Danielle K Longmore1,2, Elizabeth L M Barr1,3, I-Lynn Lee1, Federica Barzi1, Marie Kirkwood1, Cherie Whitbread1,4, Vanya Hampton1, Sian Graham1, Paula Van Dokkum1,5, Christine Connors6, Jacqueline A Boyle7, Patrick Catalano8, Alex D H Brown9, Kerin O'Dea1, Jeremy Oats10, H David McIntyre11, Jonathan E Shaw3, Louise J Maple-Brown1,4. 1. Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia. 2. Department of Paediatrics, Western Health, Melbourne, Australia. 3. Baker Heart and Diabetes Institute, Melbourne, Australia. 4. Division of Medicine, Royal Darwin Hospital, Darwin, Australia. 5. Baker Heart and Diabetes Institute, Alice Springs, Australia. 6. Northern Territory Department of Health, Darwin, Australia. 7. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. 8. Tufts University School of Medicine, Boston, Massachusetts. 9. South Australian Health and Medical Research Institute, Adelaide, Australia. 10. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. 11. Mater Medical Research Institute, University of Queensland, Brisbane, Australia.
Abstract
BACKGROUND: In-utero exposures likely influence the onset and severity of obesity in youth. With increasing rates of type 2 diabetes mellitus (T2DM) and maternal adiposity in pregnancy globally, it is important to assess the impact of these factors on neonatal adipose measures. OBJECTIVES: To evaluate the contribution of maternal ethnicity, body mass index (BMI), gestational weight gain, and hyperglycaemia to neonatal adiposity. METHODS: Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) is a longitudinal cohort study of Australian mother and neonate pairs. In this analysis, Indigenous (n = 519) and Europid (n = 358) women were included, of whom 644 had hyperglycaemia (type 2 diabetes [T2DM], diabetes in pregnancy [DIP], or gestational diabetes [GDM]). Associations between maternal ethnicity, hyperglycaemia, BMI and gestational weight gain, and the neonatal outcomes of length, head circumference, sum of skinfolds, total body fat, and percentage body fat were examined. Models were adjusted for maternal age, smoking status, parity, education, neonatal gender, and gestational age. RESULTS: Among those with hyperglycaemia in pregnancy, Indigenous women had a higher proportion of T2DM and DIP (36%, 13%) compared with Europid women (4%, 3%). In multivariate analysis, maternal T2DM (compared with no hyperglycaemia), BMI during pregnancy, and excess compared with appropriate gestational weight gain, were significantly associated with greater neonatal measures. DIP was associated with greater sum of skinfolds, total body fat, and percentage body fat. Indigenous ethnicity was associated with greater sum of skinfolds. CONCLUSIONS: Maternal BMI, excess gestational weight gain, and hyperglycaemia operated as independent factors influencing neonatal adiposity. Interventions addressing these factors are needed to reduce neonatal adiposity.
BACKGROUND: In-utero exposures likely influence the onset and severity of obesity in youth. With increasing rates of type 2 diabetes mellitus (T2DM) and maternal adiposity in pregnancy globally, it is important to assess the impact of these factors on neonatal adipose measures. OBJECTIVES: To evaluate the contribution of maternal ethnicity, body mass index (BMI), gestational weight gain, and hyperglycaemia to neonatal adiposity. METHODS:Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) is a longitudinal cohort study of Australian mother and neonate pairs. In this analysis, Indigenous (n = 519) and Europid (n = 358) women were included, of whom 644 had hyperglycaemia (type 2 diabetes [T2DM], diabetes in pregnancy [DIP], or gestational diabetes [GDM]). Associations between maternal ethnicity, hyperglycaemia, BMI and gestational weight gain, and the neonatal outcomes of length, head circumference, sum of skinfolds, total body fat, and percentage body fat were examined. Models were adjusted for maternal age, smoking status, parity, education, neonatal gender, and gestational age. RESULTS: Among those with hyperglycaemia in pregnancy, Indigenous women had a higher proportion of T2DM and DIP (36%, 13%) compared with Europid women (4%, 3%). In multivariate analysis, maternal T2DM (compared with no hyperglycaemia), BMI during pregnancy, and excess compared with appropriate gestational weight gain, were significantly associated with greater neonatal measures. DIP was associated with greater sum of skinfolds, total body fat, and percentage body fat. Indigenous ethnicity was associated with greater sum of skinfolds. CONCLUSIONS: Maternal BMI, excess gestational weight gain, and hyperglycaemia operated as independent factors influencing neonatal adiposity. Interventions addressing these factors are needed to reduce neonatal adiposity.
Authors: I-Lynn Lee; Elizabeth L M Barr; Danielle Longmore; Federica Barzi; Alex D H Brown; Christine Connors; Jacqueline A Boyle; Marie Kirkwood; Vanya Hampton; Michael Lynch; Zhong X Lu; Kerin O'Dea; Jeremy Oats; H David McIntyre; Paul Zimmet; Jonathan E Shaw; Louise J Maple-Brown Journal: Diabetologia Date: 2020-01-08 Impact factor: 10.122
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