Association of ultrasound‐based measures of fetal body composition with newborn adiposity

Abstract

Background Newborns exhibit substantial variation in gestational age- and sex-adjusted fat mass proportion. The antecedent characteristics of fetal body composition that are associated with newborn fat mass proportion are poorly understood. Objective The aim of this study was to determine whether a composite measure of fetal fat mass is prospectively associated with newborn adiposity. Methods In a longitudinal study of 109 low-risk pregnancies, fetal ultrasonography was performed at approximately 12, 20 and 30 weeks gestation. Estimated fetal adiposity (EFA) was derived by integrating cross-sectional arm and thigh percent fat area and anterior abdominal wall thickness. Newborn percent body fat was quantified by Dual Energy X-Ray Absorptiometry. The association between EFA and newborn percent body fat was determined by multiple linear regression. Results After controlling for confounding factors, EFA at 30 weeks was significantly associated with newborn percent body fat (standardized β = 0.41, p < 0.001) and explained 24.0% of its variance, which was substantially higher than that explained by estimated fetal weight (8.1%). The observed effect was driven primarily by arm percent fat area. Conclusions A composite measure of fetal adiposity at 30 weeks gestation may constitute a better predictor of newborn percent body fat than estimated fetal weight by conventional fetal biometry. Fetal arm fat deposition may represent an early indicator of newborn adiposity. After replication, these findings may provide a basis for an improved understanding of the ontogeny of fetal fat deposition, thereby contributing to a better understanding of its intrauterine determinants and the development of potential interventions.

In overweight and obese women, fetal ultrasound biometry accurately predicts newborn measures

“…This relationship is not exactly a 2:1 ratio due to compression of the tissue by the caliper, and may have contributed to the weak correlations in our analysis. Fetal thigh and arm circumferences and volumes utilising both two‐ and three‐dimensional ultrasound techniques have shown the most promising results, improving the predictive value of both macrosomia and infant birthweight in women with obesity and diabetes . There is a clear need for prospective studies with robust methodology, consistency in fetal and neonatal measurement and large sample sizes to further delineate the predictive value of fetal and neonatal adiposity.…”

“…The current literature is limited by the inclusion of women with gestational or pre‐existing diabetes, small sample sizes and a wide variation in the measurement studied . The estimation of fetal adiposity has included arm and thigh volumes, abdominal wall thickness, subscapular fat mass, and other compartments . Tools to assess neonatal adiposity have included skinfold thickness measurements, dual‐energy X‐ray absorptiometry (DEXA) and air displacement plethysmography .…”

“…[13][14][15][16][17][18][19][20] The estimation of fetal adiposity has included arm and thigh volumes, 16,21 abdominal wall thickness, 19,22 subscapular fat mass, 18 and other compartments. 23 Tools to assess neonatal adiposity have included skinfold thickness measurements, 20 dual-energy X-ray absorptiometry (DEXA) 23 and air displacement plethysmography. 21 While air displacement plethysmography 24,25 has been reported to correlate poorly with fetal ultrasound body composition measures, 21 the correlation between fetal ultrasound and neonatal measures, and the impact of maternal obesity have not been reported.…”

Prospective association of fetal liver blood flow at 30 weeks gestation with newborn adiposity

“…11,12 The elucidation of the determinants, underlying mechanisms, and biomarkers of fetal programming of obesity and metabolic dysfunction represents an area of active investigation. 13–15 …”

Foetal fractional thigh volume: an early 3D ultrasound marker of neonatal adiposity

“…Previous studies have assessed the use of prenatal imaging as markers for neonatal adiposity . Standard obstetrical two‐dimensional biometric measures, such as estimated foetal weight, do not predict neonatal adiposity well . A promising three‐dimensional ultrasound (3D US) marker is fractional thigh volume (TVol) .…”