Effects of early pregnancy BMI, mid-gestational weight gain, glucose and lipid levels in pregnancy on offspring's birth weight and subcutaneous fat: A population-based cohort study

摘要

Background: Maternal glucose and lipid levels are associated with neonatal anthropometry of the offspring, alsoindependently of maternal body mass index (BMI). Gestational weight gain, however, is often not accounted for.The objective was to explore whether the effects of maternal glucose and lipid levels on offspring’s birth weightand subcutaneous fat were independent of early pregnancy BMI and mid-gestational weight gain.Methods: In a population-based, multi-ethnic, prospective cohort of 699 women and their offspring, maternalanthropometrics were collected in gestational week 15 and 28. Maternal fasting plasma lipids, fasting and 2-hourglucose post 75 g glucose load, were collected in gestational week 28. Maternal risk factors were standardized usingz-scores. Outcomes were neonatal birth weight and sum of skinfolds in four different regions.Results: Mean (standard deviation) birth weight was 3491 ± 498 g and mean sum of skinfolds was 18.2 ± 3.9mm. Maternal fasting glucose and HDL-cholesterol were predictors of birth weight, and fasting and 2-hour glucosewere predictors of neonatal sum of skinfolds, independently of weight gain as well as early pregnancy BMI, gestationalweek at inclusion, maternal age, parity, smoking status, ethnic origin, gestational age and offspring’s sex. However,weight gain was the strongest independent predictor of both birth weight and neonatal sum of skinfolds, with a 0.21kg/week increased weight gain giving a 110.7 (95% confidence interval 76.6-144.9) g heavier neonate, and with 0.72(0.38-1.06) mm larger sum of skinfolds. The effect size of mother’s early pregnancy BMI on birth weight was higher innon-Europeans than in Europeans.Conclusions: Maternal fasting glucose and HDL-cholesterol were predictors of offspring’s birth weight, and fasting and2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain. Mid-gestational weightgain was a stronger predictor of both birth weight and neonatal sum of skinfolds than early pregnancy BMI, maternalglucose and lipid levels.