Dataset Information

Maternal obesity and development of the preterm newborn at 2 years.

ABSTRACT: AIM:To evaluate to what extent extremely preterm children (<28 weeks' gestational age) of overweight (BMI 25-29) or obese (BMI ?30) women are at increased risk of adverse development at 2 years measured with the Bayley Scales of Infant Development II in a multicenter prospective cohort study. METHODS:Heights and prepregnancy weights of the mothers of 852 preterm born children were collected and included in multinomial logistic regression models. RESULTS:Compared to newborns born to mothers with normal BMIs, newborns of obese mothers, but not those of overweight mothers, were more likely to have Bayley Scales indices more than 3 standard deviations below the reference mean (mental: OR = 2.1; 95% CI: 1.3, 3.5) (motor: OR = 1.7; 95% CI: 1.1, 2.7). These associations were even more prominent in children who did not have the intermittent or sustained systemic inflammation profile previously shown to be associated with severely impaired development (mental: OR = 4.6; 95% CI: 1.6, 14) (motor: OR = 3.7; 95% CI: 1.5, 8.9). CONCLUSION:Maternal obesity is associated with an increased risk of impaired offspring development. Some of this impaired development cannot be attributed to confounding due to immaturity, socio-economic correlates or neonatal systemic inflammation.

SUBMITTER: van der Burg JW

PROVIDER: S-EPMC4537690 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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Maternal obesity and development of the preterm newborn at 2 years.

van der Burg Jelske W JW Allred Elizabeth N EN Kuban Karl K O'Shea T Michael TM Dammann Olaf O Leviton Alan A

Acta paediatrica (Oslo, Norway : 1992) 20150529 9

<h4>Aim</h4>To evaluate to what extent extremely preterm children (<28 weeks' gestational age) of overweight (BMI 25-29) or obese (BMI ≥30) women are at increased risk of adverse development at 2 years measured with the Bayley Scales of Infant Development II in a multicenter prospective cohort study.<h4>Methods</h4>Heights and prepregnancy weights of the mothers of 852 preterm born children were collected and included in multinomial logistic regression models.<h4>Results</h4>Compared to newborns ...[more]

PMID: 25982514

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Project description:Oral feeding competency is a major determinant of length of stay in the neonatal intensive care unit. An infant must be able to consistently demonstrate the ability to take all required enteral nutrition by mouth before discharge home. Most infants born prematurely (<37?weeks) will require days, if not weeks, to master this oral feeding competency skill. Inappropriately timed feeding attempts can lead to acute and long-term morbidities, prolonged hospitalizations, and increased health-care costs. Previously, a panel of five genes involved in essential developmental pathways including sensory integration (nephronophthisis 4, Plexin A1), hunger signaling [neuropeptide Y2 receptor (NPY2R), adenosine-monophosphate-activated protein kinase (AMPK)], and facial development (wingless-type MMTV integration site family, member 3) required for oral feeding success were identified in neonatal saliva. This study aimed to translate these five transcriptomic biomarkers into a rapid proteomic platform to provide objective, real-time assessment of oral feeding skills, to better inform care, and to improve neonatal outcomes. Total protein was extracted from saliva of 10 feeding-successful and 10 feeding-unsuccessful infants matched for age, sex, and post-conceptional age. Development of immunoassays was attempted for five oral feeding biomarkers and two reference biomarkers (GAPDH and YWHAZ) to normalize for starting protein concentrations. Normalized protein concentrations were correlated to both feeding status at time of sample collection and previously described gene expression profiles. Only the reference proteins and those involved in hunger signaling were detected in neonatal saliva at measurable levels. Expression patterns for NPY2R and AMPK correlated with the gene expression patterns previously seen between successful and unsuccessful feeders and predicted feeding outcome. Salivary proteins associated with hunger signaling are readily quantifiable in neonatal saliva and may be utilized to assess oral feeding readiness in the newborn. This study lays the foundation for the development of an informative, rapid, proteomic platform to assess neonatal oral feeding maturation.

Project description:BACKGROUND/OBJECTIVES:Acylcarnitines, intermediates of fatty acid oxidation, are known to be involved in obesity and insulin resistance. Since maternal prepregnancy overweight or obesity (OWO) is a recognized major risk factor for offspring OWO, we hypothesized that maternal plasma acylcarnitines may play a role in inter-generational OWO. SUBJECTS/METHODS:This study included 1402 mother-child pairs (1043 term, 359 preterm) recruited at birth from 1998-2013 and followed prospectively up to age 18 years at the Boston Medical Center. The primary outcomes were child OWO defined as BMI???85th percentile for age and sex. The primary exposures were maternal prepregnancy OWO defined as BMI???25 kg/m2 and maternal acylcarnitine levels measured in plasma samples collected soon after delivery using liquid chromatography-tandem mass spectrometry (LC-MS) in a targeted manner. RESULTS:Approximately 40% of the children in this study were OWO by age 5. Maternal OWO had a significant association with childhood OWO, both in term and preterm births. ?-hydroxybutyryl-carnitine (C4-OH) levels were significantly and positively associated with child OWO among term births after adjustment for potential confounders and multiple-comparisons. Children born to OWO mothers in the top tertile C4-OH levels were at the highest risk of OWO: OR?=?3.78 (95%CI: 2.47, 5.79) as compared with those born to non-OWO mothers in the lowest tertile (P for interaction of maternal OWO and C4-OH?=?0.035). In a four-way decomposition of mediation/interaction analysis, we estimated that C4-OH levels explained about 27% (se?=?0.08) of inter-generational OWO risk (P?=?0.001). In contrast, these associations were not observed in preterm births. CONCLUSIONS:In this U.S. urban low-income birth cohort, we provide further evidence of the inter-generational link of OWO and reveal the differential role of C4-OH in explaining the inter-generational obesity between term and preterm births. Further investigations are warranted to better understand and prevent the inter-generational transmission of OWO.

Dataset Information

Maternal obesity and development of the preterm newborn at 2 years.

Publications

Maternal obesity and development of the preterm newborn at 2 years.

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