The association between fetal growth and neonatal adiposity in urban South African infants

Abstract

Summary Objective To examine associations between maternal body mass index (BMI), gestational weight gain (GWG) and fetal growth and neonatal adiposity in urban South Africans. Methods Maternal BMI was assessed at recruitment and GWG (kg/week) was calculated. Longitudinal fetal growth was measured via ultrasound and modelled using Superimposition by Translation and Rotation (SITAR). Neonatal adiposity was assessed using air displacement plethysmography or dual‐energy X‐ray absorptiometry. Multiple linear regression models were used to examine associations between maternal BMI, GWG and SITAR fetal growth parameters and neonatal fat mass index (FMI; kg/m3) in 304 mother‐neonate pairs. Results In pooled analyses, longitudinally modelled abdominal circumference size (β = 0.64 kg/m3, P < .001) and velocity (β = 8.39 kg/m3, P < .001) and biparietal diameter velocity (β = 4.55 kg/m3, P = .020) were positively associated with neonatal FMI. GWG was positively associated with neonatal FMI in preliminary models (β = 1.07 kg/m3 per 1 kg/week; P = .040), with pooled models indicating mediation via fetal growth. Conclusion In utero abdominal growth is predictive of neonatal adiposity. Additionally, greater fetal growth – particularly of the abdominal circumference – mediates the effect of GWG on neonatal adiposity. In settings such as South Africa, strategies to ensure healthy pregnancy weight gain can contribute to prevention of intergenerational obesity risk.

Anti-inflammatory diets reduce the risk of excessive gestational weight gain in urban South Africans from the Soweto First 1000-Day Study (S1000)

“…This, and previous, findings from S1000 emphasise the need to prioritise preconception health of adolescent girls and young women to establish healthy dietary practices, body size and metabolic profiles prior to pregnancy [ 4 – 6 , 36 ]. However, in low-income settings such as Soweto, poverty and limited financial resources restrict access to diverse, high quality diets [ 37 ].…”

“…Similarly, while our study showed no association between E-DII scores and birth outcomes, we have previously demonstrated an inverse association between adherence to the “traditional” dietary pattern and birth size and neonatal adiposity [ 6 ]. In addition, we have provided evidence of a pathway for greater neonatal adiposity in this cohort via an effect of higher GWG on fetal growth—particularly at the abdominal circumference [ 36 ].…”

Building knowledge, optimising physical and mental health and setting up healthier life trajectories in South African women (Bukhali): a preconception randomised control trial part of the Healthy Life Trajectories Initiative (HeLTI)

“…The trial was designed following the Standard Protocol Items (Recommendations for Interventional Trials (SPIRIT) 2013 statement). Through extensive qualitative (focus groups, in-depth individual interviews and stakeholder engagement)18–23 and epidemiological research,24–31 we identified our young women (18–28 years) as the target group given that a high proportion these women are already either overweight or obese and most will have their first child during this age range, and developed the intervention package. We initially opted for a cluster randomised study design in order to included community peer group sessions as part of the intervention.…”

Relationships between adiposity distribution and metabolic health in preconception women in South Africa

“… 6 In addition, continued obesity and excessive gestational weight gain (GWG) during pregnancy are strongly predictive of fetal growth, birth weight and obesity risk in the offspring. 7 , 8 , 9 …”

“…6 In addition, continued obesity and excessive gestational weight gain (GWG) during pregnancy are strongly predictive of fetal growth, birth weight and obesity risk in the offspring. [7][8][9] Adipose tissue is a metabolically active organ-it is a major source of inflammatory cytokines and can interfere with insulin signaling by causing defects in insulin cascade, eventually resulting in insulin sensitivity or resistance. 10 Furthermore, the location of adipose tissue deposition may determine metabolic activity and related effects, and risk for metabolic disease.…”