Large-for-Gestational-Age, Leptin, and Adiponectin in Infancy

2021 ◽  
Author(s):  
Rong Huang ◽  
Yu Dong ◽  
Emile Levy ◽  
Pierre Julien ◽  
Isabelle Marc ◽  
...  
Keyword(s):  
Gestational Age ◽  
Skinfold Thickness ◽  
Large For Gestational Age ◽  
Z Score ◽  
White Ethnicity ◽  
Female Sex ◽  
Hmw Adiponectin ◽  
Gestational Age At Delivery ◽  
Score Gain

Abstract Context Fetal overgrowth “programs” an elevated risk of obesity and type 2 diabetes in adulthood. Plausibly, adipokines may be involved in programming metabolic health. Objective This work aimed to evaluate whether large-for-gestational-age (LGA), an indicator of fetal overgrowth, is associated with altered circulating leptin and adiponectin levels in infancy, and assess the determinants. Methods In the Canadian 3D birth cohort, we studied 70 LGA (birth weight > 90th percentile) and 140 optimal-for-gestational-age (OGA, 25th-75th percentiles) infants matched by maternal ethnicity, smoking, and gestational age at delivery. The primary outcomes were fasting leptin, and total and high-molecular-weight (HMW) adiponectin concentrations at age 2 years. Results LGA infants had higher body mass index (BMI) than OGA infants. However, there were no significant differences in leptin, and total and HMW adiponectin concentrations. Leptin concentrations were positively associated with female sex, weight (z score) gain 0 to 24 months, current BMI, and the sum of triceps and subscapular skinfold thickness, and negatively associated with maternal age and White ethnicity. Female sex was associated with lower total and HMW adiponectin concentrations. Weight (z score) gain 0 to 24 months and current BMI were positively correlated with total and HMW adiponectin concentrations in LGA infants only. Conclusion This study is the first to demonstrate that LGA does not matter for circulating leptin and adiponectin concentrations in infancy, and there may be LGA-specific positive associations between weight gain or current BMI and adiponectin concentrations in infancy, suggesting dysfunction in establishing the adiposity-adiponectin negative feedback loop in LGA individuals.

scholarly journals Associations of maternal diet with infant adiposity at birth, 6 months and 12 months

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030186
Author(s):  
Sarah Gonzalez-Nahm ◽  
Cathrine Hoyo ◽  
Truls Østbye ◽  
Brian Neelon ◽  
Carter Allen ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Diet Quality ◽  
Gestational Age ◽  
Maternal Diet ◽  
Skinfold Thickness ◽  
Healthy Eating Index ◽  
Large For Gestational Age ◽  
Z Score ◽  
Public Health Importance

ObjectivesTo assess associations between maternal prenatal diet quality and infant adiposity.DesignThe design was a prospective birth cohort.SettingWe used data from the Nurture study, a cohort of women and their infants residing in the southeastern USA.Participants and exposure assessmentBetween 2013 and 2015, we enrolled 860 women between 20 and 36 weeks’ gestation. After reconsenting at delivery and excluding women with implausible calorie intakes, we measured dietary intake using the Block food frequency questionnaire, and assessed diet quality using a modified Alternate Healthy Eating Index 2010 (AHEI-2010), which assessed intake of 10 food categories, including fruits, vegetables, whole grains, nuts/legumes, fats, meats, beverages and sodium (excluding alcohol).OutcomesWe assessed birth weight for gestational age z-score, small and large for gestational age, low birth weight and macrosomia. Outcomes at 6 and 12 months were weight-for-length z-score, sum of subscapular and triceps skinfold thickness (SS+TR) and subscapular-to-triceps skinfold ratio (SS:TR).ResultsAmong mothers, 70.2% were black and 20.9% were white; less than half (45.2%) reported having a high school diploma or less. Among infants, 8.7% were low birth weight and 8.6% were small for gestational age. Unadjusted estimates showed that a higher AHEI-2010 score, was associated with a higher birth weight for gestational z-score (β=0.01; 95% CI 0.002 to 0.02; p=0.02) and a greater likelihood of macrosomia (OR=1.04; 95% CI 1.004 to 1.09; p=0.03). After adjustment, maternal diet quality was not associated with infant adiposity at birth, 6 or 12 months.ConclusionsAlthough poor maternal diet quality during pregnancy was not associated with infant adiposity in our study, maternal diet during pregnancy may still be an important and modifiable factor of public health importance.

