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Different maternal fuels drive neonatal adiposity in early vs. late pregnancy
Neonatal adiposity appears to be influenced by maternal insulin resistance in the first half of pregnancy, and by maternal glycemia in later pregnancy, according to findings from The Healthy Start Study.
In the prospective pre-birth cohort study, Tessa L. Crume, PhD, MSPH, of the University of Colorado, and colleagues evaluated 804 pregnant women at 24 weeks or less gestation recruited from prenatal obstetrics clinics at the University of Colorado Hospital in Aurora, Colorado. Participants were asked to participants in two in-person evaluations, the first in early pregnancy (median gestational age, 17 weeks) and the second in mid to late pregnancy (median gestational age, 27 weeks). At these visits, the researchers collected maternal fasting serum samples to test for glucose, insulin HbA1c, triglycerides, total cholesterol, HDL cholesterol and free fatty acids.
Tessa L. Crume
A third postpartum evaluation was conducted in neonates at the hospital prior to discharge. At this visit, the researchers recorded the infants’ anthropometric measurements and assessed total fat mass and free fat mass using densitometric techniques based on air displacement plethysmography.
The researchers discovered a substantial positive correlation between maternal estimated homeostasis model assessment insulin resistance (HOMA-IR) in the first half of pregnancy and neonatal fat mass and fat mass percent. This finding was independent of maternal BMI prior to pregnancy.
Additionally, a positive linear association was found between maternal glucose levels in the second half of pregnancy and neonatal fat mass and fat mass percent.
Maternal HDL cholesterol in the first half of pregnancy was found to be inversely related to fat mass, while maternal free fatty acid levels in the second half of pregnancy were positively correlated with higher birth weight. These associations were both independent of prepregnancy BMI and gestational weight gain.
“Our data suggest that early and late gestation fuel switching may play different roles in mechanisms responsible for fetal fat accretion and development of adiposity,” the researchers wrote. “In the first half of pregnancy maternal insulin resistance is an independent predictor of neonatal adiposity; later on, maternal glycemia, even within the normal range, becomes a main driver of fat accretion. Importantly, these relationship are independent of prepregnancy BMI and gestational weight gain. Maternal circulating lipid levels have a relatively modest impact on neonatal [fat mass] accretion and adiposity, though studies are necessary to further explore and replicate effect modification by maternal pre-pregnant BMI.” - by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.