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Maternal fuels and metabolic measures during pregnancy and neonatal body composition: the healthy start study.

ABSTRACT: CONTEXT:The impact of specific maternal fuels and metabolic measures during early and late gestation on neonatal body composition is not well defined. OBJECTIVE:To determine how circulating maternal glucose, lipids, and insulin resistance in the first and second halves of pregnancy influence neonatal body composition. DESIGN:A prospective pre-birth cohort enrolling pregnant women, the Healthy Start Study, was conducted, in which fasting maternal serum samples were collected twice during pregnancy to measure glucose, insulin, hemoglobin A1c, triglyceride, total cholesterol, high-density lipoprotein, and free fatty acids. Neonatal body composition was measured with air displacement plethysmography. SETTING:An observational epidemiology study of pregnant women attending obstetric clinics at the University of Colorado, Anschutz Medical Center. PARTICIPANTS:This analysis includes 804 maternal-neonate pairs. RESULTS:A strong positive linear relationship between maternal estimated insulin resistance (homeostasis model of assessment for insulin resistance) in the first half of pregnancy and neonatal fat mass (FM) and FM percentage (FM%) was detected, independent of prepregnancy body mass index (BMI). In the second half of pregnancy, positive linear relationships between maternal glucose levels and offspring FM and FM% were observed, independent of prepregnancy BMI. An inverse relationship was detected between high-density lipoprotein in the first half of pregnancy and FM, independent of prepregnancy BMI. Free fatty acid levels in the second half of pregnancy were positively associated with higher birth weight, independent of prepregnancy BMI. CONCLUSION:Maternal insulin resistance in the first half of pregnancy is highly predictive of neonatal FM%, whereas maternal glycemia, even within the normal range, is an important driver of neonatal adiposity in later pregnancy, independent of prepregnancy BMI. Our data provide additional insights on potential maternal factors responsible for fetal fat accretion and early development of adiposity.

SUBMITTER: Crume TL

PROVIDER: S-EPMC4399301 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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Maternal fuels and metabolic measures during pregnancy and neonatal body composition: the healthy start study.

Crume Tessa L TL Shapiro Allison L AL Brinton John T JT Glueck Deborah H DH Martinez Mercedes M Kohn Mary M Harrod Curtis C Friedman Jacob E JE Dabelea Dana D

The Journal of clinical endocrinology and metabolism 20150109 4

<h4>Context</h4>The impact of specific maternal fuels and metabolic measures during early and late gestation on neonatal body composition is not well defined.<h4>Objective</h4>To determine how circulating maternal glucose, lipids, and insulin resistance in the first and second halves of pregnancy influence neonatal body composition.<h4>Design</h4>A prospective pre-birth cohort enrolling pregnant women, the Healthy Start Study, was conducted, in which fasting maternal serum samples were collected ...[more]

PMID: 25574704

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Project description:BACKGROUND:Consistent evidence of an influence of maternal dietary intake during pregnancy on infant body size and composition in human populations is lacking, despite robust evidence in animal models. OBJECTIVE:We sought to evaluate the influence of maternal macronutrient intake and balance during pregnancy on neonatal body size and composition, including fat mass and fat-free mass. STUDY DESIGN:The analysis was conducted among 1040 mother-offspring pairs enrolled in the prospective prebirth observational cohort: the Healthy Start Study. Diet during pregnancy was collected using repeated 24-hour dietary recalls (up to 8). Direct measures of body composition were obtained using air displacement plethysmography. The National Cancer Institute measurement error model was used to estimate usual dietary intake during pregnancy. Multivariable partition (nonisocaloric) and nutrient density (isocaloric) linear regression models were used to test the associations between maternal dietary intake and neonatal body composition. RESULTS:The median macronutrient composition during pregnancy was 32.2% from fat, 15.0% from protein, and 47.8% from carbohydrates. In the partition multivariate regression model, individual macronutrient intake values were not associated with birthweight or fat-free mass, but were associated with fat mass. Respectively, 418 kJ increases in total fat, saturated fat, unsaturated fat, and total carbohydrates were associated with 4.2-g (P = .03), 11.1-g (P = .003), 5.9-g (P = .04), and 2.9-g (P = .02) increases in neonatal fat mass, independent of prepregnancy body mass index. In the nutrient density multivariate regression model, macronutrient balance was not associated with fat mass, fat-free mass, or birthweight after adjustment for prepregnancy body mass index. CONCLUSION:Neonatal adiposity, but not birthweight, is independently associated with increased maternal intake of total fat, saturated fat, unsaturated fat, and total carbohydrates, but not protein, suggesting that most forms of increased caloric intake contribute to fetal fat accretion.

