Abstract
Patterns of fetal growth predict non-communicable disease risk in adult life, but fetal growth variability appears to have a relatively weak association with maternal nutritional dynamics during pregnancy. This challenges the interpretation of fetal growth variability as ‘adaptation’. We hypothesized that associations of maternal size and nutritional status with neonatal size are mediated by the dimensions of the maternal pelvis. We analysed data on maternal height, body mass index (BMI) and pelvic dimensions (conjugate, inter-spinous and inter-cristal diameters) and neonatal gestational age, weight, length, thorax girth and head girth (n = 224). Multiple regression analysis was used to identify independent maternal predictors of neonatal size, and the mediating role of neonatal head girth in these associations. Pelvic dimensions displaced maternal BMI as a predictor of birth weight, explaining 11.6% of the variance. Maternal conjugate and inter-spinous diameters predicted neonatal length, thorax girth and head girth, whereas inter-cristal diameter only predicted neonatal length. Associations of pelvic dimensions with birth length, but not birth weight, were mediated by neonatal head girth. Pelvic dimensions predicted neonatal size better than maternal BMI, and these associations were mostly independent of maternal height. Sensitivity of fetal growth to pelvic dimensions reduces the risk of cephalo-pelvic disproportion, potentially a strong selective pressure during secular trends in height. Selection on fetal adaptation to relatively inflexible components of maternal phenotype, rather than directly to external ecological conditions, may help explain high levels of growth plasticity during late fetal life and early infancy.
Highlights
There is compelling evidence that growth patterns in early life predict diverse components of health or disease risk in later life, as summarized in the ‘developmental origins of adult health disease’ (DOHaD) hypothesis [1]
Maternal height was correlated with birth length and weight, but not thorax or head girth, while maternal body mass index (BMI) was only correlated with birth weight
Maternal BMI was strongly correlated with pelvic dimensions, whereas maternal height was more weakly associated with conjugate and inter-cristal diameters
Summary
There is compelling evidence that growth patterns in early life predict diverse components of health or disease risk in later life, as summarized in the ‘developmental origins of adult health disease’ (DOHaD) hypothesis [1]. Classic studies of rodents in the 1960 s identified ‘sensitive periods’ or ‘critical windows’ during early development, during which growth patterns generated a long-term impact on later body size and composition [2]. Most attention was directed to the high NCD risk among those of low birth weight (
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