Plasma Triglyceride Concentrations during Pregnancy Are Associated with Fetal Hyperinsulinemia, Insulin Resistance, and Birth Weight Independent of Maternal Hyperglycemia and Insulin Resistance

Abstract

Objective: Intra-uterine environment has a great influence on fetal glucose metabolism and growth. Unlike gestational diabetes, the effect of maternal lipid metabolism on fetal glucose metabolism remains unknown. In this study, we evaluate the relationship between maternal plasma triglyceride concentrations during pregnancy, cord blood c-peptide, fetal insulin resistance index and birth weight. Research Design and Methods: 663 pregnant women who delivered singleton at National Taiwan University Hospital from 2013 to 2017 were enrolled in this cohort study. We measured plasma lipid profile at each trimester, cord blood c-peptide concentrations and birth weight. Fetal insulin resistance was measured by homeostatic model assessment 2-insulin resistance index (HOMA2-IR). Results: Maternal plasma triglyceride, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol increased significantly during pregnancy (all p<0.05). Maternal plasma triglyceride at the visit for oral glucose tolerance tests (OGTT) was associated with cord blood c-peptide (adjusted p<0.05) and fetal HOMA2-IR (adjusted p<0.05), adjusted for family history of diabetes, history of gestational diabetes, pre-pregnancy body mass index (BMI), gestational age, gestational weight gain, maternal hemoglobin A1c, maternal HOMA2-IR and cord blood glucose. Maternal plasma triglyceride at delivery was significantly associated with birth weight (adjusted p<0.05), adjusted for family history of diabetes, history of gestational diabetes, pre-pregnancy BMI, gestational age, gestational weight gain and maternal hemoglobin A1c. Similar associations were also found in women without gestational diabetes. Conclusions Maternal plasma triglyceride concentrations during pregnancy are associated with fetal hyperinsulinemia, insulin resistance and birth weight. Disclosure K. Chen: None. H. Li: None.