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Increased fetal adiposity: a very sensitive marker of abnormal in utero development
Patrick M Catalano1, Alicia Thomas, Larraine Huston-Presley
1Department of Reproductive Biology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH 44109, USA. pcatalano@metrohealth.org
Insights
Infants born to mothers with gestational diabetes mellitus (GDM) have higher body fat, even at average birth weight. Maternal fasting glucose levels are the strongest predictor of this increased neonatal adiposity, a risk factor for childhood obesity.
Area of Science:
- Neonatal Health
- Endocrinology
- Pediatric Obesity
Background:
- Offspring of women with gestational diabetes mellitus (GDM) face elevated risks of obesity and diabetes later in life.
- Understanding early life body composition is crucial for predicting long-term health outcomes.
Purpose of the Study:
- To compare the body composition at birth between infants of mothers with GDM and those with normal glucose tolerance.
- To identify factors influencing fetal growth and body composition in pregnancies complicated by GDM.
Main Methods:
- Anthropometric measurements and total body electrical conductivity (TBEC) were used to assess body composition in 195 infants of mothers with GDM and 220 infants of mothers with normal glucose tolerance.
- Stepwise regression analysis incorporated parental and neonatal data to model fetal growth and body composition.
Main Results:
- No significant differences in birth weight or fat-free mass were observed between the two groups.
- Infants of mothers with GDM exhibited significantly greater skinfold measures and fat mass compared to controls.
- Maternal fasting glucose levels strongly correlated with neonatal adiposity in the GDM group, while gestational age correlated with birth weight and fat-free mass.
Conclusions:
- Infants born to mothers with GDM have increased body fat, irrespective of their birth weight for gestational age.
- Maternal fasting glucose is the primary determinant of increased infant fat mass in GDM pregnancies.
- Elevated neonatal body fat may serve as an early indicator for future obesity risk in childhood and adulthood.
Objective:
Because offspring of women with gestational diabetes mellitus have an increased risk of obesity and diabetes mellitus as young adults, our purpose was to characterize body composition at birth in infants of women with gestational diabetes mellitus and normal glucose tolerance.
Study Design:
One hundred ninety-five infants of women with gestational diabetes mellitus and 220 infants of women with normal glucose tolerance had anthropometric measurements and total body electrical conductivity body composition evaluations at birth. Parental demographic, anthropometric, medical and family history data, and diagnostic glucose values were used to develop a stepwise regression model that related to fetal growth and body composition.
Results:
There was no significant difference in birth weight (gestational diabetes mellitus [3398+/-550 g] vs normal glucose tolerance [3337+/-549 g], P=.26) or fat-free mass (gestational diabetes mellitus [2962+/-405 g] vs normal glucose tolerance [2975+/-408 g], P=.74) between groups. However, infants of women with gestational diabetes mellitus had significantly greater skinfold measures (P=.0001) and fat mass (gestational diabetes mellitus [436+/-206 g] vs normal glucose tolerance [362+/-198 g], P=.0002) compared with infants of women with normal glucose tolerance. In the gestational diabetes mellitus group, although gestational age had the strongest correlation with birth weight and fat-free mass, fasting glucose level had the strongest correlation with neonatal adiposity.
Conclusion:
Infants of women with gestational diabetes mellitus, even when they are average weight for gestational age, have increased body fat compared with infants of women with normal glucose tolerance. Maternal fasting glucose level was the strongest predictor of fat mass in infants of women with gestational diabetes mellitus. This increase in body fat may be a significant risk factor for obesity in early childhood and possibly in later life.
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