Abstract

BackgroundNeonatal body composition has implications for the health of the newborn both in short and long term perspective. The objective of the current study was first to explore the association between maternal BMI and metabolic parameters associated with BMI and neonatal percentage body fat and to determine to which extent any associations were modified if adjusting for placental weight. Secondly, we examined the relations between maternal metabolic parameters associated with BMI and placental weight.MethodsThe present work was performed in a subcohort (n = 207) of the STORK study, an observational, prospective study on the determinants of fetal growth and birthweight in healthy pregnancies at Oslo University Hospital, Norway. Fasting glucose, insulin, triglycerides, free fatty acids, HDL- and total cholesterol were measured at week 30–32. Newborn body composition was determined by Dual-Energy X-Ray Absorptiometry (DXA). Placenta was weighed at birth. Linear regression models were used with newborn fat percentage and placental weight as main outcomes.ResultsMaternal BMI, fasting glucose and gestational age were independently associated with neonatal fat percentage. However, if placental weight was introduced as a covariate, only placental weight and gestational age remained significant. In the univariate model, the determinants of placenta weight included BMI, insulin, triglycerides, total- and HDL-cholesterol (negatively), gestational weight gain and parity. In the multivariable model, BMI, total cholesterol HDL-cholesterol, gestational weight gain and parity remained independent covariates.ConclusionMaternal BMI and fasting glucose were independently associated with newborn percentage fat. This effect disappeared by introducing placental weight as a covariate. Several metabolic factors associated with maternal BMI were associated with placental weight, but not with neonatal body fat. Our findings are consistent with a concept that the effects of maternal BMI and a number of BMI-related metabolic factors on fetal fat accretion to a significant extent act by modifying placental weight.

Highlights

  • Determinants of birthweight and neonatal body composition have gained increasing attention over the recent years

  • We examined if maternal metabolic parameters associated with body mass index (BMI) were associated with placental weight

  • ***Gestational weight gain from 14–16 to 36–38 weeks. #Blood pressure $140/90 with/without proteinuria ($1+ on dipstick). ##Gestational diabetes based on weight (g) Complications: Hypertension/preeclampsia# GDM (WHO) criteria (75 g oral glucose tolerance test and corresponding 2 h- glucose value $7.8 mmol/l). doi:10.1371/journal.pone.0057467.t001

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Summary

Introduction

Determinants of birthweight and neonatal body composition have gained increasing attention over the recent years. This interest has largely been driven by the well documented relation between anthropometric characteristics at birth and future health of the newborn [1]. Birthweight is only a crude measure of intrauterine growth and especially of neonatal body composition. Neonatal body fat is an important indicator of fetal energy supply and growth conditions [3,4]. The objective of the current study was first to explore the association between maternal BMI and metabolic parameters associated with BMI and neonatal percentage body fat and to determine to which extent any associations were modified if adjusting for placental weight. We examined the relations between maternal metabolic parameters associated with BMI and placental weight

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