Abstract
BackgroundDeviations from gestational weight gain (GWG) recommendations are associated with unfavorable maternal and neonatal outcomes. There is a need to understand how maternal substrate metabolism, independent of weight status, may contribute to GWG and neonatal outcomes. The purpose of this study was to explore the potential link between maternal lipid oxidation rate, GWG, and neonatal anthropometric outcomes.MethodsWomen (N = 32) with a lean pre-pregnancy BMI were recruited during late pregnancy and substrate metabolism was assessed using indirect calorimetry, before and after consumption of a high-fat meal. GWG was categorized as follows: inadequate, adequate, or excess. Shortly after delivery (within 48 h), neonatal anthropometrics were obtained.ResultsUsing ANOVA, we found that fasting maternal lipid oxidation rate (grams/minute) was higher (p = 0.003) among women with excess GWG (0.1019 ± 0.0416) compared to women without excess GWG (inadequate = 0.0586 ± 0.0273, adequate = 0.0569 ± 0.0238). Findings were similar when lipid oxidation was assessed post-meal and also when expressed relative to kilograms of fat free mass. Absolute GWG was positively correlated to absolute lipid oxidation expressed in grams/minute at baseline (r = 0.507, p = 0.003), 2 h post-meal (r = 0.531, p = 0.002), and 4 h post-meal (r = 0.546, p = 0.001). Fasting and post-meal lipid oxidation (grams/minute) were positively correlated to neonatal birthweight (fasting r = 0.426, p = 0.015; 2-hour r = 0.393, p = 0.026; 4-hour r = 0.540, p = 0.001) and also to neonatal absolute fat mass (fasting r = 0.493, p = 0.004; 2-hour r = 0.450, p = 0.010; 4-hour r = 0.552, p = 0.001).ConclusionsA better understanding of the metabolic profile of women during pregnancy may be critical in truly understanding a woman’s risk of GWG outside the recommendations. GWG counseling during prenatal care may need to be tailored to women based not just on their weight status, but other metabolic characteristics.
Highlights
Deviations from gestational weight gain (GWG) recommendations are associated with unfavorable maternal and neonatal outcomes
Prior work has focused on the impact that pre-pregnancy weight status has on the risk of exceeding GWG recommendations and there is a general consensus that women with overweight/obesity are at greater risk of excessive GWG
Lipid oxidation was higher among women that exceeded the GWG recommendation at baseline and in the postprandial states compared to women with adequate GWG (Table 2; Fig. 1)
Summary
Deviations from gestational weight gain (GWG) recommendations are associated with unfavorable maternal and neonatal outcomes. Prior work has focused on the impact that pre-pregnancy weight status has on the risk of exceeding GWG recommendations and there is a general consensus that women with overweight/obesity are at greater risk of excessive GWG. Lipid oxidation during late pregnancy is significantly higher among women that were overweight, compared to lean pregnant women. This is consistent with other reports that pregnant women with overweight/obesity are resistant to insulinmediated suppression of lipid oxidation and lipolysis [12, 13] In this scenario, the lack of insulin-mediated suppression of lipid metabolic processes could produce excess free fatty acids that could eventually be stored and contribute to excessive GWG. Little is known about the potential impact that maternal lipid oxidation during pregnancy may have on exceeding GWG recommendations
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
