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Maternal obesity and ancestry distance in influencing birth outcomes
Randy Le1,2, Richard J Biedrzycki3, Fasil Tekola-Ayele4
1Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Background:
Maternal pre-pregnancy obesity has been associated with birth outcomes, but the influence of genetic distance (GD) on this relationship is unclear. Therefore, the objective of this study was to assess the interplay of GD and maternal obesity on birthweight, placental weight, and large for gestational age (LGA).
Methods:
We used data from the NICHD Fetal Growth Studies-Singletons cohort, a prospective cohort study of multi-ancestral pregnant women. GD was estimated using data from 1810 women across four ancestral reference populations. We categorized GD into five quintiles, with quintile one and quintile five representing the closest and farthest distances, respectively. Linear regression models were used to test association between GD and birth outcomes and to estimate the association of interaction of GD and maternal obesity with birth outcomes.
Results:
Farther maternal GD from an African reference was significantly associated with higher birthweight and higher odds of LGA, with associations persisting after adjusting for socioeconomic status (SES). The interaction between the third Amerindigenous GD quintile and obesity was significantly associated with a 198 g larger placental weight (95% CI = 51-345, p = 0.009) compared to the first Amerindigenous GD quintile. We also found the interaction between East Asian fourth GD quintile and obesity to be significantly associated with 86.0% lower odds of infants being born LGA (OR = 0.14 g, 95% CI = 0.02-74, p = 0.031) compared to the first quintile. These associations persisted after SES adjustment.
Conclusions:
Interplays between maternal GD from Amerindigenous and East Asian references and pre-pregnancy obesity influence placental weight and risk of LGA. The results underline that consideration of maternal obesity in the context of GD from multiple ancestries and SES may facilitate interventions that will minimize adverse pregnancy outcomes.
Clinical Trial Registration:
The study has been registered at ClinicalTrials.gov (Trial registration: NCT00912132).
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