Body mass index, gestational weight gain and fatty acid concentrations during pregnancy: the Generation R Study

Vidakovic, Aleksandra Jelena; Jaddoe, Vincent W. V.; Gishti, Olta; Felix, Janine F.; Williams, Michelle A.; Hofman, Albert; Demmelmair, Hans; Koletzko, Berthold; Tiemeier, Henning; Gaillard, Romy

doi:10.1007/s10654-015-0106-6

Cited by 49 publications

(51 citation statements)

References 52 publications

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“…In non-pregnant populations, 3-hydroxybutyrate was negatively or not associated with BMI; fatty acids were generally positively associated. In pregnancy, 3-hydroxybutyrate was positively associated with maternal BMI while medium- and long-chain fatty acids demonstrated a mix of negative and positive associations, similar to recently reported negative and positive associations of long-chain fatty acids with maternal BMI at ~20 weeks gestation [43]. Enhanced placental transfer of select fatty acids important for fetal development, e.g.…”

Section: Discussionsupporting

confidence: 79%

Associations of maternal BMI and insulin resistance with the maternal metabolome and newborn outcomes

Sandler¹,

Reisetter²,

Bain

et al. 2016

Diabetologia

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Aims/hypothesis Maternal obesity increases the risk for large-for-gestational-age birth and excess newborn adiposity, which are associated with adverse long-term metabolic outcomes in offspring, probably due to effects mediated through the intrauterine environment. We aimed to characterise the maternal metabolic milieu associated with maternal BMI and its relationship to newborn birthweight and adiposity. Methods Fasting and 1 h serum samples were collected from 400 European-ancestry mothers in the Hyperglycaemia and Adverse Pregnancy Outcome Study who underwent an OGTT at ~28 weeks gestation and whose offspring had anthropometric measurements at birth. Metabolomics assays were performed using biochemical analyses of conventional clinical metabolites, targeted MS-based measurement of amino acids and acylcarnitines and non-targeted GC/MS. Results Per-metabolite analyses demonstrated broad associations with maternal BMI at fasting and 1 h for lipids, amino acids and their metabolites together with carbohydrates and organic acids. Similar metabolite classes were associated with insulin resistance with unique associations including branched-chain amino acids. Pathway analyses indicated overlapping and unique associations with maternal BMI and insulin resistance. Network analyses demonstrated collective associations of maternal metabolite subnetworks with maternal BMI and newborn size and adiposity, including communities of acylcarnitines, lipids and related metabolites, and carbohydrates and organic acids. Random forest analyses demonstrated contribution of lipids and lipid-related metabolites to the association of maternal BMI with newborn outcomes. Conclusions/interpretation Higher maternal BMI and insulin resistance are associated with broad-based changes in maternal metabolites, with lipids and lipid-related metabolites accounting, in part, for the association of maternal BMI with newborn size at birth.

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Section: Discussionsupporting

confidence: 79%

Associations of maternal BMI and insulin resistance with the maternal metabolome and newborn outcomes

Sandler¹,

Reisetter²,

Bain

et al. 2016

Diabetologia

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show abstract

“…Lipid factor 2 was composed of saturated fatty acids including palmitic acid, which alone was higher in OW/OB mothers. The higher palmitic acid may reflect an overall higher concentration of saturated fatty acids related to dietary intake in mothers with increased weight status and leads to mixed infant outcomes (Jenkins, West, & Koulman, ; Panagos et al, ; Petersen et al, ; Pfeuffer & Jaudszus, ; Vidakovic et al, ). This is consistent with a lack of relationship of lipid factor 2 with infant weight and length growth in our cohort.…”

