Maternal lipids and leptin concentrations are associated with large-for-gestational-age births: a prospective cohort study

Abstract

The change in maternal lipid, leptin and adiponectin concentrations during pregnancy and infant birth weight (BW) is still poorly characterized. Thus, the aim of the study was to evaluate the association of maternal lipids, leptin and adiponectin throughout pregnancy with large-for-gestational-age (LGA) births and BW z-score. A prospective cohort of 199 mothers was followed during pregnancy in Rio de Janeiro, Brazil. The statistical analyses comprised multiple logistic and linear regression. Women delivered 36 LGA and 11 small-for-gestational-age newborns. HDL-c rate of change throughout pregnancy was negatively associated with BW z-score (β = −1.99; p = 0.003) and the delivery of a LGA newborn (OR = 0.02; p = 0.043). Pregnancy baseline concentration of log leptin was positively associated (OR = 3.92; p = 0.025) with LGA births. LDL-c rate of change throughout pregnancy was positively associated with BW z-score (β = 0.31; p = 0.004). Log triglycerides and log adiponectin were not significantly associated with BW z-score or LGA birth. In conclusion, a higher log leptin pregnancy baseline concentration and a lower HDL-c rate of change during pregnancy were associated with higher odds of having a LGA newborn. These maternal biomarkers are important to foetal growth and could be used in prenatal care as an additional strategy to screen women at risk of inadequate BW.

Association between maternal serum lipids during late pregnancy and adverse birth outcomes

“…LGA [20][21][22]. Furthermore, most results with regard to a decreased risk for preterm birth was found for high HDL levels [7,[23][24][25], and the present study con rmed this association.…”

Adequação do peso ao nascer para idade gestacional de acordo com a curva INTERGROWTH-21 st e fatores associados ao pequeno para idade gestacional

“…A categoria de referência para o desfecho PIG foi recém-nascido AIG. Essa opção leva em conta que os recém-nascidos GIG também constituem um grupo de transtorno da nutrição fetal 16,17 . A população de estudo para essa análise foi 1.412 nascidos vivos.…”

“…Na análise univariada, após a exclusão de 19% dos recém-nascidos (gravidez múltipla e/ou malformação congênita e/ou GIG), 16,17 .…”

“…Na cidade do Rio de Janeiro, uma coorte de 199 gestantes entre 20 e 40 anos, sem doenças crônicas, exceto obesidade, foi acompanhada no pré-natal desde o primeiro trimestre em um centro municipal de saúde, entre 2009 e 2012. Foram estimadas prevalências para PIG (5,5%) e GIG (18,1%) 16 . O estudo na cidade de Caxias abordou uma maternidade pública, com mulheres de baixa renda, e estimou apenas o percentual de GIG (13%).…”

“…No Brasil, são poucos os estudos recentes avaliando tanto a prevalência como os fatores associados ao pequeno para idade gestacional [14][15][16] . Poucos estudos 16,17 , até o momento, utilizaram a curva INTERGROWTH-21 st para estimar adequação peso/idade gestacional.…”