Table_6_Association between maternal shift work during pregnancy child overweight and metabolic outcomes in early childhood.docx

BackgroundPrevious studies found that maternal shift work during pregnancy was associated with many reproductive hazards, including small for gestational age, preterm birth, stillbirth, and neurodevelopmental impairment. Some studies also showed that these children are more likely to become overweight in early childhood. However, the association with metabolic factors, such as insulin resistance and dyslipidemia, was less studied. Hence, we aimed to understand better the relationship between maternal shift work during pregnancy and the risk of childhood overweight and metabolic outcomes. Confounding factors were also discussed, including diet, exercise, and demographical factors. MethodsWe enrolled pregnant women before delivery in the Taiwan Birth Panel Study (TBPS) II conducted between 2010 and 2012, and followed the children of these participants in 2018. The objective of this study is to investigate the influence of prenatal and postnatal factors on infant and early childhood health. During the follow-up in 2018, we checked children's demographic data, obtained blood specimens, and checked their blood sugar, blood insulin, and lipid profiles. Structured questionnaires were used to evaluate demographic data. Multiple linear and logistic regressions were used to examine the associations between maternal shift work during pregnancy and child overweight, metabolic disorders, such as HOMA-IR, and lipid profiles. ResultsIn this study, we included 407 mother-children pairs with different work shifts (350 day workers and 57 shift workers), and a sub-population without underweight children was also created (290 day workers and 47 shift workers). Shift work during pregnancy was associated with a higher Homeostasis Model Assessment-Insulin Resistance index (HOMA-IR) and a higher odds ratio for overweight in children born from mothers doing shift work during pregnancy after adjustment. The findings were attenuated when we investigated the effect of shift work before pregnancy. ConclusionOur study suggested that maternal shift work during pregnancy was associated with child overweight and insulin resistance in early childhood.研究背景 既往研究表明，妊娠期母亲轮班作业与多种生殖健康风险相关，包括小于胎龄儿、早产、死产以及神经发育损伤。另有研究显示，此类母亲所生育的儿童在幼儿期更易出现超重问题。然而，针对妊娠期母亲轮班作业与胰岛素抵抗、血脂异常等代谢因素之间的关联，相关研究仍较为匮乏。因此，本研究旨在进一步阐明妊娠期母亲轮班作业与儿童超重风险及代谢结局的关联，并探讨饮食、运动及人口统计学因素等潜在混杂因素的影响。 研究方法 本研究纳入2010至2012年间开展的台湾出生队列研究（Taiwan Birth Panel Study, TBPS）II中分娩前的孕妇，并于2018年对这些受试者的子代进行随访。本研究旨在探讨产前及产后因素对婴幼儿及早期儿童健康的影响。2018年随访期间，我们收集了儿童的人口统计学资料，采集血液标本并检测其血糖、胰岛素及血脂水平；同时采用结构化问卷完成人口统计学信息的评估。本研究采用多重线性回归与logistic回归分析，以探究妊娠期母亲轮班作业与儿童超重、稳态模型评估-胰岛素抵抗指数（Homeostasis Model Assessment-Insulin Resistance, HOMA-IR）等代谢紊乱及血脂谱之间的关联。 研究结果 本研究共纳入407对不同作业模式的母婴对（350名白班作业母亲与57名轮班作业母亲），同时构建了无低体重儿童的亚队列（290名白班作业母亲与47名轮班作业母亲）。校正混杂因素后，妊娠期母亲轮班作业与子代更高的稳态模型评估-胰岛素抵抗指数（Homeostasis Model Assessment-Insulin Resistance, HOMA-IR）及儿童超重的更高比值比显著相关。进一步分析孕前轮班作业的影响时，上述关联有所减弱。 研究结论 本研究结果表明，妊娠期母亲轮班作业与幼儿期儿童超重及胰岛素抵抗存在显著关联。