scholarly journals Temporal Trends in Gestational Diabetes Prevalence, Treatment, and Outcomes at Aarhus University Hospital, Skejby, between 2004 and 2016

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Per Glud Ovesen ◽  
Jens Fuglsang ◽  
Mette Bisgaard Andersen ◽  
Charlotte Wolff ◽  
Olav Bjørn Petersen ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Diabetes ◽  
Insulin Therapy ◽  
Gestational Age ◽  
Temporal Trends ◽  
University Hospital ◽  
Large For Gestational Age ◽  
Z Score ◽  
Glucose Levels ◽  
Obesity And Diabetes

Background. The prevalence of gestational diabetes (GDM) is increasing worldwide. The most important risk of GDM in pregnancy is excessive fetal growth, increasing the risk of complications during delivery as well as long-term complications like obesity and diabetes in both the mother and the offspring. Method. All women with GDM who delivered a singleton between 2004 and 2016 were included. The treatment of GDM patients sought to achieve normal blood glucose levels, primarily by diet and exercise. If the glycemic targets were not reached, insulin therapy was initiated. Birth weight and birth weight Z-score was calculated corrected for gender and gestational age at delivery. Results. The study included 1910 women. The number of GDM women increased significantly each year over the course of the study, as did the proportion requiring insulin therapy. Birth weight and birth weight Z-score fell significantly over the years largely due to a decrease in large for gestational age frequency from 29% to around 19%. Conclusion. During the last 13 years, the number of women diagnosed with GDM has increased. Furthermore, the proportion of GDM women receiving insulin treatment has increased. The birth weight in diet-treated women has been virtually normal for the last 5 years of the reported period.

scholarly journals A Maternal Serum Metabolite Ratio Predicts Large for Gestational Age Infants at Term: A Prospective Cohort Study

2021 ◽  
Author(s):  
Ulla Sovio ◽  
Neil Goulding ◽  
Nancy McBride ◽  
Emma Cook ◽  
Francesca Gaccioli ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Characteristic Curve ◽  
External Validation ◽  
Maternal Serum ◽  
Large For Gestational Age ◽  
Z Score ◽  
Liquid Chromatography Tandem Mass ◽  
Metabolite Ratio ◽  
Ultrahigh Performance Liquid Chromatography

Abstract Context Excessive birth weight is associated with maternal and neonatal complications. However, ultrasonically estimated large for gestational age (LGA; >90th percentile) predicts these complications poorly. Objective To determine whether a maternal serum metabolite ratio developed for fetal growth restriction (FGR) is predictive of birth weight across the whole range, including LGA at birth. Methods Metabolites were measured using ultrahigh performance liquid chromatography-tandem mass spectroscopy. The 4-metabolite ratio was previously derived from an analysis of FGR cases and a random subcohort from the Pregnancy Outcome Prediction study. Here, we evaluated its relationship at 36 weeks of gestational age (wkGA) with birth weight in the subcohort (n = 281). External validation in the Born in Bradford (BiB) study (n = 2366) used the metabolite ratio at 24 to 28 wkGA. Results The inverse of the metabolite ratio at 36 wkGA predicted LGA at term [the area under the receiver operating characteristic curve (AUROCC) = 0.82, 95% CI 0.73 to 0.91, P = 6.7 × 10−5]. The ratio was also inversely associated with birth weight z score (linear regression, beta = −0.29 SD, P = 2.1 × 10−8). Analysis in the BiB cohort confirmed that the ratio at 24 to 28 wkGA predicted LGA (AUROCC = 0.60, 95% CI 0.54 to 0.67, P = 8.6 × 10−5) and was inversely associated with birth weight z score (beta = −0.12 SD, P = 1.3 × 10−9). Conclusions A metabolite ratio which is strongly predictive of FGR is equally predictive of LGA birth weight and is inversely associated with birth weight across the whole range.

