54 Impact of Maternal Body Mass Index on Offspring Liver Lipid Depends on Mode of Delivery

Abstract

Background: Maternal overweight/obesity is associated with increased risk of Caesarean Section (CS) and offspring metabolic syndrome, though the mediating biological pathway is unknown. In an animal model pre-labour CS in comparison with vaginal delivery (VD), is associated with significantly higher offspring intrahepatocellular lipid (IHCL), a central component of the metabolic syndrome (Hyde MJ, 2010).Aim: To examine the effects of maternal Body Mass Index (BMI) and mode of delivery on neonatal IHCL.Methods: With research ethics approval and informed written parent consent we employed 1H Magnetic Resonance Spectroscopy of liver during natural sleep in healthy term neonates (Thomas EL, 2008). We used analysis of covariance to explore the effect of maternal BMI, diabetes and mode of delivery, and infant gender, birth weight and postnatal age and their interactions on IHCL (presented as the ratio of lipid CH2/water).Results: To date we have studied 57 infants (45 VD, 12 pre-labour CS). IHCL ranged from 0 to 5.5, and maternal BMI from 17 to 35 kg/m2. There was a significant interaction between maternal BMI and mode of delivery (p=0.010). In neonates born by pre-labour CS, IHCL increased by a mean of 29% [95%CI 9-54%] per unit increase in maternal BMI (p=0.004). Maternal BMI had no impact on IHCL in VD infants (p=0.81).Conclusion: VD may activate pathways that protect against liver lipid accumulation in the presence of increasing maternal BMI. Pre-labour CS may pose an added risk for the development of the metabolic syndrome in offspring of overweight/ obese mothers.