Energy-sparing strategies to protect human fetal growth

Abstract

Our purpose was to test whether energy-sensitive adjustments in gestational metabolism, previously observed in studies of Gambian and British women, are a general phenomenon and to define the nutritional factors that direct them. Retrospective analysis of data on basal metabolic rate and fat deposition in 360 pregnancies from 10 studies in a wide range of nutritional settings was performed. The energy costs of pregnancy varied widely between different communities: maintenance costs from -45 to +210 MJ, fat deposition from -23 to +267 MJ, and total energy costs from -20 to +523 MJ. Total costs were correlated with prepregnancy fatness (r = 0.80, p < 0.01) and pregnancy weight gain (r = 0.94, p < 0.001). Marginally nourished women conserved energy by suppressing metabolic rate and by gaining little fat. The energy needs of pregnancy are modulated over a wide range in response to maternal energy status. This may be an important means of protecting fetal growth.