437 Maternal inflammation, maternal and fetal metabolism, pregnancy outcomes and an antenatal healthy lifestyle intervention

Abstract

Elevated maternal inflammatory markers have been linked with adverse pregnancy outcomes. Lifestyle interventions may hold potential to ameliorate these effects. In this secondary analysis of the Pregnancy Exercise And nutrition Research study (PEARs), we investigated the effect of an antenatal healthy lifestyle intervention on maternal Complement 3 (C3) and C-Reactive Protein (CRP) concentrations and assessed their relationship with pregnancy outcomes and maternal and fetal metabolism. n=406 women with available C3 and CRP concentrations determined in early pregnancy (14-6 weeks) and/or late pregnancy (28-weeks) with corresponding glucose, insulin, c-peptide, Homeostatic Model Assessment of Insulin Resistance (HOMA2-IR) and lipid profiles were included in the analysis. Pregnancy outcomes included: diagnoses of gestational diabetes (GDM), pre-eclampsia (PET) or pregnancy induced hypertension (PIH), pre-term birth (delivery < 37 weeks), low birth weight defined as birth weight < 2500g, intra-uterine growth restriction (IUGR) defined as estimated fetal weight (EFW) < 10th centile and cord blood measures of glucose and lipid metabolism. There were no differences in maternal C3 or CRP concentrations between study groups, or based on diagnosis of PET, PIH or GDM. Maternal C3 was higher in those who experienced pre-term birth (p=0.04) or delivered a low birth weight infant (p=0.02). In early pregnancy, maternal C3 was a small but significant predictor of maternal insulin (β= 0.021, p= 0.03) and total cholesterol (β = 0.005, p= 0.026) and LDL-C cholesterol in late pregnancy (β= 0.01, p= 0.003). Maternal C3 concentration in late pregnancy was a small but significant predictor or insulin (β= 0.043, p= 0.014) and insulin resistance (β= 0.007, p= 0.002) in late pregnancy. No relationship between maternal C3 or CRP and fetal glucose or lipids were observed Higher maternal C3 concentration was associated with maternal insulin resistance and un-favourable lipid profile. Levels of maternal C3 were higher in those who experienced pre-term birth or low birth weight.