Abstract
BackgroundBirth weight is associated with cardiometabolic factors at birth. However, it is unclear when these associations occur in fetal life. We aimed to investigate the associations between fetal growth in different gestational periods and cord blood cardiometabolic factors.MethodsWe included 1,458 newborns from the Born in Guangzhou Cohort Study, China. Z-scores of fetal size parameters [weight, abdominal circumference (AC), and femur length (FL)] at 22 weeks and growth at 22–27, 28–36, and ≥37 weeks were calculated from multilevel linear spline models. Multiple linear regression was used to examine the associations between fetal growth variables and z-scores of cord blood cardiometabolic factors.ResultsFetal weight at each period was positively associated with insulin levels, with stronger association at 28–36 weeks (β, 0.31; 95% CI, 0.23 to 0.39) and ≥37 weeks (β, 0.15; 95% CI, 0.10 to 0.20) compared with earlier gestational periods. Fetal weight at 28–36 (β, −0.32; 95% CI, −0.39 to −0.24) and ≥37 weeks (β, −0.26; 95% CI, −0.31 to −0.21) was negatively associated with triglyceride levels, whereas weight at 28–36 weeks was positively associated with HDL levels (β, 0.12; 95% CI, 0.04 to 0.20). Similar results were observed for AC. Fetal FL at 22 and 22–27 weeks was associated with increased levels of insulin, glucose, and HDL.ConclusionsFetal growth at different gestational periods was associated with cardiometabolic factors at birth, suggesting that an interplay between fetal growth and cardiometabolic factors might exist early in pregnancy.
Highlights
Fetal life is the period that an individual is most susceptible to environmental influences due to high plasticity of cells and organs [1, 2]
We investigated the relationship between fetal growth measures at different gestational periods and cord blood cardiometabolic factors
In line with this study, we observed that fetal weight at early and mid-pregnancy was associated with insulin levels at birth; in contrast to this previous study [24], we found that fetal weight in the third trimester was associated with cord blood insulin
Summary
Fetal life is the period that an individual is most susceptible to environmental influences due to high plasticity of cells and organs [1, 2]. Large-for-gestational-age (LGA) infants have higher cord blood insulin level [9] All these studies have used birth weight as a proxy of fetal growth. Birth weight is a summary indicator and does not reflect the longitudinal pattern of fetal growth It is unclear when the association between fetal growth and cardiometabolic markers appears during prenatal period. Abdominal circumference (AC) is considered an indicator of body fat storage and is most predictive of birth weight, whereas femur length (FL) reflects fetal skeletal growth [10]. These measures may have different implications for metabolic changes in the fetus. We aimed to investigate the associations between fetal growth in different gestational periods and cord blood cardiometabolic factors
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