Limited Impact of Fetal Sex and Maternal Body Mass Index on Fetal and Maternal Insulin Resistance and Lipid Metabolism: Findings from the PEARs Study

Rafferty, Aran; Geraghty, Aisling A.; Kennelly, Maria A.; O’Brien, Eileen C.; Reji, Reshma Merin; Mehegan, John; Segurado, Ricardo; Smith, Thomas P.; Maguire, Orla; Cronin, Martina

doi:10.1007/s43032-019-00045-0

Cited by 8 publications

(9 citation statements)

References 37 publications

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“…Maternal obesity increases the risk of many pregnancy complications and adverse birth outcomes [ 50 ]. Previously published work with data from the PEARS study, however, found that women with obesity did not have a significantly greater incidence of caesarean delivery compared to women with overweight [ 51 ]. In a separate analysis, the data from Project VIVA was used measure maternal DII ® rather than E-DII TM in the second and third trimester, and it was found that higher values were associated with lower birthweight in mothers with obesity but not overweight [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the sub-analysis, higher E-DII TM score increased the odds of being metabolically healthy by over two-fold, and a greater proportion of women who delivered male infants with a proinflammatory E-DII TM had metabolically unhealthy phenotype compared to those with an anti-inflammatory value (E-DII TM < 0). Rafferty et al, using data from the PEARS study, did not find a relationship between infant sex and maternal early pregnancy cardiometabolic markers alone, suggesting a unique interaction in relation to E-DII TM [ 51 ]. In the ALPHABET study, gender differences were also observed.…”

Section: Discussionmentioning

confidence: 99%

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Effect of an Antenatal Lifestyle Intervention on Dietary Inflammatory Index and Its Associations with Maternal and Fetal Outcomes: A Secondary Analysis of the PEARS Trial

et al. 2021

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We investigated the effect of an antenatal lifestyle intervention of a low-glycaemic index (GI) diet and physical activity on energy-adjusted dietary inflammatory index (E-DIITM) and explored its relationship with maternal and child health in women with overweight and obesity. This was a secondary analysis of 434 mother−child pairs from the Pregnancy Exercise and Nutrition Study (PEARS) trial in Dublin, Ireland. E-DIITM scores were calculated for early (10–16 weeks) and late (28 weeks) pregnancy. Outcomes included lipids, inflammation markers, insulin resistance, mode of delivery, infant size, pre-eclampsia, and gestational diabetes. T-tests were used to assess changes in E-DIITM. Chi-square, correlations, and multiple regression were employed to investigate relationships with outcomes. The mean (SD) age of participants was 32.45 (4.29) years with median (IQR) BMI 28.25 (26.70, 31.34) kg/m2. There was no change in E-DIITM in the controls (−0.14 (1.19) vs. −0.07 (1.09), p = 0.465) but E-DIITM reduced by 10% after the intervention (0.01 (1.07) vs −0.75 (1.05), p < 0.001). No associations were found between early pregnancy E-DIITM and maternal and child outcomes, except for increased odds of adverse cardiometabolic phenotype in women who delivered male (OR = 2.29, p = 0.010) but not female infants (OR = 0.99, p = 0.960). A low-GI antenatal intervention can reduce the inflammatory potential of diets. Sex differences should be explored further in future research.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of an Antenatal Lifestyle Intervention on Dietary Inflammatory Index and Its Associations with Maternal and Fetal Outcomes: A Secondary Analysis of the PEARS Trial

et al. 2021

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“…By contrast, Yamashita et al [ 32 ] and Xiao et al [ 33 ] observed higher maternal insulin resistance in pregnancies with female fetuses at 24-28 weeks gestation. Measuring fasting blood glucose longitudinally throughout pregnancy in a cohort including only overweight and obese women, Rafferty and colleagues observed no effect of fetal sex [ 34 ]. As the investigated cohorts differ in average BMI of the participants, in the proportion of women suffering from glucose metabolism disorders, or ethnicity, results are difficult to compare or extrapolate to the general population.…”

Section: Adaptation and Disruption Of Maternal Glucose Metabolism Depends On Fetal Sexmentioning

confidence: 99%

Placental Endocrine Activity: Adaptation and Disruption of Maternal Glucose Metabolism in Pregnancy and the Influence of Fetal Sex

