Observational study of maternal anthropometry and fetal insulin

Soltani-K, H; Bruce, Christine; Fraser, Robert S.

doi:10.1136/fn.81.2.f122

Cited by 21 publications

(18 citation statements)

References 16 publications

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“…We are uncertain why the results of this study differ from others, but it may reflect the relatively large numbers in our study, the accurate prospectively collected data using a research protocol to measure length, the mode of collection of cord samples, and the use of a specific insulin assay. As predicted, we found correlations with measures of the intrauterine environment such as maternal glycaemia, maternal insulin resistance and maternal BMI, and relationships of these factors with both cord insulin and fetal growth have been reported previously [5][6][7][8][9]. These expected findings provide validation for our insulin results.…”

Section: Discussionsupporting

confidence: 89%

“…Birthweight is directly correlated with maternal glycaemia, both fasting and stimulated glucose levels, in the non-diabetic pregnancy [5]. Other environmental factors altering fetal insulin concentrations and growth include maternal insulin sensitivity during pregnancy [6][7][8] and maternal size [9], with associations also seen with maternal nutrition [10], parity [10,11], and social class [10].…”

Section: Introductionmentioning

confidence: 99%

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Paternal insulin resistance and its association with umbilical cord insulin concentrations

et al. 2006

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Aims/hypothesis: Fetal growth is influenced by genetic factors as well as the intra-uterine environment. We hypothesised that some genetic factors may alter fetal insulin secretion and insulin action. Subjects, materials and methods: To assess this, we analysed plasma insulin concentration in umbilical cord blood from 644 normal, term, UK Caucasian deliveries from the Exeter Family Study of Childhood Health. We tested for associations between cord insulin and each of parental anthropometry, fasting glucose, insulin and lipids. Results: As expected, cord insulin concentrations correlated with all measures of birth size (weight, length, head and arm circumferences, sum of skinfold thicknesses, ponderal index: r=0.16-0.4, p<0.01 for all) and maternal BMI (r=0.11, p=0.005), maternal glucose (r=0.25, p<0.001) and maternal insulin resistance (r=0.23, p<0.001). Paternal fasting insulin and insulin resistance were correlated with cord insulin (r=0.15, p=0.006; r=0.13, p=0.001, respectively), and this was independent of paternal BMI. Multiple linear regression analysis revealed paternal insulin resistance to be a predictor of cord insulin concentrations, independently of maternal factors. Conclusion: Our results show an independent relationship between paternal insulin resistance and cord insulin concentrations. This is consistent with heritability of insulin resistance from father to offspring and a compensatory increase in fetal insulin secretion, the latter occurring prenatally before the homeostatic feedback loop between glucose and insulin is established.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Paternal insulin resistance and its association with umbilical cord insulin concentrations

et al. 2006

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“…Thus, there appears to be additional metabolic factors related to maternal overweight that influence fetal growth [40][41][42] . Insulin resistance increases with maternal weight and this may cause metabolic disturbances that result in an increased flux of nutrients across the placenta, causing fetal hyperinsulinemia and accelerated fetal growth [43][44][45][46] . Diabetes in pregnancy is associated with a significant risk of fetal macrosomia, even when good metabolic control is achieved [35] .…”

Section: Discussionmentioning

confidence: 99%

First-Trimester Prediction of Macrosomia

Poon¹,

Karagiannis²,

Stratieva³

et al. 2010

Fetal Diagn Ther

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Objective: To determine if combinations of maternal characteristics and measurements of parameters used in screening for aneuploidies at 11–13 weeks provide significant prediction of macrosomia. Method: Maternal characteristics, fetal nuchal translucency (NT), free β-human chorionic gonadotrophin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) were recorded at 11⁺⁰–13⁺⁶ weeks in 36,743 singleton pregnancies. Regression analysis was used to determine if in predicting macrosomia significant contributions are provided by maternal factors, fetal NT, free β-hCG and PAPP-A. Results: The risk for macrosomia increased with maternal weight and height and was higher in parous women with previous delivery of a macrosomic baby and in those with diabetes mellitus; the risk was lower in women of African and South Asian racial origins, in cigarette smokers and in those with chronic hypertension. In the macrosomic group compared to the unaffected group there were higher Δ-NT (0.167 vs. 0.116 mm), free β-hCG (1.010 vs. 0.964 MoM) and PAPP-A (1.103 vs. 1.003 MoM). Prediction of macrosomia provided by maternal factors was significantly improved by fetal NT, free β-hCG and PAPP-A (34.4 vs. 33.1% at a false-positive rate of 10%). Conclusion: Prediction of macrosomia is provided in the first trimester of pregnancy by a combination of maternal characteristics and measurements of parameters used in screening for aneuploidies.

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“…BMI in early pregnancy is associated with infant birth weight and maternal fasting glucose in the third trimester, 125 and with cord insulin levels. The same correlation with cord insulin was seen with fat mass as estimated by skinfold measurements.…”

Section: Risk Factor Screeningmentioning

confidence: 99%

“…A 1.7% prevalence in adolescents < 19 years was reported The authors found a sensitivity of 63% and specificity of 56% using clinical history (birth of a baby ≥ 9 lbs, history in two or more pregnancies of fetal death, neonatal death, congenital anomaly, prematurity, excessive weight gain, hypertension or proteinuria, or family history of diabetes) as a screening test. When age > 25 years was added to risk factors, sensitivity was 69% and specificity was 35%.BMI in early pregnancy is associated with infant birth weight and maternal fasting glucose in the third trimester, 125 and with cord insulin levels. The same correlation with cord insulin was seen with fat mass as estimated by skinfold measurements.…”

mentioning

confidence: 99%

Screening for gestational diabetes: a systematic review and economic evaluation

Scott

Loveman

McIntyre³

et al. 2002

Health Technol Assess

180

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Observational study of maternal anthropometry and fetal insulin

Cited by 21 publications

References 16 publications

Paternal insulin resistance and its association with umbilical cord insulin concentrations

Paternal insulin resistance and its association with umbilical cord insulin concentrations

First-Trimester Prediction of Macrosomia

Screening for gestational diabetes: a systematic review and economic evaluation

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