Maternal lipids are associated with newborn adiposity independent of GDM status, obesity and insulin resistance: a prospective observational cohort study.
Journal: 2019/November - BJOG: An International Journal of Obstetrics and Gynaecology
ISSN: 1471-0528
Abstract:
To determine association between maternal lipaemia and neonatal anthropometrics in Malaysian mother-offspring pairs.

DESIGN
Prospective observational cohort study SETTING: Single tertiary multi-disciplinary antenatal clinic in Malaysia POPULATION: 507 mothers: 145 gestational diabetes mellitus (GDM), 94 obese with normal glucose tolerance (NGT)( pregravid BMI>27.5 kg/m2 ) and 268 non-obese NGT.

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 screening 75g OGTT, and at 36 weeks. At birth, neonatal anthropometrics were assessed and data such as gestational weight gain (GWG) were extracted from records.

MAIN OUTCOME MEASURES
Macrosomia, large for gestational age (LGA) status, cohort-specific birth weight (BW), neonatal fat mass (NFM), sum of skinfold thickness (SSFT) >90th centile.

RESULTS
Fasting Tg>95th centile (3.6 mmol/L) at screening OGTT was independently associated with LGA (adjusted odds ratio [aOR] 10.82, 95% CI 1.26-93.37) after adjustment for maternal glucose, pregravid BMI and insulin sensitivity. Fasting glucose was independently associated with BWR >90th centile(aOR 2..06 95% CI 1.17-3.64) but not LGA status in this well-treated GDM cohort with pre-delivery HbA1c of 5.27%. 45% mothers had pregravid BMI<23 kg/m2 and 61% BMI ≤ 25 kg/m2 ; yet GWG>10kg was associated with 4.25-fold-risk(95% CI 1.71-10.53) of BW>90th centile.

Maternal lipaemia and GWG at a low threshold (>10kg) adversely impact neonatal adiposity in Asian offspring independent of glucose/insulin resistance/pregravid BMI. These may therefore be important modifiable metabolic targets in pregnancy.
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