Newborn Adiposity and Cord Blood C-Peptide as Mediators of the Maternal Metabolic Environment and Childhood Adiposity

Abstract

OBJECTIVE Excessive childhood adiposity is a risk factor for adverse metabolic health. The objective was to investigate associations of newborn body composition and cord C-peptide with childhood anthropometrics and explore whether these newborn measures mediate associations of maternal midpregnancy glucose and BMI with childhood adiposity. RESEARCH DESIGN AND METHODS Data on mother/offspring pairs (N = 4,832) from the epidemiological Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study and HAPO Follow-up Study (HAPO FUS) were analyzed. Linear regression was used to study associations between newborn and childhood anthropometrics. Structural equation modeling was used to explore newborn anthropometric measures as potential mediators of the associations of maternal BMI and glucose during pregnancy with childhood anthropometric outcomes. RESULTS In models including maternal glucose and BMI adjustments, newborn adiposity as measured by the sum of skinfolds was associated with child outcomes (adjusted mean difference, 95% CI, P value) BMI (0.26, 0.12–0.39, <0.001), BMI z-score (0.072, 0.033–0.11, <0.001), fat mass (kg) (0.51, 0.26–0.76, <0.001), percentage of body fat (0.61, 0.27–0.95, <0.001), and sum of skinfolds (mm) (1.14, 0.43–1.86, 0.0017). Structural equation models demonstrated significant mediation by newborn sum of skinfolds and cord C-peptide of maternal BMI effects on childhood BMI (proportion of total effect 2.5% and 1%, respectively), fat mass (3.1%, 1.2%), percentage of body fat (3.6%, 1.8%), and sum of skinfolds (2.9%, 1.8%), and significant mediation by newborn sum of skinfolds and cord C-peptide of maternal glucose effects on child fat mass (proportion of total association 22.0% and 21.0%, respectively), percentage of body fat (15.0%, 18.0%), and sum of skinfolds (15.0%, 20.0%). CONCLUSIONS Newborn adiposity is independently associated with childhood adiposity and, along with fetal hyperinsulinemia, mediates, in part, associations of maternal glucose and BMI with childhood adiposity.

Umbilical Cord Blood Leptin and IL-6 in the Presence of Maternal Diabetes or Chorioamnionitis

“…This is typically ascribed to increased insulin production by the fetal pancreas in response to maternal hyperglycemia, although transplacental insulin passage may contribute (1,39). As noted by others, we observed an independent association between maternal BMI and cord blood insulin which may reflect a role for subclinical insulin resistance in overweight or obese individuals that have not been diagnosed with diabetes (39)(40)(41).…”

Decreased Fatty Acid Transporter FABP1 and Increased Isoprostanes and Neuroprostanes in the Human Term Placenta: Implications for Inflammation and Birth Weight in Maternal Pre-Gestational Obesity

“…A word of caution is necessary when investigating birth weight in the context of gestational obesity as it has been suggested that neonatal adiposity, and not total weight, is independently associated with childhood adiposity [ 71 ]. The association between placental oxidised fatty acids and neonatal outcomes, including adiposity, has never been addressed.…”

The influence of parental body composition and lifestyle on offspring growth trajectories

“…Sex differences in growth trajectories could be explained by sex differences in body composition present at birth and birth weight Z ‐scores, and different magnitudes of absolute gain in fat free mass between boys and girls during the first months of life 24 . It appears that higher levels of neonatal adiposity, as opposed to higher weight, is associated with childhood obesity 25,26 . In the current study, differences in body composition could not be investigated as no anthropometric data, apart from weight and length, were available.…”