Level of maternal triglycerides is a predictor of fetal macrosomia in non-obese pregnant women with gestational diabetes mellitus

Hashemipour, Sima; Seidjavadi, Ezzatalsadat Haji; Maleki, Firoozeh; Esmailzadehha, Neda; Movahed, Farideh; Yazdi, Zohreh

doi:10.1016/j.pedneo.2018.01.008

Cited by 20 publications

(26 citation statements)

References 30 publications

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“…In a mixed Chinese population of mothers with NGT or GDM (prospective, n = 934, 7.6% GDM), third‐trimester Tg was associated with risk of LGA and macrosomia . On the other hand, mid‐pregnancy fasting Tg, independently of glucose, was predictive of macrosomia only in Iranian non‐obese GDM mothers, but not in mothers who were obese with GDM …”

Section: Discussionmentioning

confidence: 97%

“…20 On the other hand, mid-pregnancy fasting Tg, independently of glucose, was predictive of macrosomia only in Iranian non-obese GDM mothers, but not in mothers who were obese with GDM. 26 As demonstrated by the large multinational HAPO study (n = 23 316), maternal BMI is a stronger predictor of BW compared with glucose. 27 The HAPO study involved ten countries, with Asians comprising 29% of the population; however, a detailed subgroup analysis of the strength of association of BMI with BW amongst the Asian motheroffspring pairs has not been published.…”

Section: Interpretation (In Light Of Other Evidence)mentioning

confidence: 96%

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Maternal lipids are associated with newborn adiposity, independent of GDM status, obesity and insulin resistance: a prospective observational cohort study

Samsuddin

Arumugam

Amin

et al. 2019

BJOG

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Objective To determine the association between maternal lipaemia and neonatal anthropometrics in Malaysian mother-offspring pairs. Design Prospective observational cohort study.Setting Single tertiary multidisciplinary antenatal clinic in Malaysia.Population A total of 507 mothers: 145 with gestational diabetes mellitus (GDM); 94 who were obese with normal glucose tolerance (NGT) (pre-gravid body mass index, BMI ≥ 27.5 kg/m 2 ), and 268 who were not obese with NGT.Methods Maternal demographic, anthropometric, and clinical data were collected during an interview/examination using a structured questionnaire. Blood was drawn for insulin, C-peptide, triglyceride (Tg), and non-esterified fatty acid (NEFA) during the 75-g 2-hour oral glucose tolerance test (OGTT) screening, and again at 36 weeks of gestation. At birth, neonatal anthropometrics were assessed and data such as gestational weight gain (GWG) were extracted from the records.Main outcome measures Macrosomia, large-for-gestational-age (LGA) status, cohort-specific birthweight (BW), neonatal fat mass (NFM), and sum of skinfold thickness (SSFT) > 90th centile.Results Fasting Tg > 95th centile (3.6 mmol/L) at screening for OGTT was independently associated with LGA (adjusted odds ratio, aOR 10.82, 95% CI 1.26-93.37) after adjustment for maternal glucose, pre-gravid BMI, and insulin sensitivity. Fasting glucose was independently associated with a birthweight ratio (BWR) of >90th centile (aOR 2.06, 95% CI 1.17-3.64), but not with LGA status, in this well-treated GDM cohort with predelivery HbA1c of 5.27%. In all, 45% of mothers had a pre-gravid BMI of <23 kg/m 2 and 61% had a pre-gravid BMI of ≤ 25 kg/m 2 , yet a GWG of >10 kg was associated with a 4.25-fold risk (95% CI 1.71-10.53) of BWR > 90th centile.Conclusion Maternal lipaemia and GWG at a low threshold (>10 kg) adversely impact neonatal adiposity in Asian offspring, independent of glucose, insulin resistance and pre-gravid BMI. These may therefore be important modifiable metabolic targets in pregnancy.

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Section: Discussionmentioning

confidence: 97%

Section: Interpretation (In Light Of Other Evidence)mentioning

confidence: 96%

Maternal lipids are associated with newborn adiposity, independent of GDM status, obesity and insulin resistance: a prospective observational cohort study

Samsuddin

Arumugam

Amin

et al. 2019

BJOG

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“…Conversely, the lipoprotein lipase activity decreases in the third trimester of pregnancy due to the increase in insulin resistance, a phenomenon which is more prominent in GDM. 40 The derived fatty acids enter the umbilical cord blood, are stored in fetal adipose tissues, and result in increased fetal growth and adiposity. 41 In addition, the serum concentration of HDL-c has been reported to be negatively associated with the risk for GDM and macrosomia and a moderate rise in concentration of HDL-c is a protective factor for both of them.…”

Section: Discussionmentioning

confidence: 99%

<p>The Predictive Ability of Two Triglyceride-Associated Indices for Gestational Diabetes Mellitus and Large for Gestational Age Infant Among Chinese Pregnancies: A Preliminary Cohort Study</p>

