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

Samsuddin, Syahrizan and Arumugam, P.A. and Md Amin, Md S. and Yahya, Abqariyah and Musa, Nurbazlin and Lim, Lee Ling and Paramasivam, Sharmila Sunita and Ratnasingam, Jeyakantha and Ibrahim, Luqman and Chooi, Kheng Chiew and Tan, Alexander Tong Boon and Tan, Peng Chiong and Omar, Siti Zawiah and Samingan, Nurshadia and Ahmad Kamar, Azanna and Anuar Zaini, Azriyanti and Jalaluddin, M.Y. and Vethakkan, Shireene Ratna (2020) Maternal lipids are associated with newborn adiposity, independent of GDM status, obesity and insulin resistance: a prospective observational cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 127 (4). pp. 490-499. ISSN 1470-0328, DOI

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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. Tweetable abstract: Maternal lipids are associated with adiposity in Asian babies independently of pre-gravid BMI, GDM status, and insulin resistance. © 2019 Royal College of Obstetricians and Gynaecologists

Item Type: Article
Funders: University of Malaya BKP grant (BK039-2015)
Uncontrolled Keywords: Asian; gestational weight gain; maternal triglyceride; neonatal adiposity; pre-gravid BMI
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 20 Jul 2020 00:53
Last Modified: 08 Feb 2021 07:30

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