Maternal lipids are associated with newborn adiposity, independent of GDM status, obesity and insulin resistance: a prospective observational cohort study

Autor: Siti Zawiah Omar, Nurshadia Samingan, Syahrizan Samsuddin, Abqariyah Yahya, Premila Arul Arumugam, Shireene Ratna Vethakkan, Sharmila Sunita Paramasivam, Jeyakantha Ratnasingam, Luqman Ibrahim, Md. Syazwan Md. Amin, Lee Ling Lim, Nurbazlin Musa, Peng Chiong Tan, Muhammad Yazid Jalaluddin, Alexander Tong Boon Tan, Azanna Ahmad Kamar, Azriyanti Anuar Zaini, Kheng Chiew Chooi
Rok vydání: 2019
Předmět:
Zdroj: BJOG: An International Journal of Obstetrics & Gynaecology. 127:490-499
ISSN: 1471-0528
1470-0328
DOI: 10.1111/1471-0528.16031
Popis: Objective To determine the association between maternal lipaemia and neonatal anthropometrics in Malaysian mother-offspring pairs. Design Prospective observational cohort study. Setting Single tertiary multidisciplinary antenatal clinic in Malaysia. Population A total of 507 mothers: 145 with gestational diabetes mellitus (GDM); 94 who were obese with normal glucose tolerance (NGT) (pre-gravid body mass index, BMI ≥ 27.5 kg/m2 ), and 268 who were not obese with NGT. Methods Maternal demographic, anthropometric, and clinical data were collected during an interview/examination using a structured questionnaire. Blood was drawn for insulin, C-peptide, triglyceride (Tg), and non-esterified fatty acid (NEFA) during the 75-g 2-hour oral glucose tolerance test (OGTT) screening, and again at 36 weeks of gestation. At birth, neonatal anthropometrics were assessed and data such as gestational weight gain (GWG) were extracted from the records. Main outcome measures Macrosomia, large-for-gestational-age (LGA) status, cohort-specific birthweight (BW), neonatal fat mass (NFM), and sum of skinfold thickness (SSFT) > 90th centile. Results Fasting Tg > 95th centile (3.6 mmol/L) at screening for OGTT was independently associated with LGA (adjusted odds ratio, aOR 10.82, 95% CI 1.26-93.37) after adjustment for maternal glucose, pre-gravid BMI, and insulin sensitivity. Fasting glucose was independently associated with a birthweight ratio (BWR) of >90th centile (aOR 2.06, 95% CI 1.17-3.64), but not with LGA status, in this well-treated GDM cohort with pre-delivery HbA1c of 5.27%. In all, 45% of mothers had a pre-gravid BMI of 10 kg was associated with a 4.25-fold risk (95% CI 1.71-10.53) of BWR > 90th centile. Conclusion Maternal lipaemia and GWG at a low threshold (>10 kg) adversely impact neonatal adiposity in Asian offspring, independent of glucose, insulin resistance and pre-gravid BMI. These may therefore be important modifiable metabolic targets in pregnancy. Tweetable abstract Maternal lipids are associated with adiposity in Asian babies independently of pre-gravid BMI, GDM status, and insulin resistance.
Databáze: OpenAIRE
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