scholarly journals Pregnancy Outcomes in Young Women With Youth-Onset Type 2 Diabetes Followed in the TODAY Study

2021 ◽  
Author(s):  
Jeanie B. Tryggestad ◽  
Megan M. Kelsey ◽  
Kimberly L. Drews ◽  
Steven D. Chernausek ◽  
Elia N. Escaname ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Women ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Self Report ◽  
Large For Gestational Age ◽  
Chronic Hypertension ◽  
Onset Type ◽  
Contraception Use

<b>Objective:</b> To assess pregnancy outcomes in young women with youth-onset type 2 diabetes followed in the TODAY study. <p><em><b>Research Design and Methods:</b></em><em> </em>Pregnancy information (outcome, any maternal or fetal complications) was obtained from the female participants by self-report. Additionally, medical records for the pregnancy and the child’s neonatal course were obtained with data abstracted into standardized forms.<em></em></p> <p><b>Results:</b> Over a maximum of 15 years, 260 pregnancies were reported by 141 women (age 21.5 years ± 3.2 years, BMI 35.6 ± 7.2 kg/m<sup>2</sup>, diabetes duration 8.1 ± 3.2 years). Contraception use prior to pregnancy reported by 13.5% of the women. Complications were reported by 65% of the women during their pregnancy. Pregnancy loss was observed in 25.3% and preterm birth in 32.6% of pregnancies. HbA1c ≥ 8% was observed in 31.9% of the pregnancies and 35% of the pregnancies were complicated by chronic hypertension. Nephropathy prior to pregnancy was observed in 25% of the women. In the offspring, 7.8% were classified as small for gestational age, 26.8% large for gestational age, and 17.9% in the macrosomic range.</p> <b>Conclusion:</b> Based on observations from the TODAY cohort, young women with pre-gestational, youth-onset type 2 diabetes had very high rates of maternal complications stemming from significant socioeconomic disadvantage. The substantial maternal and infant complications seen in these young moms could potentially be avoided with improved contraception rates and reproductive planning.

scholarly journals Pregnancy Outcomes in Young Women With Youth-Onset Type 2 Diabetes Followed in the TODAY Study

2021 ◽  
Author(s):  
Jeanie B. Tryggestad ◽  
Megan M. Kelsey ◽  
Kimberly L. Drews ◽  
Steven D. Chernausek ◽  
Elia N. Escaname ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Women ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Self Report ◽  
Large For Gestational Age ◽  
Chronic Hypertension ◽  
Onset Type ◽  
Contraception Use

<b>Objective:</b> To assess pregnancy outcomes in young women with youth-onset type 2 diabetes followed in the TODAY study. <p><em><b>Research Design and Methods:</b></em><em> </em>Pregnancy information (outcome, any maternal or fetal complications) was obtained from the female participants by self-report. Additionally, medical records for the pregnancy and the child’s neonatal course were obtained with data abstracted into standardized forms.<em></em></p> <p><b>Results:</b> Over a maximum of 15 years, 260 pregnancies were reported by 141 women (age 21.5 years ± 3.2 years, BMI 35.6 ± 7.2 kg/m<sup>2</sup>, diabetes duration 8.1 ± 3.2 years). Contraception use prior to pregnancy reported by 13.5% of the women. Complications were reported by 65% of the women during their pregnancy. Pregnancy loss was observed in 25.3% and preterm birth in 32.6% of pregnancies. HbA1c ≥ 8% was observed in 31.9% of the pregnancies and 35% of the pregnancies were complicated by chronic hypertension. Nephropathy prior to pregnancy was observed in 25% of the women. In the offspring, 7.8% were classified as small for gestational age, 26.8% large for gestational age, and 17.9% in the macrosomic range.</p> <b>Conclusion:</b> Based on observations from the TODAY cohort, young women with pre-gestational, youth-onset type 2 diabetes had very high rates of maternal complications stemming from significant socioeconomic disadvantage. The substantial maternal and infant complications seen in these young moms could potentially be avoided with improved contraception rates and reproductive planning.

scholarly journals Maternal urinary concentrations of organophosphate ester metabolites: associations with gestational weight gain, early life anthropometry, and infant eating behaviors among mothers-infant pairs in Rhode Island

