Fetal Growth Trajectories and Their Association with Maternal, Cord Blood, and 5-year Child Adipokines

Abstract

Background. The growth of the fetus is a complex process influenced by multiple factors. Studies have highlighted the important role of biochemical growth markers such as leptin and adiponectin on fetal growth. Objective. To compare fetal growth trajectories with biochemical growth markers from maternal blood samples at 28 weeks’ gestation, cord blood samples at birth, and in child blood samples at 5 years of age from mother-infant pairs who were part of the longitudinal ROLO study. Methods. 781 mother-infant pairs from the ROLO and ROLO Kids study were included. Ultrasound measurements and birth weight were used to develop fetal growth trajectory groups for estimated abdominal circumference and estimated weight. Blood serum levels of leptin, adiponectin, insulin, TNF-alpha, and IL-6 from maternal, cord, and 5-year child samples were recorded. ANOVA and chi-square tests were applied to test the associations between fetal growth trajectory membership and maternal and child biochemical growth indicators. The influence of child sex was also investigated. Results. Male sex was associated with a faster weight trajectory compared to females (p=0.001). At 28 weeks’ gestation, maternal leptin levels were significantly higher in mothers with a fetus on a slower estimated abdominal circumference trajectory compared to fast (25616 [IQR: 11656.0 to 35341.0] vs. 14753.8 [IQR: 8565.4 to 24308.1], p<0.001) and maternal adiponectin levels were lower in fetuses on a slower estimated abdominal circumference trajectory compared to a fast trajectory (22.4 [IQR: 13.6 to 35.9] vs. 27.6 [IQR: 17.6 to 46.3], p=0.027). No associations were noted with inflammatory markers. No associations were identified between fetal growth trajectories and growth markers at 5 years of age. Conclusions. This study shows that male sex is associated with an accelerated estimated weight trajectory. Furthermore, high leptin and low adiponectin in maternal serum in late gestation are associated with a slower fetal growth trajectory. No associations were identified with blood growth markers after pregnancy.

Associations between maternal metabolic parameters during pregnancy and fetal and child growth trajectories from 20 weeks' gestation to 5 years of age: Secondary analysis from the ROLO longitudinal birth cohort study

“…Maternal BMI has been shown in various studies to influence birth weight, with a positive correlation between higher maternal BMI and birth weight. 21 , 47 Differences in fetal growth among various ethnic groups have also previously been described, 48 , 49 with current recommendations that fetal growth centiles should take into account maternal ethnicity to avoid incorrect diagnosis of growth restriction. 50 Furthermore, socioeconomic status, which is often measured by education level, has been shown as a key determinant of birth weight.…”

“…Compared to our work, participants in the HAPO study had a similar BMI, however, were of a more diverse ethnicity and had no history of a macrosomic foetus. Maternal BMI has been shown in various studies to influence birth weight, with a positive correlation between higher maternal BMI and birth weight 21,47 . Differences in fetal growth among various ethnic groups have also previously been described, 48,49 with current recommendations that fetal growth centiles should take into account maternal ethnicity to avoid incorrect diagnosis of growth restriction 50 .…”

“…Some studies have demonstrated that both elevated maternal serum leptin 19 and umbilical cord leptin levels 3,20 are positively associated with increased birth weight. Other studies, however, found contrasting results, with higher maternal leptin levels associated with a slower fetal growth trajectory in one study, 21 and a further study noting that children born to mothers with highest leptin levels during pregnancy had lower adiposity in childhood and early adolescence 22 . Hence, the role of maternal leptin in child growth is not yet clearly described.…”

Including the child’s voice in research from a longitudinal birth cohort: insights from the ROLO young person’s advisory group

“…The aim was to reduce the recurrence of macrosomia in secundigravida women attending the National Maternity Hospital, Dublin, Ireland (2007-2011) [10]. It has developed into a well-recognised longitudinal birth cohort study, with follow-up of 759 mother-child dyads at multiple timepoints in childhood [10][11][12][13][14][15].…”