Maternal Fuels and Metabolic Measures During Pregnancy and Neonatal Body Composition: The Healthy Start Study

Crume, Tessa; Shapiro, Allison; Brinton, John T.; Glueck, Deborah H.; Martinez, Mercedes; Kohn, Mary; Harrod, Curtis S.; Friedman, Jacob E.; Dabelea, Dana

doi:10.1210/jc.2014-2949

Cited by 79 publications

(98 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…25 It has recently been demonstrated that insulin resistance in the first half of pregnancy is highly predictive of increased neonatal adiposity. 26 The excess of maternal fuels and hormones (i.e. fetal over-nutrition) associated with insulin resistance include hyperglycemia, circulating lipids, free fatty acids, and leptin, all of which, individually and in conjunction, have been correlated with fetal fat accretion.…”

Section: Discussionmentioning

confidence: 99%

Excessive gestational weight gain in the first trimester among women with normal glucose tolerance and resulting neonatal adiposity

et al. 2016

View full text Add to dashboard Cite

ObjectiveTo assess whether weight gain above or below Institute of Medicine (IOM) recommended amounts in an ethnically diverse obstetric population with normal glucose tolerance is associated with differences in neonatal adiposity.Study DesignIn this prospective cohort study, healthy women with normal glucose tolerance based on the International Association of Diabetes and Pregnancy Study Groups guidelines were enrolled. Gestational weight at multiple time points were collected. Neonatal adiposity was measured by air displacement plethysmography at 24-72 hours of life. Analyses included Fisher's exact test, ANOVA, and a trajectory analysis using a group-based weight gain trajectory model with a censored normal distribution.ResultOverweight and obese women were more likely to exceed IOM weight gain guidelines. Regardless, there was no significant difference in %body fat of neonates born to mothers who either met or exceeded gestational weight gain guidelines. Gestational weight gain timing influenced neonatal anthropometrics: women who gained excessively by the first prenatal visit had neonates with significantly higher birth weight (3.91 kg vs. 3.45 kg, p<0.001), and %body fat (13.7% vs. 10.9%, p=0.0001) compared to women who had steady, moderate gestational weight gain.ConclusionAvoidance of excessive gestational weight gain in the first trimester may prevent high amounts of neonatal adiposity.

show abstract

Section: Discussionmentioning

confidence: 99%

Excessive gestational weight gain in the first trimester among women with normal glucose tolerance and resulting neonatal adiposity

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Broadly, these studies point to a model whereby dietary changes or exposure to one or more obesity associated metabolites or hormones during critical stages of development can alter developmental pathways in the offspring and lead to greater accrual of fat mass. [118][119][120][121][122] Studies in experimental models and limited human data suggest that the earliest stages of development (both preconception and periconception) are crucial. [123][124][125] Although, developmental programming associated with obesity probably occurs throughout gestation and neonatal life, understanding the crucial periods during which the major changes are initiated is key to devising effective interventions.…”

Section: Potential Mechanisms Linking Maternal Obesity To Offspring Smentioning

confidence: 99%

“…[118][119][120][121][122][123][124][125][126][127][128][129][130][131][132][133] Overall, although poor quality diets seem to have detrimental effects in the offspring, they are unlikely to be mediators of changes associated with maternal obesity but probably represent an independent risk factor. Studies have also evaluated the association between type of dietary fat and child health outcomes.…”

Section: Dietary Patterns and Nutrient Changesmentioning

confidence: 99%

Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child

Catalano

Shankar

2017

BMJ

789

696

View full text Add to dashboard Cite

Obesity is the most common medical condition in women of reproductive age. Obesity during pregnancy has short term and long term adverse consequences for both mother and child. Obesity causes problems with infertility, and in early gestation it causes spontaneous pregnancy loss and congenital anomalies. Metabolically, obese women have increased insulin resistance in early pregnancy, which becomes manifest clinically in late gestation as glucose intolerance and fetal overgrowth. At term, the risk of cesarean delivery and wound complications is increased. Postpartum, obese women have an increased risk of venous thromboembolism, depression, and difficulty with breast feeding. Because 50-60% of overweight or obese women gain more than recommended by Institute of Medicine gestational weight guidelines, postpartum weight retention increases future cardiometabolic risks and prepregnancy obesity in subsequent pregnancies. Neonates of obese women have increased body fat at birth, which increases the risk of childhood obesity. Although there is no unifying mechanism responsible for the adverse perinatal outcomes associated with maternal obesity, on the basis of the available data, increased prepregnancy maternal insulin resistance and accompanying hyperinsulinemia, inflammation, and oxidative stress seem to contribute to early placental and fetal dysfunction. We will review the pathophysiology underlying these data and try to shed light on the specific underlying mechanisms.

show abstract

“…However, some past and more recent data suggest that maternal glycemia is a poor predictor of infant birth weight (9,10) and that markers of maternal lipid metabolism during pregnancy might contribute to and possibly be a better predictor of infant birth weight and adiposity (11–19). Previous studies demonstrating associations between indices of maternal glucose and lipid metabolism and infant birth weight have focused only on clinical measures of maternal metabolism, including fasting plasma glucose (9,16,17,20), HbA 1c (15), oral glucose tolerance testing (9,11,16,18,19), and plasma concentrations of free fatty acid (FFA) (15), triglyceride (11–15,20), and cholesterol (20). Although clinical measures are easily collected and some are part of routine clinical care, these measures have not elucidated the pathologic abnormalities that lead to pregnancy-associated risks.…”

Section: Introductionmentioning

confidence: 99%

Maternal Glucose and Fatty Acid Kinetics and Infant Birth Weight in Obese Women With Type 2 Diabetes

et al. 2016

View full text Add to dashboard Cite

The objectives of this study were 1) to describe maternal glucose and lipid kinetics and 2) to examine the relationships with infant birth weight in obese women with pregestational type 2 diabetes during late pregnancy. Using stable isotope tracer methodology and mass spectrometry, maternal glucose and lipid kinetic rates during the basal condition were compared in three groups: lean women without diabetes (Lean, n = 25), obese women without diabetes (OB, n = 26), and obese women with pregestational type 2 diabetes (OB+DM, n = 28; total n = 79). Glucose and lipid kinetics during hyperinsulinemia were also measured in a subset of participants (n = 56). Relationships between maternal glucose and lipid kinetics during both conditions and infant birth weight were examined. Maternal endogenous glucose production (EGP) rate was higher in OB+DM than OB and Lean during hyperinsulinemia. Maternal insulin value at 50% palmitate Ra suppression (IC50) for palmitate suppression with insulinemia was higher in OB+DM than OB and Lean. Maternal EGP per unit insulin and plasma free fatty acid concentration during hyperinsulinemia most strongly predicted infant birth weight. Our findings suggest maternal fatty acid and glucose kinetics are altered during late pregnancy and might suggest a mechanism for higher birth weight in obese women with pregestational diabetes.

show abstract

Maternal Fuels and Metabolic Measures During Pregnancy and Neonatal Body Composition: The Healthy Start Study

Cited by 79 publications

References 51 publications

Excessive gestational weight gain in the first trimester among women with normal glucose tolerance and resulting neonatal adiposity

Excessive gestational weight gain in the first trimester among women with normal glucose tolerance and resulting neonatal adiposity

Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child

Maternal Glucose and Fatty Acid Kinetics and Infant Birth Weight in Obese Women With Type 2 Diabetes

Contact Info

Product

Resources

About