Abstract
IntroductionMaternal nutritional and metabolic factors influence the developmental environment of the fetus. Virtually any nutritional factor in the maternal blood has to pass the placental membranes to reach the fetal blood. Placental weight is a commonly used measure to summarize placental growth and function. Placental weight is an independent determinant of fetal growth and birthweight and modifies the associations between maternal metabolic factors and fetal growth. We hypothesized that maternal factors known to be related to fetal growth, newborn size and body composition are determinants of placental weight and that effects of maternal metabolic factors on placental weight differ between the genders.MethodsThe STORK study is a prospective longitudinal study including 1031 healthy pregnant women of Scandinavian heritage with singleton pregnancies. Maternal determinants (parity, body mass index, gestational weight gain and fasting plasma glucose) of placental weight were explored by linear regression models, stratified by fetal sex.ResultsParity, maternal BMI, gestational weight gain and fasting glucose had positive effects on placental weight. There was a sex specific effect in these associations. Fasting glucose was significantly associated with placental weight in females but not in males.ConclusionMaternal factors known to influence fetal growth, birthweight and neonatal body composition are determinants of placental weight. The effect of maternal factors on placental weight is influenced by sex as illustrated in the relation between maternal glucose and placental weight.
Highlights
Maternal nutritional and metabolic factors influence the developmental environment of the fetus
Fasting glucose was significantly associated with placental weight in females but not in males
Maternal metabolic markers like plasma glucose and BMI are linearly related to birthweight, risk of macrosomia and percentage body fat of the newborn, clearly demonstrated in large studies like the Hyperglycemia and Adverse Outcome Study (HAPO) [2,3,4]
Summary
Maternal nutritional and metabolic factors influence the developmental environment of the fetus. Any nutritional factor in the maternal blood has to pass the placental membranes to reach the fetal blood. Placental weight is an independent determinant of fetal growth and birthweight and modifies the associations between maternal metabolic factors and fetal growth. We hypothesized that maternal factors known to be related to fetal growth, newborn size and body composition are determinants of placental weight and that effects of maternal metabolic factors on placental weight differ between the genders. In contrast to the HAPO study we have considered placental weight as a determinant of fetal growth in addition to the maternal factors. We have previously illustrated the mediating effect of placental weight in the associations between maternal factors and three different measures of fetal growth; birthweight, intrauterine fetal growth and neonatal fat percentage [5,7]
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