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Prenatal markers of neonatal fat mass: A systematic review
Jorine A Roelants1, Rogier C J de Jonge1, Régine P M Steegers-Theunissen2
1Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
Insights
No reliable prenatal markers currently identify fetuses at risk for neonatal adiposity. Further research is needed to find clinically applicable methods for assessing infant body composition during pregnancy.
Area of Science:
- Perinatal health
- Neonatal development
- Maternal-fetal medicine
Background:
- Prenatal environmental factors can permanently influence offspring phenotype.
- Identifying fetuses at risk for neonatal adiposity requires clinically applicable markers.
- Neonatal adiposity has lifelong health implications.
Purpose of the Study:
- To systematically review existing literature on prenatal markers for neonatal fat mass.
- To evaluate the clinical applicability of identified prenatal markers for neonatal adiposity risk.
Main Methods:
- Systematic literature search for original English research papers.
- Inclusion criteria: dynamic prenatal markers, neonatal fat mass measured within one month post-birth using validated methods (e.g., DXA, MRI).
- Independent review of study selection, quality assessment (QUADAS-II), and clinical applicability appraisal.
Main Results:
- 16 studies were included from 2333 initially identified; only 4 were of moderate/high methodological and statistical quality.
- Investigated prenatal markers included ultrasound parameters, maternal biochemical markers (e.g., BMI, glucose, HbA1c), and maternal characteristics, yielding inconsistent results.
- Clinical applicability of all assessed markers was rated as poor, precluding meta-analysis due to heterogeneity.
Conclusions:
- Despite identified associations, no prenatal marker proved sufficiently reliable or clinically applicable for identifying neonatal adiposity risk.
- Lack of methodological/statistical quality, inconsistent findings, and poor applicability limit current options.
- No markers were assessed during the periconceptional or embryonic periods, indicating a research gap.
Background:
Environmental influences during pregnancy are able to affect off spring phenotype with lifelong effects. Clinical applicable markers are needed to identify foetuses at risk for neonatal adiposity. This systematic review aims to 1) review the current literature on prenatal markers of neonatal fat mass, and 2) appraise the clinical applicability of the assessed markers.
Methods:
A systematic literature search was conducted to identify studies meeting the following inclusion criteria: 1) original research papers in English; 2) research on dynamic and measurable prenatal markers of neonatal fat mass; 3) neonatal fat mass measurement within one month after birth, using the four-compartment model, magnetic resonance imaging, dual-energy X-ray absorptiometry or air displacement plethysmography. Two reviewers independently performed study selection, assessment of methodological (QUADAS-II) and statistical quality and appraisal of clinical applicability.
Results:
Of 2333 studies primarily identified by the search strategy, 16 studies were included. Four of these were both methodologically and statistically of moderate or high quality. Prenatal markers investigated were ultrasound parameters, maternal biochemical markers and maternal characteristics. Markers of predefined interest were maternal pre-pregnancy body mass index, fasting glucose and HbA1c, showing varying results. A meta-analysis was not possible due to substantial methodological heterogeneity. Clinically applicability of all markers was rated poor.
Conclusions:
Although associations were found, no useful marker was identified, due to lack of methodological and statistical quality, inconsistent results and poor clinical applicability. No markers were investigated in the periconceptional and embryonic period.
