Maternal body mass index and placental weight: a role for fetal insulin, maternal insulin and leptin

Kristiansen, Oddrun; Roland, M; Zucknick, Manuela; Reine, Trine M.; Kolset, Svein Olav; Henriksen, Tore; Lekva, Tove; Michelsen, Trond M.

doi:10.1007/s40618-022-01842-2

Cited by 6 publications

(2 citation statements)

References 63 publications

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“…Thus, treatment guidelines which focus on reducing factors that cause insulin resistance (such as limiting total carbohydrate intake and restricting gestational weight gain) may potentially contribute to the increased prevalence of SGA babies in mothers with low BMI and GDM. Similarly, smaller placental size and lower vascularity may be present in non-overweight women, further limiting nutrient delivery to the fetus ( 25 , 26 ). Unlike pre-eclampsia, which also limits placental size and vascularity, there are no guidelines for optimal timing of delivery in GDM.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of gestational diabetes among underweight and normal weight women worldwide: a scoping review

Gitlin,

Demetres,

Vaidyanathan

et al. 2024

Front. Clin. Diabetes Healthc.

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BackgroundGestational diabetes (GDM) affects nearly 15% of pregnancies worldwide and is increasing globally. While this growth is thought to be primarily from overweight and obesity, normal and underweight women are affected as well, particularly in low and middle-income countries. However, GDM in non-overweight women remains understudied. Thus, we examined the prevalence among normal and underweight women globally.MethodsA comprehensive literature search was performed in Ovid MEDLINE, Ovid EMBASE, and The Cochrane Library. Studies retrieved were screened for eligibility against predefined inclusion/exclusion criteria. Prevalence of GDM among women with normal and underweight body mass index (BMI) was extracted, and average prevalence was calculated globally, by World Health Organization region, and by country. Pregnancy outcomes were described when available.ResultsA total of 145 studies were included. The average global prevalence of GDM among non-overweight women (BMI <25 kg/m2) was 7.3% and among underweight women (BMI <18.5 kg/m2) was 5.0%. GDM prevalence in non-overweight women was highest in Asia (average 12.1%) and lowest in the African region (0.7%). The countries with the highest prevalence were Vietnam (21.1%), Finland (19.8%), Poland (19.3%), Bangladesh (18.65%), and China (17.7%). The average global prevalence of large for gestational age infants (LGA) born to non-overweight women with GDM was 9.9%, which is lower than the average prevalence in the general population with GDM (14%).ConclusionGDM is more common than previously recognized in non-overweight women, particularly in Asia, but also in European countries. Non-overweight women with GDM had lower prevalence of LGA babies compared to prior reported prevalence in all women with GDM, though data on pregnancy outcomes was limited. These findings challenge guidelines that recommend restriction of weight gain for GDM management. Further research on the pathophysiology and complications of GDM in women who are not overweight should be urgently conducted to inform appropriate management guidelines and support optimal pregnancy outcomes.

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Section: Discussionmentioning

confidence: 99%

The prevalence of gestational diabetes among underweight and normal weight women worldwide: a scoping review

Gitlin,

Demetres,

Vaidyanathan

et al. 2024

Front. Clin. Diabetes Healthc.

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“…Gestational weight gain (GWG) comprises the fetus, placenta, amniotic fluid, blood volume, and fat deposits and is a modifiable factor associated with several pregnancy outcomes, such as fetal growth, placental weight, GDM, hypertensive disorders of pregnancy, and long‐term metabolic health in the offspring. 8 , 9 , 10 , 11 However, how GWG affects the maternal metabolism, is largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Maternal metabolic profiling across body mass index groups: An exploratory longitudinal study

Skytte,

Roland,

Christensen

et al. 2023

Acta Obstet Gynecol Scand

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IntroductionIncreased BMI has been identified as a risk factor for most pregnancy complications, but the underlying metabolic factors mediating the detrimental effects of BMI are largely unknown. We aimed to compare metabolic profiles in overweight/obese women (body mass index [BMI] ≥ 25 kg/m2) and normal weight/underweight women (BMI < 25 kg/m2) across gestation. We also explored how gestational weight gain (GWG) affected maternal metabolic profiles.Material and methodsExploratory nested case–control study based on a prospective longitudinal cohort of women who were healthy prior to pregnancy and gave birth at Oslo University Hospital from 2002 to 2008. The sample consisted of 48 women who were overweight/obese and 59 normal‐weight/underweight women. Plasma samples from four time points in pregnancy (weeks 14–16, 22–24, 30–32 and 36–38) were analyzed by nuclear magnetic resonance spectroscopy and 91 metabolites were measured. Linear regression models were fitted for each of the metabolites at each time point.ResultsOverweight or obese women had higher levels of lipids in very‐low‐density lipoprotein (VLDL), total triglycerides, triglycerides in VLDL, total fatty acids, monounsaturated fatty acids, saturated fatty acids, leucine, valine, and total branched‐chain amino acids in pregnancy weeks 14–16 compared to underweight and normal‐weight women. Docosahexaenoic acid and degree of unsaturation were significantly lower in overweight/obese women in pregnancy weeks 36–38. In addition, overweight or obese women had higher particle concentration of XXL‐VLDL and glycoprotein acetyls (GlycA) at weeks 14–16 and 30–32. GWG did not seem to affect the metabolic profile, regardless of BMI group when BMI was treated as a dichotomous variable, ≥25 kg/m2 (yes/no).ConclusionsOverweight or obese women had smaller pregnancy‐related metabolic alterations than normal‐weight/underweight women. There was a trend toward higher triglyceride and VLDL particle concentration in overweight/obese women. As this was a hypothesis‐generating study, the similarities with late‐onset pre‐eclampsia warrant further investigation. The unfavorable development of fatty acid composition in overweight/obese women, with possible implication for the offspring, should also be studied further in the future.

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Associations between the maternal healthy lifestyle score and its individual components during early pregnancy with placental outcomes

et al. 2023

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Maternal body mass index and placental weight: a role for fetal insulin, maternal insulin and leptin

Cited by 6 publications

References 63 publications

The prevalence of gestational diabetes among underweight and normal weight women worldwide: a scoping review

The prevalence of gestational diabetes among underweight and normal weight women worldwide: a scoping review

Maternal metabolic profiling across body mass index groups: An exploratory longitudinal study

Associations between the maternal healthy lifestyle score and its individual components during early pregnancy with placental outcomes

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