Liu¹,

Liu²,

Ma³

et al. 2020

DMSO

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Background/Aims: To investigate the potential of maternal first-trimester triglyceride (TG) to high-density lipoprotein cholesterol (TG/HDL-c) ratio, triglyceride glucose index (TyG) and total cholesterol (TC)/HDL-c to predict the risk of later gestational diabetes mellitus (GDM) and large for gestational age (LGA) newborn in Chinese women. Methods: We included 352 women with a singleton pregnancy, who were followed up prospectively from the first prenatal visit until delivery. Fasting glucose and plasma lipid profiles including TG, TC, HDL-c, and low-density lipoprotein cholesterol (LDL-c) were measured in the first trimester. A binary logistic regression analysis was performed to determine the odds ratios (ORs) and 95% confidence intervals (CIs) of GDM and LGA according to tertiles of those indices, respectively. Receiver-operating characteristic curve (ROC) and areas under the curve (AUC) were employed to evaluate the ability of those indices to predict the risk of GDM and LGA infants, and differences in the AUC values between them were compared. Results: Women with the top tertile of TG/HDL-c or TyG other than TC/HDL-c had a significantly higher risk of GDM (OR TG/HDL-c =2.388, 95% CI 1.026-5.467; OR TyG =3.535, 95% CI 1.483-8.426, respectively) and LGA infant delivery (OR TG/HDL-c =3.742, 95% CI 1.114-12.569; OR TyG =3.011, 95% CI 1.012-8.962, respectively) than women with the lowest tertile of TG/HDL-c or TyG after adjusting for confounders. The AUC of TG/ HDL-c and TyG to detect GDM was 0.664 (95% CI 0.595-0.733) and 0.686 (95% CI 0.615-0.756), respectively, and that to detect LGA was 0.646 (95% CI 0.559-0.734) and 0.643 (95% CI 0.552-0.735), respectively (all P < 0.01). There were no statistical differences between TG/HDL-c and TyG in the ability of predicting the risk of GDM or LGA infants. Conclusion: Maternal first-trimester TG/HDL-c and TyG are both good indicators in predicting the risk of later GDM and LGA newborn, and it may be useful to evaluate them in early pregnancy.

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“…Macrosomia is directly or indirectly associated with impairment of pancreatic β cell function, sensitivity to insulin and high maternal blood glucose 12,22,23 . From our ndings we observed a larger signi cance of macrosomal in newborns from mothers with GDM.…”

Section: Discussionmentioning

confidence: 99%

Application of ATR-FTIR Spectroscopy and Decreased Proteins As Parameter of Negative Neonatal Outcomes in Women With Gestational Diabetes Mellitus

Bernardes-Oliveira¹,

Freitas²,

Cobucci³

et al. 2021

Preprint

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In this study, we found for the first time that macrosomal newborns were associated with lower protein density when mothers with GDM were analyzed by infrared ATR-FTIR (Attenuated Total Reflection Fourier Transform) spectroscopy, and the Genetic Algorithm (GA) mathematical model associated with Linear Discriminant Analysis (LDA). This is a case-control study, comprised of a total of 49 newborns from mothers with GDM compared with 45 newborns from mothers without GDM. The evaluated neonatal outcomes were: type of delivery, prematurity, weight in relation to gestational age, apgar, macrosomia, and head/chest perimeter. Furthermore, we correlated the presence of these neonatal adverse effects with the density of proteins in GDM. The neonatal outcomes observed in newborns of mothers with GDM showed prematurity (p = 0.018), minimum head circumference (p = 0.027), abdominal circumference (p <0.01) and macrosomia (p <0.01) when compared to newborns of mothers without GDM. Prematurity and macrosomia occurred with greater significance among pregnant women diagnosed with gestational diabetes (p <0.05). There was a correlation between macrosomal newborns and low protein density confirmed by ATR-FTIR (GA-LDA) in diabetic pregnant women. On the other hand, macrosomal newborns of mothers with GDM were correlated with women who showed lower density of protein when analyzed by ATR-FTIR (GA-LDA). In this study, we observed that macrosomia was associated with low protein density of a mother with GDM. The approach described here, can be useful for the identification and exploration of macrosomia inunder various pathophysiological conditions of maternal GDM.

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Level of maternal triglycerides is a predictor of fetal macrosomia in non-obese pregnant women with gestational diabetes mellitus

Abstract: Hypertriglyceridemia was a predictor of macrosomia in non-obese women. More studies on different ethnicities and lifestyles are necessary to determine the association between the level of maternal TG and fetal macrosomia in BMI subgroups.

Cited by 20 publications

References 30 publications

Maternal lipids are associated with newborn adiposity, independent of GDM status, obesity and insulin resistance: a prospective observational cohort study

Maternal lipids are associated with newborn adiposity, independent of GDM status, obesity and insulin resistance: a prospective observational cohort study

<p>The Predictive Ability of Two Triglyceride-Associated Indices for Gestational Diabetes Mellitus and Large for Gestational Age Infant Among Chinese Pregnancies: A Preliminary Cohort Study</p>

Application of ATR-FTIR Spectroscopy and Decreased Proteins As Parameter of Negative Neonatal Outcomes in Women With Gestational Diabetes Mellitus

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