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Kathryn A. Crawford ◽  
Nicola Hawley ◽  
Antonia M. Calafat ◽  
Nayana K. Jayatilaka ◽  
Rosemary J. Froehlich ◽  
...  
Keyword(s):  
Weight Gain ◽  
Feeding Behavior ◽  
Infant Feeding ◽  
Rhode Island ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Skinfold Thickness ◽  
Abdominal Circumference ◽  
Gestational Weight ◽  
Gestational Age At Delivery

Abstract Background Organophosphate esters (OPEs)—used as flame retardants and plasticizers—are associated with adverse pregnancy outcomes such as reduced fecundity and live births and increased preterm delivery. OPEs may interfere with growth and metabolism via endocrine-disruption, but few studies have investigated endocrine-related outcomes. The objective of this pilot study (n = 56 mother-infant pairs) was to evaluate associations of OPEs with gestational weight gain (GWG), gestational age at delivery, infant anthropometry, and infant feeding behaviors. Methods We quantified OPE metabolites (bis-2-chloroethyl phosphate [BCEP], bis (1,3-dichloro-2-propyl) phosphate [BDCPP], diphenyl phosphate [DPHP]) in pooled maternal spot urine collected throughout pregnancy (~ 12, 28, and 35 weeks’ gestation). We obtained maternal sociodemographic characteristics from questionnaires administered at enrollment and perinatal characteristics from medical record abstraction. Trained research assistants measured infant weight, length, head and abdominal circumferences, and skinfold thicknesses at birth and 6 weeks postpartum. Mothers reported infant feeding behavior via the Baby Eating Behavior Questionnaire (BEBQ). Using multiple linear regression, we assessed associations of log2-transformed maternal urinary OPE metabolites with GWG, gestational age at delivery, infant anthropometry at birth, weekly growth rate, and BEBQ scores at 6 weeks postpartum. We used linear mixed effects (LME) models to analyze overall infant anthropometry during the first 6 weeks of life. Additionally, we considered effect modification by infant sex. Results We observed weak positive associations between all OPE metabolites and GWG. In LME models, BDCPP was associated with increased infant length (β = 0.44 cm, 95%CI = 0.01, 0.87) and weight in males (β = 0.14 kg, 95%CI = 0.03, 0.24). BDCPP was also associated with increased food responsiveness (β = 0.23, 95%CI = 0.06, 0.40). DPHP was inversely associated with infant abdominal circumference (β = − 0.50 cm, 95%CI = − 0.86, − 0.14) and female weight (β = − 0.19 kg, 95%CI = − 0.36, − 0.02), but positively associated with weekly growth in iliac skinfold thickness (β = 0.10 mm/wk., 95%CI = 0.02, 0.19). Further, DPHP was weakly associated with increased feeding speed. BCEP was associated with greater infant thigh skinfold thickness (β = 0.34 mm, 95%CI = 0.16, 0.52) and subscapular skinfold thickness in males (β = 0.14 mm, 95%CI = 0.002, 0.28). Conclusions Collectively, these findings suggest that select OPEs may affect infant anthropometry and feeding behavior, with the most compelling evidence for BDCPP and DPHP.

scholarly journals Social gradient of birthweight in England assessed using the INTERGROWTH-21st gestational age-specific standard

2018 ◽  
Vol 104 (5) ◽  
pp. F486-F492
Author(s):  
Jane E Hirst ◽  
Hannah Ellin Knight ◽  
Eric O Ohuma ◽  
Terence Dwyer ◽  
Benjamin D Hennig ◽  
...  
Keyword(s):  
Gestational Age ◽  
Cross Sectional Study ◽  
Social Gradient ◽  
Large For Gestational Age ◽  
Z Score ◽  
Cross Sectional ◽  
Socioeconomic Gradient ◽  
Using Data ◽  
Newborn Size ◽  
Deprived Areas