Stern

Schwarz

Moser

et al. 2021

IJMS

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The placenta is an endocrine fetal organ, which secretes a plethora of steroid- and proteo-hormones, metabolic proteins, growth factors, and cytokines in order to adapt maternal physiology to pregnancy. Central to the growth of the fetus is the supply with nutrients, foremost with glucose. Therefore, during pregnancy, maternal insulin resistance arises, which elevates maternal blood glucose levels, and consequently ensures an adequate glucose supply for the developing fetus. At the same time, maternal β-cell mass and function increase to compensate for the higher insulin demand. These adaptations are also regulated by the endocrine function of the placenta. Excessive insulin resistance or the inability to increase insulin production accordingly disrupts physiological modulation of pregnancy mediated glucose metabolism and may cause maternal gestational diabetes (GDM). A growing body of evidence suggests that this adaptation of maternal glucose metabolism differs between pregnancies carrying a girl vs. pregnancies carrying a boy. Moreover, the risk of developing GDM differs depending on the sex of the fetus. Sex differences in placenta derived hormones and bioactive proteins, which adapt and modulate maternal glucose metabolism, are likely to contribute to this sexual dimorphism. This review provides an overview on the adaptation and maladaptation of maternal glucose metabolism by placenta-derived factors, and highlights sex differences in this regulatory network.

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“…Previous work by our group found higher levels of cord leptin in female fetuses compared to males [ 51 ], however, we found no differences in fetal sex and associations with biochemical markers and fetal growth trajectory grouping. Furthermore, we previously found that fetal sex did not impact maternal and fetal metabolic parameters in women with a BMI > 25 kg/m 2 [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Fetal Growth Trajectories and Their Association with Maternal, Cord Blood, and 5-year Child Adipokines

Bartels

Geraghty

O’Brien

et al. 2020

Journal of Nutrition and Metabolism

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Background. The growth of the fetus is a complex process influenced by multiple factors. Studies have highlighted the important role of biochemical growth markers such as leptin and adiponectin on fetal growth. Objective. To compare fetal growth trajectories with biochemical growth markers from maternal blood samples at 28 weeks’ gestation, cord blood samples at birth, and in child blood samples at 5 years of age from mother-infant pairs who were part of the longitudinal ROLO study. Methods. 781 mother-infant pairs from the ROLO and ROLO Kids study were included. Ultrasound measurements and birth weight were used to develop fetal growth trajectory groups for estimated abdominal circumference and estimated weight. Blood serum levels of leptin, adiponectin, insulin, TNF-alpha, and IL-6 from maternal, cord, and 5-year child samples were recorded. ANOVA and chi-square tests were applied to test the associations between fetal growth trajectory membership and maternal and child biochemical growth indicators. The influence of child sex was also investigated. Results. Male sex was associated with a faster weight trajectory compared to females (p=0.001). At 28 weeks’ gestation, maternal leptin levels were significantly higher in mothers with a fetus on a slower estimated abdominal circumference trajectory compared to fast (25616 [IQR: 11656.0 to 35341.0] vs. 14753.8 [IQR: 8565.4 to 24308.1], p<0.001) and maternal adiponectin levels were lower in fetuses on a slower estimated abdominal circumference trajectory compared to a fast trajectory (22.4 [IQR: 13.6 to 35.9] vs. 27.6 [IQR: 17.6 to 46.3], p=0.027). No associations were noted with inflammatory markers. No associations were identified between fetal growth trajectories and growth markers at 5 years of age. Conclusions. This study shows that male sex is associated with an accelerated estimated weight trajectory. Furthermore, high leptin and low adiponectin in maternal serum in late gestation are associated with a slower fetal growth trajectory. No associations were identified with blood growth markers after pregnancy.

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Limited Impact of Fetal Sex and Maternal Body Mass Index on Fetal and Maternal Insulin Resistance and Lipid Metabolism: Findings from the PEARs Study

Cited by 8 publications

References 37 publications

Effect of an Antenatal Lifestyle Intervention on Dietary Inflammatory Index and Its Associations with Maternal and Fetal Outcomes: A Secondary Analysis of the PEARS Trial

Effect of an Antenatal Lifestyle Intervention on Dietary Inflammatory Index and Its Associations with Maternal and Fetal Outcomes: A Secondary Analysis of the PEARS Trial

Placental Endocrine Activity: Adaptation and Disruption of Maternal Glucose Metabolism in Pregnancy and the Influence of Fetal Sex

Fetal Growth Trajectories and Their Association with Maternal, Cord Blood, and 5-year Child Adipokines

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