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

• Published in: BJOG : an international journal of obstetrics and gynaecology Vol. 127; no. 4; pp. 490 - 499
• Main Authors: Samsuddin, S, Arumugam, PA, Md. Amin, Md.S, Yahya, A, Musa, N, Lim, L‐L, Paramasivam, SS, Ratnasingam, J, Ibrahim, L, Chooi, KC, Tan, ATB, Tan, PC, Omar, SZ, Samingan, N, Ahmad Kamar, A, Anuar Zaini, A, Jalaluddin, MY, Vethakkan, SR
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-03-2020
• Subjects: Adipose tissue; Adult; Asian; Asian Continental Ancestry Group; Birth Weight; Body fat; Body Mass Index; Body weight gain; Case-Control Studies; Cohort analysis; Diabetes mellitus; Fasting; Female; Fetal Macrosomia - blood; Fetal Macrosomia - epidemiology; Gestation; Gestational diabetes; gestational weight gain; Glucose; Glucose tolerance; Health risk assessment; Humans; Hyperlipidemias - blood; Hyperlipidemias - complications; Infant, Newborn; Insulin; Insulin resistance; Laboratory testing; Lipid metabolism; Malaysia - epidemiology; Male; maternal triglyceride; neonatal adiposity; Neonates; Newborn babies; Obesity; Obesity - epidemiology; Observational studies; Offspring; Pregnancy; pre‐gravid BMI; Prospective Studies; Skinfold thickness; Surveys and Questionnaires; Triglycerides - blood; Malaysia; neonatal adiposity; gestational weight gain; pre-gravid BMI; Asian; maternal triglyceride
• DOI: 10.1111/1471-0528.16031
• EISSN: 1471-0528
• ISSN: 1470-0328

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 <23 kg/m2 and 61% had a pre‐gravid BMI of ≤ 25 kg/m2, yet a GWG 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.
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Maternal lipids are associated with adiposity in Asian babies independently of pre‐gravid BMI, GDM status, and insulin resistance.
Tweetable
Maternal lipids are associated with adiposity in Asian babies independently of pre‐gravid BMI, GDM status, and insulin resistance.