Abstract
BackgroundThe in utero environment is known to affect fetal development however many of the mechanisms by which this occurs remain unknown. The aim of this study was to examine the association between maternal dietary macronutrient intake and lifestyle throughout pregnancy and neonatal weight and adiposity.MethodsThis was an analysis of 542 mother and infant pairs from the ROLO study (Randomised cOntrol trial of LOw glycaemic index diet versus no dietary intervention to prevent recurrence of fetal macrosomia). Food diaries as well as food frequency and lifestyle and physical activity questionnaires were completed during pregnancy. Maternal anthropometry was measured throughout pregnancy and neonatal anthropometry was measured at birth.ResultsMultiple linear regression analysis revealed the main maternal factor associated with increased birth weight was greater gestational weight gain R2adj23.3% (F = 11.547, p < 0.001). The main maternal factor associated with increased birth length was non-smoking status R2adj27.8% (F = 6.193, p < 0.001). Neonatal central adiposity (determined using waist:length ratio) was negatively associated with maternal age, and positively associated with the following parameters: smoking status, maternal pre-pregnancy arm circumference, percentage energy from saturated fat in late pregnancy, postprandial glucose at 28 weeks gestation and membership of the control group with a positive trend towards association with trimester 2 glycaemic load R2adj 38.1% (F = 8.000, p < 0.001).ConclusionsSeveral maternal diet and lifestyle factors were associated with neonatal anthropometry . Low glycaemic index dietary intervention in pregnancy was found to have a beneficial effect on neonatal central adiposity. Additionally, central adiposity was positively associated with maternal dietary fat intake and postprandial glucose highlighting the important role of healthy diet in pregnancy in promoting normal neonatal adiposity.Trial registrationCurrent Controlled Trials ISRCTN54392969.
Highlights
The in utero environment is known to affect fetal development many of the mechanisms by which this occurs remain unknown
The aim of this study was to use a cohort from the ROLO (Randomised cOntrol trial of LOw glycaemic index diet versus no dietary intervention to prevent recurrence of fetal macrosomia) study to examine the effect of maternal body composition, demographic characteristics, macronutrient intake and lifestyle both pre-pregnancy and throughout pregnancy on neonatal weight and adiposity
Low GI dietary advice was given at week 14 of pregnancy while demographic, well-being and lifestyle questionnaires were returned by 28 weeks gestation. 3-day food diaries were completed in each trimester of pregnancy and used to determine the glycaemic index and glycaemic load of the women’s diets
Summary
The in utero environment is known to affect fetal development many of the mechanisms by which this occurs remain unknown. The fetus produces its own insulin which acts as a growth hormone resulting in increased fetal growth and adiposity [9,10]. Studies support this hypothesis during gestational diabetes [11] and within normal limits of maternal blood glucose [12]. As such it is important for maternal blood glucose levels to be maintained within normal levels to ensure fetal glucose levels, and subsequent insulin levels are maintained within normal ranges
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