Maternal cardiometabolic markers are associated with fetal growth: a secondary exploratory analysis of the LIMIT randomised trial

Cecelia M O’Brien,Andrea Deussen,Jennie Louise,Jodie M Dodd

doi:10.1186/s12902-019-0416-x

Cecelia M O’Brien, Andrea Deussen + Show 2 more

Open Access

https://doi.org/10.1186/s12902-019-0416-x

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Abstract

BackgroundTo determine the association between maternal cardiometabolic and inflammatory markers with measures of fetal biometry and adiposity.MethodsWomen included in this exploratory analysis were randomised to the ‘Standard Care’ group (N = 911) from the LIMIT randomised trial involving a total of 2212 pregnant women who were overweight or obese (ACTRN12607000161426, Date of registration 9/03/2007, prospectively registered). Fetal biometry including abdominal circumference (AC), estimated fetal weight (EFW), and adiposity measurements (mid-thigh fat mass, subscapular fat mass, abdominal fat mass) were obtained from ultrasound assessments at 28 and 36 weeks’ gestation. Maternal markers included C reactive protein (CRP), leptin and adiponectin concentrations, measured at 28 and 36 weeks’ gestation and fasting triglycerides and glucose concentrations measured at 28 weeks’ gestation.ResultsThere were negative associations identified between maternal serum adiponectin and fetal ultrasound markers of biometry and adiposity. After adjusting for confounders, a 1-unit increase in log Adiponectin was associated with a reduction in the mean AC z score [− 0.21 (− 0.35, − 0.07), P = 0.004] and EFW [− 0.23 (− 0.37, − 0.10), P < 0.001] at 28 weeks gestation. Similarly, a 1-unit increase in log Adiponectin was association with a reduction in the mean AC z score [− 0.30 (− 0.46, − 0.13), P < 0.001] and EFW [− 0.24 (− 0.38, − 0.10), P < 0.001] at 36 weeks gestation. There were no consistent associations between maternal cardiometabolic and inflammatory markers with measurements of fetal adiposity.ConclusionAdiponectin concentrations are associated with measures of fetal growth. Our findings contribute to further understanding of fetal growth in the setting of women who are overweight or obesity.

Highlights

To determine the association between maternal cardiometabolic and inflammatory markers with measures of fetal biometry and adiposity
All analyses were performed using SAS 9.4 (Cary, NC, USA). Demographic characteristics This secondary exploratory analysis included a total of 1104 women, who were randomised to the ‘Standard Care’ group of the LIMIT randomised controlled trial
The baseline characteristics of the women contributing ultrasound data were comparable to all women in the standard care group, and to the full randomized LIMIT cohort [33]

Summary

Introduction

To determine the association between maternal cardiometabolic and inflammatory markers with measures of fetal biometry and adiposity. There are well-recognised associations between obesity in pregnancy and maternal, fetal and neonatal health outcomes [3]. Triglycerides and fatty acids are required for fetal development and growth [8]. Higher concentrations of triglycerides and lipids have been found in women who are obese [12] and those women who have delivered a large for gestational age infant [9, 14]. Studies investigating newborn cord blood concentrations of lipoproteins [15] have shown an association with adipose tissue in the fetus and newborn, contributing to higher infant birth weight [9] and neonatal adiposity [16]

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