) treatment and neonatal anthropometry.Methods Covariate-adjusted multivariable linear regression analyses were used in 9,907 offspring of the Born in Bradford cohort. GDM treatment type (lifestyle changes advice only, lifestyle changes and insulin or lifestyle changes and metformin) was the exposure, offspring not exposed to GDM the control, and birth weight, head, mid-arm and abdominal circumference, and subscapular and triceps skinfold thickness the outcomes.Results Lower birth weight in offspring exposed to insulin (-117.2g (95% CI -173.8,-60.7)) and metformin (-200.3g (-328.5,-72.1)) than offspring not exposed to GDM was partly attributed to lower gestational age at birth and greater proportion of Pakistani mothers in the treatment groups. Higher subscapular skinfolds in offspring exposed to treatment compared to offspring not exposed to GDM was partly attributed to higher maternal glucose concentrations at diagnosis. In fully adjusted analyses, GDM treatment was associated with lower weight, smaller abdominal circumference and skinfolds at birth than offspring not exposed to GDM. Metformin was associated with smaller mid-arm circumference (-0.3cm (-0.6,-0.07)) than insulin in fully adjusted models with no other differences found.Conclusions for Practice Offspring exposed to GDM treatment were lighter and smaller at birth than offspring not exposed to GDM. Metformin-exposed offspring had largely comparable birth anthropometric characteristics to those exposed to insulin.© 本文作者，CC BY-NC许可。本文为《妊娠期糖尿病治疗暴露与新生儿人体测量学指标的关联：来自布拉德福德出生队列（Born in Bradford, BiB）的证据》论文补充材料。 研究目的：旨在探讨妊娠期糖尿病（gestational diabetes mellitus, GDM）治疗与新生儿人体测量学指标之间的关联。 研究方法：本研究纳入布拉德福德出生队列的9907名子代，采用协变量校正的多变量线性回归分析。以未暴露于GDM治疗的子代作为对照，暴露因素为GDM治疗类型（仅生活方式干预、生活方式干预联合胰岛素、生活方式干预联合二甲双胍（metformin）），结局指标包括出生体重、头围、上臂围、腹围以及肩胛下皮褶厚度和肱三头肌皮褶厚度。 研究结果：相较于未暴露于GDM治疗的子代，接受胰岛素（insulin）治疗的子代出生体重较对照组低117.2g（95%置信区间（confidence interval, CI）：-173.8~-60.7），接受二甲双胍治疗的子代出生体重较对照组低200.3g（95%置信区间：-328.5~-72.1）；上述差异部分可由出生时胎龄更小以及治疗组中巴基斯坦裔母亲占比更高所解释。与未暴露于GDM治疗的子代相比，接受GDM治疗的子代肩胛下皮褶厚度更高，这一关联部分可由诊断时母体血糖浓度更高所解释。在完全校正的分析模型中，GDM治疗组子代的出生体重更低、腹围更小、皮褶厚度更薄，与未暴露组存在显著差异。在完全校正模型中，二甲双胍治疗组子代的上臂围较胰岛素治疗组更小（-0.3cm，95%置信区间：-0.6~-0.07），其余指标未观察到显著组间差异。 实践启示：接受GDM治疗的子代出生时体重更轻、体格更小，与未暴露于GDM治疗的子代相比差异显著。接受二甲双胍治疗的子代与接受胰岛素治疗的子代，其出生时的人体测量学指标整体较为相近。