Pancreatic Beta Cell Function in Infants Varies by Maternal Weight

Area of Science:

• Endocrinology
• Pediatrics
• Maternal-Fetal Medicine

Background:

• Maternal nutritional status is a critical determinant of fetal development and long-term health.
• Infant pancreatic beta cell function and insulin resistance are key metabolic parameters influenced by the intrauterine environment.

Purpose of the Study:

• To investigate the association between maternal pre-pregnancy weight categories and infant pancreatic beta cell function and insulin resistance up to 7 months postpartum.
• To explore potential U-shaped relationships between maternal weight and infant metabolic adaptations.

Main Methods:

• Prospective cohort study in Hyderabad, India, involving pregnant women classified as underweight (UW), normal weight (NW), or overweight (OW) based on first-trimester BMI.
• Infant oral glucose tolerance tests (OGTT) and blood C-peptide/glucose assays were performed at >7 months postpartum.
• Infant beta cell function (HOMA2-B, disposition index [DI]) and insulin resistance (HOMA2-IR) were calculated and compared across maternal weight groups.

Main Results:

• Infant cord HOMA2-B showed a U-shaped relationship with maternal weight, being significantly higher in UW and OW groups compared to NW.
• No significant differences in infant HOMA2-IR at birth were observed across maternal weight groups.
• By 7 months postpartum, infants of UW mothers showed the largest median reduction in HOMA2-IR, while infants of OW mothers showed the least.
• Infant disposition index (DI) at 7 months was significantly higher in the UW group compared to NW and OW groups.

Conclusions:

• Maternal pre-pregnancy weight influences infant pancreatic beta cell function and insulin sensitivity, with distinct adaptations observed in infants of underweight and overweight mothers.
• The findings highlight the role of the maternal nutritional environment in programming infant metabolic health, suggesting potential long-term implications for glucose homeostasis.