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Maternal and pregnancy related predictors of cardiometabolic traits in newborns
Katherine M Morrison1, Sonia S Anand, Salim Yusuf
1Department of Pediatrics, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada. kmorrison@mcmaster.ca
Insights
Maternal health and pregnancy factors influence newborn cardiometabolic traits beyond gestational age. These findings highlight key determinants of infant metabolic health for future research.
Area of Science:
- Cardiometabolic health research
- Perinatal and developmental origins of health and disease (DOHaD)
Background:
- The impact of maternal and pregnancy factors on offspring cardiometabolic health at birth is not fully understood.
- This study aimed to investigate these influences in a prospective cohort.
Purpose of the Study:
- To examine the association between maternal characteristics, health behaviors, pregnancy factors, and newborn cardiometabolic traits.
- To identify key determinants of infant cardiometabolic health at birth.
Main Methods:
- The Family Atherosclerosis Monitoring In earLY life (FAMILY) Study prospectively enrolled 901 infants and 857 mothers.
- Evaluated 11 newborn cardiometabolic traits and their relationship with maternal pre-pregnancy health, behaviors, and pregnancy characteristics.
- Utilized principal component analysis to group newborn traits and identify determinants.
Main Results:
- Greater gestational age positively influenced newborn lipids, glucose, insulin, body fat, and blood pressure.
- Maternal pre-pregnancy weight and gestational weight gain were key predictors of infant anthropometry and insulin resistance.
- Maternal smoking and dietary fat intake were inversely associated with infant anthropometry/insulin.
- Maternal age was linked to lipid profiles, while hypertension and triglycerides were associated with newborn triglycerides.
- Placental-fetal ratio was inversely associated with newborn glycemia.
Conclusions:
- Maternal health, behaviors, and placental-fetal ratio are significant determinants of newborn cardiometabolic traits, independent of gestational age.
- These factors may play a crucial role in establishing long-term cardiometabolic health trajectories in children.
- Further research is warranted to confirm the persistence of these associations throughout childhood.
Background:
The influence of multiple maternal and pregnancy characteristics on offspring cardiometabolic traits at birth is not well understood and was evaluated in this study.
Methods And Findings:
The Family Atherosclerosis Monitoring In earLY life (FAMILY) Study prospectively evaluated 11 cardiometabolic traits in 901 babies born to 857 mothers. The influence of maternal age, health (pre-pregnancy weight, blood pressure, glycemic status, lipids), health behaviors (diet, activity, smoking) and pregnancy characteristics (gestational age at birth, gestational weight gain and placental-fetal ratio) were examined. Greater gestational age influenced multiple newborn cardiometabolic traits including cord blood lipids, glucose and insulin, body fat and blood pressure. In a subset of 442 singleton mother/infant pairs, principal component analysis grouped 11 newborn cardiometabolic traits into 5 components (anthropometry/insulin, 2 lipid components, blood pressure and glycemia), accounting for 74% of the variance of the 11 outcome variables. Determinants of these components, corrected for sex and gestational age, were examined. Baby anthropometry/insulin was independently predicted by higher maternal pre-pregnancy weight (standardized estimate 0.30) and gestational weight gain (0.30; both p<0.0001) and was inversely related to smoking during pregnancy (-0.144; p = 0.01) and maternal polyunsaturated to saturated fat intake (-0.135;p = 0.01). Component 2 (HDL-C/Apo Apolipoprotein1) was inversely associated with maternal age. Component 3 (blood pressure) was not clustered with any other newborn cardiometabolic trait and no associations with maternal pregnancy characteristics were identified. Component 4 (triglycerides) was positively associated with maternal hypertension and triglycerides, and inversely associated with maternal HDL and age. Component 5 (glycemia) was inversely associated with placental/fetal ratio (-0.141; p = 0.005). LDL-C was a bridging variable between the lipid factors and glycemia.
Conclusions:
Maternal health, health behaviours and placenta to fetal weight ratio are associated with newborn cardiometabolic traits over and above gestational age. Future investigations are needed to determine if these factors remain important determinants of cardiometabolic health throughout childhood.
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