Abstract
BackgroundLarge for gestational age infants have an increased risk of obesity, cardiovascular and metabolic complications during life. Knowledge of the key predictive factors of neonatal adiposity is required to devise targeted antenatal interventions. Our objective was to determine the fetal metabolic factors that influence regional neonatal adiposity in a cohort of women with previous large for gestational age offspring.MethodsData from the ROLO [Randomised COntrol Trial of LOw Glycaemic Index in Pregnancy] study were analysed in the ROLO Kids study. Neonatal anthropometric and skinfold measurements were compared with fetal leptin and C-peptide results from cord blood in 185 cases. Analyses were performed to examine the association between these metabolic factors and birthweight, anthropometry and markers of central and generalised adiposity.ResultsFetal leptin was found to correlate with birthweight, general adiposity and multiple anthropometric measurements. On multiple regression analysis, fetal leptin remained significantly associated with adiposity, independent of gender, maternal BMI, gestational age or study group assignment, while fetal C-peptide was no longer significant.ConclusionFetal leptin may be an important predictor of regional neonatal adiposity. Interventional studies are required to assess the impact of neonatal adiposity on the subsequent risk of childhood obesity and to determine whether interventions which reduce circulating leptin levels have a role to play in improving neonatal adiposity measures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-015-0499-0) contains supplementary material, which is available to authorized users.
Highlights
Large for gestational age infants have an increased risk of obesity, cardiovascular and metabolic complications during life
There was no significant difference in the degree of association between cord leptin and each circumference or skinfolds using simple linear regression (Additional file 2: Table S2)
We have comprehensively examined regional neonatal anthropometry and its relationship to fetal leptin and fetal C-peptide in a European cohort at risk of macrosomia and subsequent childhood obesity
Summary
Large for gestational age infants have an increased risk of obesity, cardiovascular and metabolic complications during life. Our objective was to determine the fetal metabolic factors that influence regional neonatal adiposity in a cohort of women with previous large for gestational age offspring. Many factors, both maternal and environmental, are known to affect birthweight [1]. Birthweight, and in particular the incidence of large for gestational age (LGA) infants, is increasing in most populations [3,4,5] which may be attributed to the increasing prevalence of maternal obesity and gestational diabetes mellitus [GDM] [4]. Previous research by Muthayya et al [8] has shown that for the same birth weight different populations can different in their percentage of fat mass to lean mass, birthweight alone is a crude estimate of adiposity in children
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