Associations between anthropometric characteristics and insulin markers in mothers and their neonates and with neonate`s birth weight: An observational cohort study

Abstract

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.

Association of maternal insulin resistance with neonatal insulin resistance and body composition/size: a prospective cohort study in a sub-Saharan African population

“…Our finding of no association between maternal IR and birth weight agrees with a report by Bomba-Opon et al [ 31 ] among Polish mothers and babies and a prospective study among Turkish mothers and their infants [ 11 ]. In contrast, a retrospective database review of second-to-third trimester healthy pregnant Japanese mothers by Yamashita et al [ 18 ] found maternal HOMAIR to be positively associated with birth weight and LGA.…”

“…Maternal obesity, excessive intrapregnancy weight gain and maternal IR independently, but variably, impair fetal growth and adiposity and birth size [ 8 - 11 ]. Impaired fetal growth (IFG) (which includes wasting or stunting) or excessive fetal growth (EFG) (macrosomia or large-for-gestational-age [LGA] birth) increases the risk of cardiometabolic disorders intergenerationally [ 12 - 14 ].…”

“…Impaired fetal growth (IFG) (which includes wasting or stunting) or excessive fetal growth (EFG) (macrosomia or large-for-gestational-age [LGA] birth) increases the risk of cardiometabolic disorders intergenerationally [ 12 - 14 ]. While the adverse association of maternal IR with birth size is well-known among pregnant women with pregestational diabetes, gestational diabetes (GDM) or maternal obesity [ 15 , 16 ], findings are somewhat conflicting among healthier non-GDM cohorts [ 11 , 17 , 18 ]. Specifically, studies are scarce on the prospective association of maternal IR with neonatal IR, birth size and composition in non-GDM, nonobese pregnant women in sub-Saharan Africa, including Nigeria.…”

Associations between insulin resistance and adverse pregnancy outcomes in women with gestational diabetes mellitus: a retrospective study

“…However, it has been found that even when the recommended plans are well followed, the pregnancy outcomes cannot be effectively improved [15]. Some researches ascribes this to IR [16] and the heterogeneity of IR in pregnant women with GDM somehow results in different outcomes [11,17]. Therefore, more exploration on the relationship between IR in the second trimester (24-28 weeks) and adverse pregnancy outcomes in GDM women may help identify women who are at high risk of these adverse outcomes, and management can therefore be carried out in early pregnancy even pre-pregnancy, sometimes adding insulin sensitization therapy if necessary to improve the prognosis.…”

Associations Between Insulin Resistance and Adverse Pregnancy Outcomes in Women With Gestational Diabetes Mellitus: a Retrospective Study

“…However, it has been found that even when the recommended plans are well followed, the pregnancy outcomes cannot be effectively improved (3). Some researches ascribes this to insulin resistance IR (4) and the heterogeneity of IR in pregnant women with GDM somehow results in different outcomes (5,6). Therefore, more exploration on the relationship between IR in the second trimester (24-28 weeks) and adverse pregnancy outcomes in GDM women may help identify women who are at high risk of these adverse outcomes, and management can therefore be carried out in early pregnancy even pre-pregnancy, sometimes adding insulin sensitization therapy if necessary to improve the prognosis.…”