Association between maternal mid-pregnancy glucose levels and offspring wheezing in early childhood: a prospective multicentre birth cohort study in Eastern China
5 affiliations
- 1Department of Pediatrics and Neonatology, The First People’s Hospital of Changzhou, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
- 2Department of Pediatrics and Neonatology, The Third Affiliated Hospital of Soochow University, Changzhou, China
- 3Department of Tumor Biotherapy, The First People’s Hospital of Changzhou, Changzhou, China
- 4Clinical Medical Research Center, Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- 5Department of Pulmonary and Critical Care Medicine, The First People’s Hospital of Changzhou, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
Abstract
Background: We examined maternal glucose concentrations and diabetes status in relation to wheeze in early childhood.
Methods: We analysed 2986 singleton mother–child pairs from a prospective multicentre birth cohort in three centres in Jiangsu Province, China. Participants had recorded wheeze status and complete same-day oral glucose tolerance test (OGTT) measurements at 24–28 gestational weeks. The outcome was a wheeze recorded during early childhood follow-up. The protocol targeted wheezing before age 3, although ascertainment ages were not uniformly available. Adjusted logistic regression estimates were pooled across 50 imputations.
Results: Wheeze was recorded in 293 children (9.8%). Adjusted ORs per 1 mmol/L higher glucose were 0.98 (95% CI 0.76 to 1.26) for fasting, 1.03 (0.96 to 1.11) for 1 hour and 1.02 (0.94 to 1.11) for 2 hour measurements, with no evidence of nonlinearity. In a secondary analysis, recorded maternal gestational diabetes mellitus (GDM) was associated with higher odds of wheeze than no diabetes (adjusted OR 1.39, 95% CI 1.06 to 1.82; Holm-adjusted p=0.034). Standardised risks were 12.1% and 9.1%, respectively, a difference of 3.0 percentage points (95% CI 0.4 to 5.6).
Conclusion: Mid-pregnancy glucose concentrations showed no clear association with early-childhood wheeze, with a secondary association between recorded GDM and higher odds of wheeze. Unavailable diagnostic and treatment details and residual confounding limit interpretation. These findings concern wheeze, not subsequent asthma, and do not support changing GDM screening or treatment thresholds.
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BibTeX
@article{ni2026association,
title = {{Association between maternal mid-pregnancy glucose levels and offspring wheezing in early childhood: a prospective multicentre birth cohort study in Eastern China}},
author = {Huiping Ni and Jiaxin Qin and Yibo Zhuang and Bin Xu and Zheng Guo and Yan Xu and Yan-Qun Sun and Jun Zhou},
journal = {BMJ Paediatrics Open},
year = {2026},
month = nov,
doi = {10.1136/bmjpo-2026-005105},
url = {https://doi.org/10.1136/bmjpo-2026-005105},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Association between maternal mid-pregnancy glucose levels and offspring wheezing in early childhood: a prospective multicentre birth cohort study in Eastern China
AU - Huiping Ni
AU - Jiaxin Qin
AU - Yibo Zhuang
AU - Bin Xu
AU - Zheng Guo
AU - Yan Xu
AU - Yan-Qun Sun
AU - Jun Zhou
PY - 2026
DA - 2026/11/02
JO - BMJ Paediatrics Open
DO - 10.1136/bmjpo-2026-005105
UR - https://doi.org/10.1136/bmjpo-2026-005105
AB - Background: We examined maternal glucose concentrations and diabetes status in relation to wheeze in early childhood. Methods: We analysed 2986 singleton mother–child pairs from a prospective multicentre birth cohort in three centres in Jiangsu Province, China. Participants had recorded wheeze status and complete same-day oral glucose tolerance test (OGTT) measurements at 24–28 gestational weeks. The outcome was a wheeze recorded during early childhood follow-up. The protocol targeted wheezing before age 3, although ascertainment ages were not uniformly available. Adjusted logistic regression estimates were pooled across 50 imputations. Results: Wheeze was recorded in 293 children (9.8%). Adjusted ORs per 1 mmol/L higher glucose were 0.98 (95% CI 0.76 to 1.26) for fasting, 1.03 (0.96 to 1.11) for 1 hour and 1.02 (0.94 to 1.11) for 2 hour measurements, with no evidence of nonlinearity. In a secondary analysis, recorded maternal gestational diabetes mellitus (GDM) was associated with higher odds of wheeze than no diabetes (adjusted OR 1.39, 95% CI 1.06 to 1.82; Holm-adjusted p=0.034). Standardised risks were 12.1% and 9.1%, respectively, a difference of 3.0 percentage points (95% CI 0.4 to 5.6). Conclusion: Mid-pregnancy glucose concentrations showed no clear association with early-childhood wheeze, with a secondary association between recorded GDM and higher odds of wheeze. Unavailable diagnostic and treatment details and residual confounding limit interpretation. These findings concern wheeze, not subsequent asthma, and do not support changing GDM screening or treatment thresholds.
SN - 2399-9772
ER -