Gestational diabetes mellitus (GDM) is one of the most common disorders which occured during pregnancy. GDM is not only associated with short-term maternal and fetal adverse outcomes, but also related to a wide range of long-term consequences for both mother and child. The GDM and Its Consequences for mothers and offsprings (GDMCMO) aims to establish a cohort to follow both maternal and offsprings'short-term and long-term outcomes, including fetal malformations including congenital heart diseases, birth weight, preterm birth, caesarean section delivery, body growth and neurodevelopment after birth, obesity, type 2 diabetes and impaired insulin sensitivity and secretion, lung health and allergic diseases later in life for offspring, as well as future type 2 diabetes and cardiovascular risk factors for mother after delivery. Biological samples including blood and tissue samples of mothers and children are also collected during pregnancy and after delivery.
Gestational diabetes mellitus (GDM) is one of the most common disorders which occured during pregnancy. GDM is not only associated with short-term maternal and fetal adverse outcomes, but also related to a wide range of long-term consequences for both mother and child. Although maternal hyperglycemia often become normal shortly after pregnancy, women with GDM have crucially increased risk of development of type 2 diabetes later in life and the mechanisms are not fully understand. Systematic follow-up of the outcomes related to GDM would be ideal to observe the nature progression of GDM to diabetes and could help to develop preventable targets for intervention. The risks of obesity, the metabolic syndrome, and type 2 diabetes in offspring of mothers with GDM significantly increased 1-7 folds than those whose mothers didn't have GDM. The underlying pathogenic mechanisms behind the impaired metabolic risk profile and other diseases in offspring are unknown, but environmental changes including epigenetic changes induced by exposure to maternal hyperglycaemia and genetic factors may play essential roles. The GDM and Its Consequences for mothers and offsprings (GDMCMO) aims to establish a cohort to follow both maternal and offsprings'short-term and long-term outcomes, including fetal malformations including congenital heart diseases, birth weight, preterm birth, caesarean section delivery, body growth and neurodevelopment after birth, obesity, type 2 diabetes and impaired insulin sensitivity and secretion, lung health and allergic diseases later in life for offspring, as well as future type 2 diabetes and cardiovascular risk factors for mother after delivery. Biological samples including blood and tissue samples of mothers and children are also collected during pregnancy and after delivery. We also aim to identify the high-risk population of mother-child pairs who are more likely to develop these adverse consequences, which might help to improve precise intervention and resource saving and provide evidence for preventable targets development.
Study Type
OBSERVATIONAL
Enrollment
7,000
Guangzhou Women and Children's Medical Center
Guangzhou, Guangdong, China
RECRUITINGChange of obesity status during childhood and adolescence
Weight in kilograms and height in meters were measured by nurses in clinic using standard tools. Weight and height will be combined to report BMI in kg/m\^2. Childhood obesity is defined as a BMI equal to or larger than the 95th percentile for age by sex based on WHO Child Growth Standards.
Time frame: At age of 6 months, 1 year, 3 years, 6 years, 12 years and 18 year
Number of participants with adverse pregnancy outcomes
Including abortion, stillbirth, live birth, macrosomia, preterm birth, low birth weight, caesarean section delivery, and birth defects.
Time frame: At delivery
Change of type 2 diabetes status in mothers
Assessed by testing concentrations of maternal blood glucose.
Time frame: At 1 year, 3 years , 6 years, 12 years and 18 year after delivery
Change of body composition of mothers
Assessed body composition using dual-energy X-ray absorptiometry.
Time frame: At 42 days, 6 months, 1 year, 3 years , 6 years, 12 years and 18 year after delivery
Change of depression symptom of mothers
Using Edinburgh Postnatal Depression Scale and Self-rating Depression Scale to assess maternal depression. Higher score is considered more depressive.
Time frame: At 1 year, 3 years , 6 years, 12 years and 18 year after delivery
Change of neurodevelopment at early childhood
Assessed by Gesell Developmental Schedules and Ages\&Stages Questionnaires which include adaptive, gross motor, fine motor, language, and social function domains. Higher intelligence quotient score in each domain is considered a better outcome. Intelligence quotient of Gesell Developmental Schedules being less than 86 or intelligence quotient of Ages\&Stages Questionnaires being no more than -2SD under the mean is defined as suspected development retardation.
Time frame: age of 6 weeks, 6 months, 1 year and 3 years.
Change of lung function during childhood and adolescence
Zrs, R5, R20, X5, X20, Fres assessed by impulse oscillometry
Time frame: At age of 6 years, 12 years and 18 years.
Change of Allergic diseases status during childhood and adolescence
Eczema, allergic rhinitis, wheeze, and asthma diagnosed by the doctors or assessed by the standardized questionnaires
Time frame: At age of 1 year, 3 years, 6 years, 12 years and 18 years.
Change of type 2 diabetes during childhood and adolescence
Assessed by testing concentrations of children's blood glucose.
Time frame: At age of 6 years, 12 years and 18 years.
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