Stephanie V Wrottesley1, Alessandra Prioreschi1, Shane A Norris1,2. 1. SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 2. Global Health Research Institute, School of Health and Human Development, University of Southampton, Southampton General Hospital, Southampton, UK.
Abstract
OBJECTIVE: To examine associations between maternal body mass index (BMI), gestational weight gain (GWG) and fetal growth and neonatal adiposity in urban South Africans. METHODS: Maternal BMI was assessed at recruitment and GWG (kg/week) was calculated. Longitudinal fetal growth was measured via ultrasound and modelled using Superimposition by Translation and Rotation (SITAR). Neonatal adiposity was assessed using air displacement plethysmography or dual-energy X-ray absorptiometry. Multiple linear regression models were used to examine associations between maternal BMI, GWG and SITAR fetal growth parameters and neonatal fat mass index (FMI; kg/m3 ) in 304 mother-neonate pairs. RESULTS: In pooled analyses, longitudinally modelled abdominal circumference size (β = 0.64 kg/m3 , P < .001) and velocity (β = 8.39 kg/m3 , P < .001) and biparietal diameter velocity (β = 4.55 kg/m3 , P = .020) were positively associated with neonatal FMI. GWG was positively associated with neonatal FMI in preliminary models (β = 1.07 kg/m3 per 1 kg/week; P = .040), with pooled models indicating mediation via fetal growth. CONCLUSION: In utero abdominal growth is predictive of neonatal adiposity. Additionally, greater fetal growth - particularly of the abdominal circumference - mediates the effect of GWG on neonatal adiposity. In settings such as South Africa, strategies to ensure healthy pregnancy weight gain can contribute to prevention of intergenerational obesity risk.
OBJECTIVE: To examine associations between maternal body mass index (BMI), gestational weight gain (GWG) and fetal growth and neonatal adiposity in urban South Africans. METHODS: Maternal BMI was assessed at recruitment and GWG (kg/week) was calculated. Longitudinal fetal growth was measured via ultrasound and modelled using Superimposition by Translation and Rotation (SITAR). Neonatal adiposity was assessed using air displacement plethysmography or dual-energy X-ray absorptiometry. Multiple linear regression models were used to examine associations between maternal BMI, GWG and SITAR fetal growth parameters and neonatal fat mass index (FMI; kg/m3 ) in 304 mother-neonate pairs. RESULTS: In pooled analyses, longitudinally modelled abdominal circumference size (β = 0.64 kg/m3 , P < .001) and velocity (β = 8.39 kg/m3 , P < .001) and biparietal diameter velocity (β = 4.55 kg/m3 , P = .020) were positively associated with neonatal FMI. GWG was positively associated with neonatal FMI in preliminary models (β = 1.07 kg/m3 per 1 kg/week; P = .040), with pooled models indicating mediation via fetal growth. CONCLUSION: In utero abdominal growth is predictive of neonatal adiposity. Additionally, greater fetal growth - particularly of the abdominal circumference - mediates the effect of GWG on neonatal adiposity. In settings such as South Africa, strategies to ensure healthy pregnancy weight gain can contribute to prevention of intergenerational obesity risk.
Authors: Shane A Norris; Catherine E Draper; Alessandra Prioreschi; C M Smuts; Lisa Jayne Ware; CindyLee Dennis; Philip Awadalla; D Bassani; Zulfiqar Bhutta; Laurent Briollais; D William Cameron; Tobias Chirwa; B Fallon; C M Gray; Jill Hamilton; J Jamison; Heather Jaspan; Jennifer Jenkins; Kathleen Kahn; A P Kengne; Estelle V Lambert; Naomi Levitt; Marie-Claude Martin; Michele Ramsay; Daniel Roth; Stephen Scherer; Daniel Sellen; Wiedaad Slemming; Deborah Sloboda; M Szyf; Stephen Tollman; Mark Tomlinson; Suzanne Tough; Stephen G Matthews; Linda Richter; Stephen Lye Journal: BMJ Open Date: 2022-04-21 Impact factor: 3.006