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Objective:To examine the (1) normal ranges of anthropometric and insulin resistance/sensitivity indices (homeostatic model assessment for insulin resistance, homeostatic model assessment for insulin sensitivity, and quantitative insulin sensitivity check index) for Iranian pregnant women and their newborns and (2) associations between maternal anthropometric and metabolic values and infants’ birth weights among Iranian women.Methods:Anthropometric and metabolic values of 163 singleton non-diabetic pregnant women in Tehran, Iran (2014) were collected before and during pregnancy and at delivery. Linear regression, multivariable regression, and Student t tests were used to evaluate correlations between birth weight and maternal variables.Results:Linear regression modeling suggested that maternal serum glucose (p = 0.2777) and age (p = 0.6752) were not associated with birth weight. Meanwhile, maternal weight and body mass index before pregnancy (p = 0.0006 and 0.0204, respectively), weight at delivery (p = 0.0036), maternal height (p = 0.0118), and gestational age (p = 0.0016) were positively associated with birth weight, while serum insulin (p = 0.0300) and homeostatic model assessment for insulin resistance (p = 0.0334) were negatively associated with infant’s birth weight. Using multivariate modeling, we identified severalconfounders: parity (multipara mothers delivered heavier babies compared to first-time mothers) explained as much as 24% of variation in birth weight (p = 0.005), maternal height explained 20.7% (p = 0.014), gestational age accounted for 19.7% (p = 0.027), and maternal body mass index explained 19.1% (p = 0.023) of the variation in the infant’s birth weight. Maternal serum insulin and infant’s sex were not observed to be associated with birth weight (p = 0.342 and 0.669, respectively) in the overall model.Conclusion:Overweight/obese women may experience higher incidence of delivering larger babies. Multivariable regression analyses showed that maternal body mass index and height, parity, and gestational age are associated with newborn’s birth weight.

Naseh A, Nourbakhsh S, Tohidi M, Sarkhail P, Najafian B, Azizi F. Associations between anthropometric characteristics and insulin markers in mothers and their neonates and with neonate`s birth weight: An observational cohort study. Turk J Pediatr 2017; 59: 625-635. This study aimed to identify possible associations between anthropometric characteristics and insulin markers of mothers and 1) their neonate`s birth weight, and 2) those markers of neonates. A prospective observational cohort of 100 healthy mothers who came to a hospital in Tehran in 2014 from pregnancy to delivery as well as their term neonates comprised the study population. Only newborns with weight within normal range were included. Anthropometric indices and serum glucose and insulin levels were measured in both mothers and neonates. Correlations between maternal body and serum indices and neonate`s serum indices and birth weight were assessed. Maternal weight before pregnancy (r= 0.3, p=0.001), at time of delivery (r= 0.3, p=0.001), and maternal body mass index (BMI) before pregnancy (r= 0.2, p=0.04) positively associated with neonate`s birth weight. For the neonates with normal birth weight, there was no correlation between maternal serum glucose and insulin levels and neonate`s serum glucose and insulin levels or birth weight. Neonate`s serum glucose correlated positively with insulin levels (r= 0.3, p=0.006) and HOMA-IR (r= 0.6, p < 0.0001); and negatively with HOMA-S (r= -0.6, p < 0.0001) and QUICKI (r= -0.5, p < 0.0001). Neonate`s insulin correlated positively with HOMA-IR (r= 0.9, p < 0.0001), and negatively with HOMA-S (r= -0.9, p < 0.0001), QUICKI (r= -0.9, p < 0.0001), gestational age (r= -0.2, p=0.03) and with glucose-insulin (GI) ratio (r= -0.9, p < 0.0001). Neonate`s GI ratio correlated positively with gestational age (r= 0.2, p=0.01). Maternal serum glucose and insulin showed positive correlation (r= 0.4, p < 0.0001). The lowest maternal insulin quartile had dominantly male and the highest quartile had dominantly female neonates (p=0.006). In conclusion, maternal anthropometric measures correlate with neonates` birth weight. Advancing health promotion to normalize these maternal parameters may reduce the incidence of abnormal birth weights among newborns.

BackgroundTo explore the association between systolic and diastolic blood pressure (SBP and DBP respectively) and pulse pressure (PP) with cardiovascular disease (CVD) and mortality events among Iranian patients with prevalent CKD.MethodsPatients [n = 1448, mean age: 60.9 (9.9) years] defined as those with estimated glomerular filtration rate < 60 ml/min/1.73 m2, were followed from 31 January 1999 to 20 March 2014. Multivariable Cox proportional hazard models were applied to examine the associations between different components of BP with outcomes.ResultsDuring a median follow-up of 13.9 years, 305 all-cause mortality and 317 (100 fatal) CVD events (among those free from CVD, n = 1232) occurred. For CVD and CV-mortality, SBP and PP showed a linear relationship, while a U-shaped relationship for DBP was observed with all outcomes. Considering 120 ≤ SBP < 130 as reference, SBP ≥ 140 mmHg was associated with the highest hazard ratio (HR) for CVD [1.68 (1.2–2.34)], all-cause [1.72 (1.19–2.48)], and CV-mortality events [2.21 (1.16–4.22)]. Regarding DBP, compared with 80 ≤ DBP < 85 as reference, the level of ≥ 85 mmHg increased risk of CVD and all-cause mortality events; furthermore, DBP < 80 mmHg was associated with significant HR for CVD events [1.55 (1.08–2.24)], all-cause [1.68 (1.13–2.5)] and CV-mortality events [3.0 (1.17–7.7)]. Considering PP, the highest HR was seen in participants in the 4th quartile for all outcomes of interest; HRs for CVD events [1.92 (1.33–2.78)], all-cause [1.71 (1.11–2.63)] and CV-mortality events [2.22 (1.06–4.64)].ConclusionsAmong patients with CKD, the lowest risk of all-cause and CV-mortality as well as incident CVD was observed in those with SBP < 140, 80 ≤ DBP < 85 and PP < 64 mmHg.