Abstract
As surrogate readouts reflecting tissue acyl-CoA pools, elevated levels of plasma acylcarnitines have been associated with cardiometabolic disorders, such as obesity, gestational diabetes, and type 2 diabetes. This study aimed to examine prospective associations of acylcarnitine profiles across gestation with neonatal anthropometry, including birthweight (BW), BW z-score, the sum of skinfolds (SS), body length, and head circumference. We quantified 28 acylcarnitines using electrospray ionization tandem mass spectrometry in plasma collected at gestational weeks 10-14, 15-26, 23-31 and 33-39 among 321 pregnant women from the NICHD Fetal Growth Studies-Singletons and performed latent-class trajectory approach to identify trajectories of acylcarnitines across gestation. We examined the associations of individual acylcarnitines and distinct trajectory groups with neonatal outcomes using weighted generalized linear models adjusting for maternal age, race, education, parity, gestational age of blood collection, and pre-pregnancy BMI. Women showed changes in plasma levels of all acylcartinines across gestation and had at least two significantly distinct group-based trajectories for 32% of acylcartinines. Longitudinally, women with increased C12 levels across gestation (5.7%) had significantly smaller BW (-475 g; 95% CI, -942, -6.79), BW z-score (-0.39, 95% CI, -0.71, -0.06), and length (-1.38, 95% CI, -2.49, -0.27) than those with persistently stable C12 levels during pregnancy (all FDR<0.05). Women with persistently higher levels of C10 (6.1%) or C10:1 (87.4%) had greater sum of skinfolds (4.91, 95%, 0.85, 8.98) than those with lower levels during pregnancy (P<0.05). In conclusion, this study identified that gestational trajectories of C10, C10:1, and C12 acylcarnitine levels were significantly associated with neonatal anthropometry. Further studies are needed to replicate and assess clinical utility of these findings.
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