Visceral Adiposity in the First Half of Pregnancy in Association with Glucose, Lipid and Insulin Profiles in Later Pregnancy: A Cohort Study.

Background Obesity is the most common risk factor in pregnancy but few studies have assessed the association of between visceral adiposity (VAT) depth in early to mild pregnancy and insulin resistance (IR), dysglycemia and dyslipidemia in later pregnancy. Objective To assess the association between VAT depth in early to mid pregnancy and IR [homeostatic model assessment of IR (HOMA-IR)], dysglycemia and dyslipidemia in later pregnancy. Methods We completed a prospective cohort study of 344 pregnant women at a single large hospital in Recife, Brazil. VAT depth was measured by ultrasound at 15-20 weeks gestation. Serum glucose, insulin and lipids were evaluated at 32-37 weeks gestation. Results In contrast to pre-pregnancy body mass index (BMI), VAT depth at 15-20 weeks was generally inferior in explaining the variation in the biochemical measures at 32-37 weeks gestation. This was the case for fasting HOMA-IR (adjusted r(2): 0.21 vs. 0.11, respectively), fasting insulin (adjusted r(2): 0.27 vs. 0.09, respectively), and lipids. Only for fasting glucose was the opposite true, but marginally (adjusted r(2) 0.03 vs. 0.06, respectively). Conclusion VAT depth measured in the first half of pregnancy is not better than pre-pregnancy BMI in predicting IR and related biochemical measures in later pregnancy.