R Retnakaran1, S W Wen2, H Tan3, S Zhou4, C Ye5, M Shen2, G N Smith6, M C Walker7. 1. Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada; Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada. Electronic address: ravi.retnakaran@sinaihealthsystem.ca. 2. OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada; School of Public Health, Central South University, Changsha, China. 3. School of Public Health, Central South University, Changsha, China. 4. Liuyang Municipal Hospital of Maternal and Child Health, Beizheng, Liuyang, China. 5. Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada. 6. Queen's Perinatal Research Unit, Department of Obstetrics and Gynecology, Queen's University, Kingston, Canada. 7. OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada.
Abstract
BACKGROUND AND AIMS: Both low birthweight and high birthweight have been associated with the development of cardiometabolic disease in adulthood, possibly reflecting the effect of intrauterine fetal programming. As developmental programming can begin before conception, pre-gravid factors that predict birthweight may be relevant in this context. However, little is known about such factors. Thus, we established a pre-conception cohort to identify maternal pre-gravid cardiometabolic determinants of infant birthweight. METHODS AND RESULTS: In this prospective observational cohort study, 1484 newly-married women in Liuyang, China, underwent baseline (pre-gravid) evaluation and then were followed across a subsequent pregnancy. Pre-gravid cardiometabolic characterization consisted of clinical (anthropometry, blood pressure) and biochemical evaluation (total/LDL/HDL cholesterol, triglycerides, glucose) at median 20 weeks before a singleton pregnancy. Mean birthweight was 3294 ± 444 g, with 173 neonates large-for-gestational-age (LGA) and 110 small-for-gestational-age (SGA). On multiple linear regression analysis, positive determinants of birthweight were maternal age, pre-gravid body mass index (BMI), weight gain in pregnancy, length of gestation, and male infant (all p ≤ 0.0003). On logistic regression analysis, independent predictors of an LGA delivery were maternal age (OR = 1.10 per year, 95%CI 1.03-1.18), pre-gravid BMI (OR = 1.21 per kg/m2, 1.07-1.37), and gestational weight gain (OR = 1.10 per kg, 1.06-1.14). The only independent predictor of SGA was gestational weight gain (OR = 0.93 per kg, 0.89-0.97). CONCLUSION: Maternal weight before and during pregnancy is the predominant cardiometabolic determinant of infant birthweight, rather than pre-gravid blood pressure, glucose or lipid profile.
BACKGROUND AND AIMS: Both low birthweight and high birthweight have been associated with the development of cardiometabolic disease in adulthood, possibly reflecting the effect of intrauterine fetal programming. As developmental programming can begin before conception, pre-gravid factors that predict birthweight may be relevant in this context. However, little is known about such factors. Thus, we established a pre-conception cohort to identify maternal pre-gravid cardiometabolic determinants of infant birthweight. METHODS AND RESULTS: In this prospective observational cohort study, 1484 newly-married women in Liuyang, China, underwent baseline (pre-gravid) evaluation and then were followed across a subsequent pregnancy. Pre-gravid cardiometabolic characterization consisted of clinical (anthropometry, blood pressure) and biochemical evaluation (total/LDL/HDL cholesterol, triglycerides, glucose) at median 20 weeks before a singleton pregnancy. Mean birthweight was 3294 ± 444 g, with 173 neonates large-for-gestational-age (LGA) and 110 small-for-gestational-age (SGA). On multiple linear regression analysis, positive determinants of birthweight were maternal age, pre-gravid body mass index (BMI), weight gain in pregnancy, length of gestation, and male infant (all p ≤ 0.0003). On logistic regression analysis, independent predictors of an LGA delivery were maternal age (OR = 1.10 per year, 95%CI 1.03-1.18), pre-gravid BMI (OR = 1.21 per kg/m2, 1.07-1.37), and gestational weight gain (OR = 1.10 per kg, 1.06-1.14). The only independent predictor of SGA was gestational weight gain (OR = 0.93 per kg, 0.89-0.97). CONCLUSION: Maternal weight before and during pregnancy is the predominant cardiometabolic determinant of infant birthweight, rather than pre-gravid blood pressure, glucose or lipid profile.
Authors: Roslyn Mainland; Shi Wu Wen; Hongzhuan Tan; Shujin Zhou; Chang Ye; Minxue Shen; Graeme N Smith; Mark C Walker; Ravi Retnakaran Journal: Womens Health Rep (New Rochelle) Date: 2021-03-23
Authors: Ravi Retnakaran; Shi Wu Wen; Hongzhuan Tan; Shujin Zhou; Chang Ye; Minxue Shen; Graeme N Smith; Mark C Walker Journal: JAMA Netw Open Date: 2021-12-01
Authors: Sarah Louise Killeen; Cara A Yelverton; Aisling A Geraghty; Maria A Kennelly; Shane Eakins; Lily Farrell; Jillian F Fagan; John Mehegan; Fionnuala M McAuliffe Journal: Clin Obes Date: 2022-02-24