Abstract
BackgroundGestational weight gain (GWG) has critical implications for maternal and child health. Inflammation and angiogenesis are implicated in various aspects of maternal metabolism that may play a role in gestational weight gain. The associations of inflammatory, angiogenic, and metabolic pathways with GWG are yet to be elucidated. This study evaluated associations between a panel of inflammatory, angiogenic, and metabolic proteins measured in mid-pregnancy and gestational weight gain.MethodsPregnant women were enrolled from Dar es Salaam, Tanzania, between 2001 and 2004. The participants were enrolled at mid-pregnancy (12 to 27 weeks of gestation) and followed up until delivery. This analysis focused on a cohort of 1002 women who were primigravid, had singleton live births, had longitudinal measures of gestational weight, and whose mid-pregnancy plasma samples underwent analysis for 18 proteins.ResultsHigher plasma concentrations of leptin (mean difference in GWG percent adequacy comparing highest with lowest quartiles: 10.24; 95% CI 3.31, 17.16; p-trend = 0.003) and chitinase-3-like protein-1 (CH3L1) (mean difference in GWG percent adequacy comparing highest with lowest quartiles: 7.02; 95% CI 0.31, 13.72; p-trend = 0.007) were associated with greater GWG in a dose-response pattern. Higher leptin concentrations were associated with a lower risk of inadequate GWG (risk ratio comparing highest with lowest quartiles: 0.77; 95% CI 0.65, 0.91; p-trend = 0.001) and a higher risk of excessive GWG (risk ratio comparing highest with lowest quartiles: 1.57; 95% CI 1.03, 2.39; p-trend = 0.03). Higher CH3L1 concentrations were associated with a higher risk of excessive GWG (p-trend = 0.007). The associations of leptin and CH3L1 with inadequate GWG were stronger during the second than the third trimester. The other 16 proteins examined were not significantly associated with GWG.ConclusionsMid-pregnancy plasma leptin concentrations may be associated with GWG and have clinical predictive utility in identifying women at a higher risk of inadequate or excessive gestational weight gain.
Highlights
Gestational weight gain (GWG) has critical implications for maternal and child health
3) the inverse association of Chitinase3-like protein-1 (CHI3L1) with inadequate GWG was stronger among underweight women than normal-weight women. In this observational analysis using data from a randomized controlled trial in Dar es Salaam, Tanzania, we report that higher mid-pregnancy plasma concentrations of leptin and CHI3L1 are associated with greater GWG percent adequacy in a dose-response pattern
We find that higher mid-pregnancy plasma leptin concentrations are associated with a lower risk of inadequate GWG, while higher mid-pregnancy leptin and CHI3L1 concentrations are associated with a higher risk of excessive GWG
Summary
Gestational weight gain (GWG) has critical implications for maternal and child health. The associations of inflammatory, angiogenic, and metabolic pathways with GWG are yet to be elucidated. This study evaluated associations between a panel of inflammatory, angiogenic, and metabolic proteins measured in midpregnancy and gestational weight gain. Gestational weight gain (GWG) is a complex process that supports the functions of growth and development of the fetus during pregnancy [1], with important implications for maternal and child health. Excessive GWG is a risk factor for maternal morbidity [7], large for gestational age [1, 4] and postpartum weight retention [1, 2, 8].
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