{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:19:17Z","timestamp":1787717957766,"version":"build-2784847793"},"reference-count":44,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":41,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81903331"],"award-info":[{"award-number":["81903331"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Maternal pre\u2010pregnancy overweight\/obesity and gestational hyperglycemia are linked to adverse offspring neurodevelopment, but the role of oral glucose tolerance test (OGTT) response patterns remains unclear. We investigated the independent and combined effects of maternal pre\u2010pregnancy BMI and OGTT response patterns on neurodevelopment in 2\u2010year\u2010old offspring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cohort study included 2639 mother\u2013child pairs from Wuhan, China. A 75\u2010g OGTT was performed at 24\u201328 gestational weeks, with glucose measured at fasting, 1 and 2\u2009h. Group\u2010based trajectory modeling identified distinct OGTT response patterns. Offspring neurodevelopment was assessed at 2\u2009years using the Bayley Scales of Infant Development. Associations were examined with generalized linear and logistic regression models, and additive interaction was evaluated using RERI and AP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three OGTT response patterns were identified; pattern 3 showed the most pronounced glycemic response. Maternal pre\u2010pregnancy overweight\/obesity alone showed nominal associations with lower MDI scores in the overall population and in girls, but these associations did not remain significant after FDR correction. In girls exposed to both maternal overweight\/obesity and pattern 3, MDI was markedly lower (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u221213.73, 95% CI: \u221223.06 to \u22124.39), and the risk of suboptimal mental development was higher (OR\u2009=\u20092.88, 95% CI: 1.03 to 8.09), with significant additive interaction (RERI\u2009=\u20090.76; AP\u2009=\u20090.42).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Maternal pre\u2010pregnancy overweight\/obesity and OGTT response patterns alone showed limited independent associations with offspring neurodevelopment. However, combined exposure may be associated with poorer mental developmental performance, with more consistent evidence in girls.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1753-0407.70261","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T12:57:41Z","timestamp":1786453061000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex Differences in Combined Effects of Maternal Pre\u2010Pregnancy\n                    <scp>BMI<\/scp>\n                    and\n                    <scp>OGTT<\/scp>\n                    Response Patterns on Early Neurodevelopment in Offspring: A Cohort Study"],"prefix":"10.1111","volume":"18","author":[{"given":"Kai","family":"Chen","sequence":"first","affiliation":[{"name":"Data Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxuan","family":"Fan","sequence":"additional","affiliation":[{"name":"Data Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Records Statistics Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongqiang","family":"Cao","sequence":"additional","affiliation":[{"name":"Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luli","family":"Xu","sequence":"additional","affiliation":[{"name":"Data Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiya","family":"Qin","sequence":"additional","affiliation":[{"name":"Data Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingzhao","family":"Huang","sequence":"additional","affiliation":[{"name":"Data Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Mu","sequence":"additional","affiliation":[{"name":"Data Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0379-0791","authenticated-orcid":false,"given":"Chao","family":"Xiong","sequence":"additional","affiliation":[{"name":"Data Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1291-4155","authenticated-orcid":false,"given":"Aifen","family":"Zhou","sequence":"additional","affiliation":[{"name":"Data Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"},{"name":"Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1801040"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyu030"},{"issue":"10","key":"e_1_2_14_4_1","first-page":"730","article-title":"Association Between Pre\u2010Pregnancy Body Mass Index and Offspring Neuropsychological Development From 1 to 24 Months of Age: A Birth Cohort Study in China","volume":"32","author":"Jia C. 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