Project description:BackgroundAllergic diseases in children are increasing. Although maternal diet quality in pregnancy may be protective, it is unclear which measure of maternal diet best predicts offspring diseases.ObjectiveTo examine the associations between multiple diet measures and allergy outcomes, and to compare the diagnostic accuracy of the measures for the prediction of allergy outcomes.MethodsMaternal diet during pregnancy was measured using a validated instrument, and scored using 5 measures: the maternal diet index (MDI), Healthy Eating Index, total diet diversity, healthy diet diversity, and unhealthy diet diversity. Unadjusted and adjusted logistic regression models assessed associations between maternal diet measures and offspring allergy outcomes up to age 4 years. The diagnostic accuracy of the diet measures was compared.ResultsThere were significant associations between MDI (odds ratio [OR], 0.78; 95% CI, 0.70-0.87), Healthy Eating Index (OR, 0.98; 95% CI, 0.97-0.99), and healthy diet diversity scores (OR, 0.91; 95% CI, 0.85-0.98) during pregnancy and the primary combined outcome "any allergy excluding wheeze" in children up to age 4 years. Neither maternal total diet diversity (OR, 0.99; 95% CI, 0.95-1.03) nor unhealthy diet diversity scores (OR, 1.05; 95% CI, 0.98-1.13) were associated with the "any allergy excluding wheeze" outcome. For all outcomes studied, except for food allergy, there was a significant difference in the diagnostic accuracy between the 5 measures of maternal diet. The area under the curve for MDI was highest for every disease outcome, although not always significantly higher.ConclusionsBetter quality and higher diversity of a woman's diet during pregnancy, measured in various ways, is associated with offspring allergy outcomes, with healthy foods associated with decreased risk, and unhealthy foods associated with a higher risk. The MDI, which appropriately weighted both healthy and unhealthy foods, best predicted childhood allergic disease.

Project description:Maternal obesity increases adult offspring risk for cardiovascular disease; however, the role of offspring adiposity in mediating this association remains poorly characterized.To investigate the associations of maternal pre-pregnant body mass index (maternal BMI) and gestational weight gain (GWG) with neonatal cardiometabolic markers independent of fetal growth and neonatal adiposity.A total of 753 maternal-infant pairs from the Healthy Start study, a large multiethnic pre-birth observational cohort were used. Neonatal cardiometabolic markers included cord blood glucose, insulin, glucose-to-insulin ratio (Glu/Ins), total and high-density lipoprotein cholesterol (HDL-c), triglycerides, free fatty acids and leptin. Maternal BMI was abstracted from medical records or self-reported. GWG was calculated as the difference between the first pre-pregnant weight and the last weight measurement before delivery. Neonatal adiposity (percent fat mass) was measured within 72?h of delivery using whole-body air-displacement plethysmography.In covariate adjusted models, maternal BMI was positively associated with cord blood insulin (P=0.01) and leptin (P<0.001) levels, and inversely associated with cord blood HDL-c (P=0.05) and Glu/Ins (P=0.003). Adjustment for fetal growth or neonatal adiposity attenuated the effect of maternal BMI on neonatal insulin, rendering the association nonsignificant. However, maternal BMI remained associated with higher leptin (P<0.0011), lower HDL-c (P=0.02) and Glu/Ins (P=0.05), independent of neonatal adiposity. GWG was positively associated with neonatal insulin (P=0.02), glucose (P=0.03) and leptin levels (P<0.001) and negatively associated with Glu/Ins (P=0.006). After adjusting for neonatal adiposity, GWG remained associated with higher neonatal glucose (P=0.02) and leptin levels (P=0.02) and lower Glu/Ins (P=0.048).Maternal weight prior and/or during pregnancy is associated with neonatal cardiometabolic makers including leptin, glucose and HDL-c at delivery, independent of neonatal adiposity. Our results suggest that intrauterine exposure to maternal obesity influences metabolic processes beyond fetal growth and fat accretion.

Project description:ObjectiveTo capture multidimensional maternal psychosocial stress using responses from the Edinburgh Postnatal Depression Scale (EPDS) and Cohen's Perceived Stress Scale (PSS) administered during pregnancy, and to identify sociodemographic, biological, and health behavioral correlates of the stress domains.MethodsUsing data from 1,079 pregnant women, we implemented principal component analysis on EPDS and PSS responses and retained factors based on the Scree plot and Eigenvalues >1. We then used linear regression to identify perinatal correlates of each domain.ResultsWe identified three stress domains: "Feeling Overwhelmed," "Anhedonia," and "Lack of Control," which accounted for 10.6% of variance in questionnaire responses. In multivariable analyses, household income ≤$70,000 (β = 0.21 confidence interval [95% CI: 0.05-0.39]), primiparity (0.36 [0.02-0.71]), inadequate (0.21 [0.04-0.39]) or excessive gestational weight gain (0.27 [0.11-0.42]), and Healthy Eating Index (HEI) score ≤57 (0.14 [0.00-0.28]) were associated with Feeling Overwhelmed. Older age (0.02 [0.00-0.03] per 1-year), Hispanic ethnicity (0.19 [0.00-0.38]), and HEI score ≤57 (0.15 [0.02-0.28]) were associated with Anhedonia. Non-Hispanic Black race/ethnicity (0.37 [0.10-0.63]), not having graduated from college (0.16 [-0.02 to 0.35]), having a partner born outside the United States (0.17 [-0.02 to 0.37]), household size of ≥5 persons (0.21 [-0.02 to 0.37]), receiving public assistance (0.18 [-0.02 to 0.37]), and prenatal smoking (0.32 [0.05-0.59]) were associated with Lack of Control.ConclusionsThree domains of maternal psychosocial stress during pregnancy (Feeling Overwhelmed, Anhedonia, and Lack of Control) were differentially related to sociodemographic, biological, and health behavioral characteristics that may be targets for interventions to ameliorate stress in pregnant women.Clinical trial registry: The Healthy Start study is registered as an observational study at clinicaltrials.gov (NCT #002273297).

Dataset Information

Maternal fuels and metabolic measures during pregnancy and neonatal body composition: the healthy start study.

Publications

Maternal fuels and metabolic measures during pregnancy and neonatal body composition: the healthy start study.

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