Section: Discussionmentioning

confidence: 99%

Impact of maternal overweight and obesity on milk composition and infant growth

Ellsworth

Perng

Harman

et al. 2020

Maternal & Child Nutrition

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Overweight and obesity (OW/OB) impact half of the pregnancies in the United States and can have negative consequences for offspring health. Studies are limited on human milk alterations in the context of maternal obesity. Alterations in milk are hypothesized to impact offspring development during the critical period of lactation. We aimed to evaluate the relationships between mothers with OW/OB (body mass index [BMI] ≥25 kg/m2), infant growth, and selected milk nutrients. We recruited mother–infant dyads with pre‐pregnancy OW/OB and normal weight status. The primary study included 52 dyads with infant growth measures through 6 months. Thirty‐two dyads provided milk at 2 weeks, which was analysed for macronutrients, long‐chain fatty acids, and insulin. We used multivariable linear regression to examine the association of maternal weight status with infant growth, maternal weight status with milk components, and milk components with infant growth. Mothers with OW/OB had infants with higher weight‐for‐length (WFL) and BMI Z‐scores at birth. Mothers with OW/OB had higher milk insulin and dihomo‐gamma‐linolenic, adrenic, and palmitic acids and reduced conjugated linoleic and oleic acids. N6 long‐chain polyunsaturated fatty acid (LC‐PUFA)‐driven factor 1 was associated with higher WFL, lower length‐for‐age (LFA), and lower head circumference‐for‐age Z‐scores change from 2 weeks to 2 months in human milk‐fed infants, whereas N6 LC‐PUFA‐driven factor 5 was associated with lower LFA Z‐score change. Human milk composition is associated with maternal pre‐pregnancy weight status and composition may be a contributing factor to early infant growth trajectory.

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“…In the context of this study, obese women did not exhibit overt hyperglycaemia or glucose intolerance (data not shown); this does not point towards a role for maternal plasma glucose in placental TLR4 activation. However, in late pregnancy the decreased ability of obese women to respond to the anti-lipolytic effect of insulin results in an increased circulating NEFA concentration under insulin-stimulated condition [35–37]. Furthermore, the placentas of obese women, compared with their lean counterparts, have an enhanced capacity for lipid storage [38].…”

Section: Discussionmentioning

confidence: 99%

Causal relationship between obesity-related traits and TLR4-driven responses at the maternal–fetal interface

Yang

Haghiac

et al. 2016

Diabetologia

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Aims/hypothesis Obesity triggers complex inflammatory networks within the innate immune system. During pregnancy, the placenta amplifies the low-grade inflammation through activation of Toll-like receptor 4 (TLR4) signalling pathways. The purpose of this study was to investigate the impact of obesity on placental TLR4 expression and inflammatory signals. The secondary aim was to analyse the placental cell type responsible for TLR4 activation. Methods Thirty-nine women recruited at term-scheduled Caesarean section were grouped according to their pre-gravid BMI (< 25 kg/m2 and > 30 kg/m2). Placenta, venous maternal and cord blood were obtained at delivery for analysis. Data were analysed with linear regression and Spearman’s rank correlation coefficient analysis. Results TLR4, IL6 and IL8 expression was increased three- to ninefold (p < 0.001) in the placenta of obese vs lean women. There was a positive correlation between placental TLR4 and maternal systemic and placental IL6 and IL8 concentrations. Placental TLR4 expression was correlated with maternal pre-gravid BMI, insulin resistance index, plasma insulin and C-reactive protein (r = 0.57, 0.31, 0.35, 0.53, respectively; p < 0.001) but not with plasma glucose, maternal age, gestational age and gestational weight gain (r < 0.2; p > 0.1). TLR4 was located in both trophoblast and macrovascular endothelial cells lining fetal vasculature. Lipopolysaccharide-induced TLR4 activation was more robust in trophoblasts than in endothelial vascular cells (100-fold vs tenfold; p < 0.001). Conclusions/interpretation Trophoblastic TLR4 is implicated in the propagation of placental inflammation. Placental inflammation is related to maternal metabolic conditions such as pre-gravid BMI, whilst gestational weight gain or gestational age are not. These results implicate the pre-gravid condition as a significant contributor to metabolic inflammation in late pregnancy.

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Body mass index, gestational weight gain and fatty acid concentrations during pregnancy: the Generation R Study

Cited by 49 publications

References 52 publications

Associations of maternal BMI and insulin resistance with the maternal metabolome and newborn outcomes

Associations of maternal BMI and insulin resistance with the maternal metabolome and newborn outcomes

Impact of maternal overweight and obesity on milk composition and infant growth

Causal relationship between obesity-related traits and TLR4-driven responses at the maternal–fetal interface

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