Associations of Longitudinal Fetal Growth Patterns With Cardiometabolic Factors at Birth

Abstract

BackgroundBirth weight is associated with cardiometabolic factors at birth. However, it is unclear when these associations occur in fetal life. We aimed to investigate the associations between fetal growth in different gestational periods and cord blood cardiometabolic factors.MethodsWe included 1,458 newborns from the Born in Guangzhou Cohort Study, China. Z-scores of fetal size parameters [weight, abdominal circumference (AC), and femur length (FL)] at 22 weeks and growth at 22–27, 28–36, and ≥37 weeks were calculated from multilevel linear spline models. Multiple linear regression was used to examine the associations between fetal growth variables and z-scores of cord blood cardiometabolic factors.ResultsFetal weight at each period was positively associated with insulin levels, with stronger association at 28–36 weeks (β, 0.31; 95% CI, 0.23 to 0.39) and ≥37 weeks (β, 0.15; 95% CI, 0.10 to 0.20) compared with earlier gestational periods. Fetal weight at 28–36 (β, −0.32; 95% CI, −0.39 to −0.24) and ≥37 weeks (β, −0.26; 95% CI, −0.31 to −0.21) was negatively associated with triglyceride levels, whereas weight at 28–36 weeks was positively associated with HDL levels (β, 0.12; 95% CI, 0.04 to 0.20). Similar results were observed for AC. Fetal FL at 22 and 22–27 weeks was associated with increased levels of insulin, glucose, and HDL.ConclusionsFetal growth at different gestational periods was associated with cardiometabolic factors at birth, suggesting that an interplay between fetal growth and cardiometabolic factors might exist early in pregnancy.

Associations between cord blood metabolic factors and early-childhood growth and overweight and obesity

“…One outstanding finding from this study was that cord blood TG levels and TG/TC ratios were negatively associated with early-childhood growth. It has been reported that umbilical cord blood TG levels were negatively associated with fetal weights and birth weights ( 6 – 9 ). Our results further discovered inverse correlations between cord serum TG concentrations, TG/TC ratios and weight Z-scores and BMI Z-scores up to 18 months.…”

“…The present prospective cohort study comprehensively displayed cord blood lipid and glucose metabolism in Chinese neonates and explored the associations between cord blood metabolic factors and growth indicators and overweight and obesity at the early stage of life. Previous research mostly investigated the associations between cord serum lipid profile, glucose metabolism and fetal growths and birth weights (6)(7)(8)(9)(10)12). However, few studies followed up postnatal growth indicators and explored the associations between cord blood metabolic factors and early-childhood overweight and adiposity.…”

“…Fetal weight was positively associated with insulin levels especially during the period of late gestation. Fetal weight was negatively correlated with triglyceride (TG) levels and positively correlated with high-density lipoprotein-cholesterol (HDL-C) levels during the third trimester of pregnancy ( 6 ). Results from prospective cohort studies showed that high cord serum TG levels and insulin levels were significantly associated with small for gestational age (SGA) and large for gestational age (LGA) neonates, respectively ( 7 , 8 ).…”

Associations of Cord Blood Lipids with Childhood Adiposity at the Age of Three Years: A Prospective Birth Cohort Study

“…A total of 1744 mother-child pairs were randomly selected from all eligible women. This sample has been used in our previous study [35]. We do not have an a priori sample size calculation.…”

“…All assays had low intra-day and inter-day coefficients of variation (<2%). Data on cord blood lipids have been used in our previous studies [35].…”