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Adverse metabolic outcomes evident in infants of first-time mothers
Infants born to nulliparous women with overweight or obesity compared with those born to first-time mothers are exposed to a less favorable metabolic environment in utero that may lead to adverse metabolic outcomes after birth, study data show.
Paul L. Hofman, FRACP, professor at Liggins Institute and the University of Auckland in New Zealand, and colleagues evaluated data from the Improving Maternal and Progeny Obesity via Exercise (IMPROVE) trial on 72 women with overweight or obesity to determine metabolic outcomes in the women and their offspring. Women were either multiparous (n = 54) or nulliparous (n = 18).
Nulliparous participants compared with multiparous participants had higher HbA1c in the third trimester (5.48% vs. 5.29%; P = .002), lower sex hormone-binding globulin concentrations (354 nmol/L vs. 408 nmol/L; P = .047) and 31% higher tumor necrosis factor-alpha levels (P = .025).
Pregnancy outcomes, maternal weight gain, fetal parameters in the last trimester and change in fetal weight were similar between the two groups.
Infant birth weight was an average 340 g lighter among nulliparous women compared with multiparous women (P = .013). Infants of nulliparous women had higher concentrations of triglycerides (P < .001), interleukin-6 (P = .039) and insulin-like growth factor I levels (P = .002) and lower IGF-II levels (P = .026) compared with multiparous women.
“Infants born of nulliparous overweight/obese women are likely to be exposed to metabolic perturbations in utero, which translate into subtle adverse metabolic outcomes at birth when compared to the offspring of multiparous overweight/obese mothers,” the researchers wrote. “Further elucidation of the mechanisms underlying metabolic programming in first-borns is required. Given the impact of obesity, preconceptional weight reduction in overweight and obese women should be strongly encouraged prior to the first pregnancy.” – by Amber Cox
Disclosures: The authors report no relevant financial disclosures.