ObjectiveTo determine the socioeconomic gradient of birthweights in England with reference to the prescriptive INTERGROWTH-21st Birthweight Standard.DesignNational cross-sectional study using data from Hospital Episode Statistics.SettingNational Health Service in England.ParticipantsAll singleton babies, live born between 34 weeks’ gestation and 42 weeks’ gestation, between 1 April 2011 and 31 March 2012.Main outcome measuresBirthweight distribution of babies with a birthweight of <10th centile or >90th centile, that is, small for gestational age (SGA) or large for gestational age (LGA) using Index of Multiple Deprivation quintiles as a proxy for socioeconomic status.ResultsOf 508 230 babies born alive between 1 April 2011 and 31 March 2012, 38 838 (7.6%) were SGA and 81 026 (15.9%) were LGA. Median birthweight was 3405 g, median z-score was 0.25 (SD 1.06). Birthweight z-score demonstrated a social gradient, from 0.26 (SD 1.1) in the most deprived areas to 0.53 (1.0) in the least deprived. Women in the most deprived areas were twice as likely to have SGA babies using the INTERGROWTH-21st chart (OR 1.94; 95% CI 1.87 to 2.01) compared with those in the least deprived areas. If all women had the same rate of SGA equivalent to those living in the least deprived areas, approximately 12 410 (30%) fewer babies would be born SGA in England each year.ConclusionsThis study gives a measure of the social gradient in singleton SGA and LGA babies across England using an international standard of newborn size at birth.

scholarly journals Fetal Sex-Dependent Associations Between Gestational Hormone Concentrations and Adverse Birth Outcomes: A Cohort Study

2020 ◽  
Author(s):  
Amber L Cathey ◽  
Deborah J Watkins ◽  
Zaira Y Rosario ◽  
Carmen M Vélez Vega ◽  
Bhramar Mukherjee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Endocrine Function ◽  
Sensitivity Analyses ◽  
Large For Gestational Age ◽  
Adverse Birth Outcomes ◽  
Z Score ◽  
Spontaneous Preterm Birth ◽  
Fetal Sex

Abstract Background: Adverse birth outcomes remain significant public health problems that can have long-lasting impacts on mother and child. Understanding biological mechanisms underlying these outcomes, including altered endocrine function, can inform prevention efforts. Thus, we aimed to explore associations between repeated gestational hormone measurements and birth outcomes. Secondarily, we assessed impacts of fetal sex and timing of hormone measurement on these associations. Methods: We explored associations between repeated gestational hormone measurements and birth outcomes among 976 women in PROTECT, a longitudinal prospective birth cohort in northern Puerto Rico. Birth outcomes assessed included preterm and spontaneous preterm birth (PTB), preeclampsia, gestational diabetes mellitus (GDM), small/large for gestational age (SGA, LGA), birth weight z-score, and gestational age at birth. Multivariate logistic and linear regressions were fit using pregnancy average concentrations of hormones. We also conducted sensitivity analyses assessing impacts of fetal sex and timing of hormone measurement on observed associations. Results: Among male fetuses, spontaneous PTB was associated with increased average corticotropin releasing hormone (CRH) (OR: 2.50, 95% CI: 1.19, 5.24), increased total triiodothyronine (T3) (OR: 1.80, 95% CI: 1.02, 3.16) and decreased testosterone (OR: 0.34, 95% CI: 0.15, 0.74). Odds of GDM increased with average free thyroxine (fT4) (OR: 2.80, 95% CI: 1.06, 7.41), and decreased with average testosterone (OR: 0.23, 95% CI: 0.06, 0.86). Progesterone/estriol ratio was inversely associated with birth weight z-score (b: -0.14, 95% CI: -0.27, -0.01) and gestational age (b: -0.39 weeks, 95% CI: -0.66 , -0.12), and positively associated with odds of SGA (OR: 2.08, 95% CI: 1.36, 3.19). Among females, birth weight z-score was inversely associated with progesterone (b: -0.17, 95% CI: -0.31, -0.02) and total thyroxine (T4) (b: -0.16, 95% CI: -0.30, -0.02), and GDM was inversely associated with progesterone/estriol (OR: 0.34, 95% CI: 0.12, 0.99). Conclusions: Associations between hormones and birth outcomes vary based on timing of hormone measurement and fetal sex. Future studies are needed to understand mechanisms involved in adverse birth outcomes and fetal sex differences.

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