Prediction of Neonates' Macrosomia with Maternal Lipid Profile of Healthy Mothers

Mossayebi, Elaheh; Arab, Zohreh; Rahmaniyan, Mojgan; Almassinokiani, Fariba; Kabir, Ali

doi:10.1016/j.pedneo.2013.05.006

Cited by 45 publications

(41 citation statements)

References 16 publications

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“…Some researchers have reported that only in obese pregnant women is the HDL-C value in late pregnancy negatively correlated with NBW [25]. Mossayebi et al reported that TG is a predictor of NBW in nondiabetic and nonobese pregnant women [26]. It has also been reported that the TC and LDL-C values in pregnant women are related to neonatal weight [27].…”

Section: Discussionmentioning

confidence: 99%

“…TG cannot be transported through the placenta, but it can be hydrolyzed to free fatty acids (FFA) by lipoprotein esterase in the placenta. A high level of FFA can result to high levels of fat and glucose being deposited in the fetus due to the passage of FFA through the placenta; this may ultimately lead to LGA infants [26]. The cholesterol of mothers can be transported to the fetus through the placenta and further regulate the synthesis of fetal cholesterol, thereby affecting the size and weight of the fetus [27].…”

Section: Discussionmentioning

confidence: 99%

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Association Between Maternal Glucose/Lipid Metabolism Parameters and Abnormal Newborn Birth Weight in Gestational Diabetes Complicated by Preeclampsia: A Retrospective Analysis of 248 Cases

Xiao

Zhang

2020

Diabetes Ther

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Introduction: Women with gestational diabetes mellitus (GDM) with co-existent preeclampsia (GCP) are at increased risk of giving birth to a baby with an abnormal birth weight. We have analyzed the risk factors for abnormal newborn birth weight (NBW) in women with co-presence of GDM and GCP, focusing on maternal glucose/lipid metabolism, with the aim to optimize the clinical intervention strategy. Methods: The clinical data of 248 pregnant women with GCP and their infants were retrospectively analyzed through a comprehensive review of the electronic medical records of Women and Children's Hospital, Xiamen University (Xiamen, China). These women had received prenatal care and had their baby delivered in the hospital between January 2016 and November 2018. Major characteristics assessed were large for gestational age (LGA), small for gestational age (SGA), severe preeclampsia (S-PE), and maternal plasma glucose/lipid profile in late pregnancy. Secondary characteristics were maternal age, height, body mass index (BMI), gestational weight gain (GWG), abortion history, education level, primipara or not, preterm or not, and fetal gender. Regression analysis was used to analyze the association between maternal glucose/lipid metabolism parameters and LGA or SGA. Results: There was no difference in the ratio of advanced maternal age, primipara, abortion history, preterm delivery, and newborn sex between the control group and the LGA or SGA group. Logistic regression analysis, with such factors as maternal stature, BMI, among others, was applied. Multivariate analysis of SGA infants revealed the following associations: S-PE (odds ratio [OR] 3.226, 95% confidence interval [CI] 1.385-7.515; adjusted OR [AOR] 3.675, 95% CI 1.467-9.207; p \ 0.05); high levels of glycated hemoglobin (HbA1c [ 6.5%) (OR 0.436, 95% CI 0.187-1.017; AOR 0.459, 95% CI 0.179-1.173; p [ 0.05); low levels of high-density lipoprotein cholesterol (HDL-C \ 1.0 mmol/L) (OR 0.625, 95% CI 0.287-1.361; AOR 0.637, 95% CI 0.267-1.520; p [ 0.05). Multivariate analysis of LGA revealed the following associations: S-PE (OR 30.885, 95% CI 0.398-2.013; AOR 0.974, 95% CI 0.400-2.371; p [ 0.05); high levels of HbA1c (OR 4.542, 95% CI 0.187-11.824; AOR 3.997, 95% CI 1.452-10.998; p \ 0.05); low Yunshan Xiao and Xueqin Zhang contributed equally to this work and should be considered co-first authors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association Between Maternal Glucose/Lipid Metabolism Parameters and Abnormal Newborn Birth Weight in Gestational Diabetes Complicated by Preeclampsia: A Retrospective Analysis of 248 Cases

Xiao

Zhang

2020

Diabetes Ther

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“…Although an independent association between glucose and LDL-cholesterol with LGA was shown in our study, the contribution to the predictive performance was minimal (Table 3). The lack of association with triglycerides may reflect the time of measurement at 14–16 weeks, which may have little relevance to later fetal growth, [25] or, alternatively, previously observed association could be explained by unmeasured confounders, as this association was also not apparent using mendelian randomisation [21]. VEGFR1 is the receptor for vascular endothelial growth factor (VEGF) and provided a mild increase in the AUC.…”

Section: Discussionmentioning

confidence: 99%

Clinical, ultrasound and molecular biomarkers for early prediction of large for gestational age infants in nulliparous women: An international prospective cohort study

et al. 2017

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ObjectiveTo develop a prediction model for term infants born large for gestational age (LGA) by customised birthweight centiles.MethodsInternational prospective cohort of nulliparous women with singleton pregnancy recruited to the Screening for Pregnancy Endpoints (SCOPE) study. LGA was defined as birthweight above the 90th customised centile, including adjustment for parity, ethnicity, maternal height and weight, fetal gender and gestational age. Clinical risk factors, ultrasound parameters and biomarkers at 14–16 or 19–21 weeks were combined into a prediction model for LGA infants at term using stepwise logistic regression in a training dataset. Prediction performance was assessed in a validation dataset using area under the Receiver Operating Characteristics curve (AUC) and detection rate at fixed false positive rates.ResultsThe prevalence of LGA at term was 8.8% (n = 491/5628). Clinical and ultrasound factors selected in the prediction model for LGA infants were maternal birthweight, gestational weight gain between 14–16 and 19–21 weeks, and fetal abdominal circumference, head circumference and uterine artery Doppler resistance index at 19–21 weeks (AUC 0.67; 95%CI 0.63–0.71). Sensitivity of this model was 24% and 49% for a fixed false positive rate of 10% and 25%, respectively. The addition of biomarkers resulted in selection of random glucose, LDL-cholesterol, vascular endothelial growth factor receptor-1 (VEGFR1) and neutrophil gelatinase-associated lipocalin (NGAL), but with minimal improvement in model performance (AUC 0.69; 95%CI 0.65–0.73). Sensitivity of the full model was 26% and 50% for a fixed false positive rate of 10% and 25%, respectively.ConclusionPrediction of LGA infants at term has limited diagnostic performance before 22 weeks but may have a role in contingency screening in later pregnancy.

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“…Different components of the metabolic syndrome are also risk factors for LGA (i.e. obesity, impaired glucose metabolism and hypertriglyceridemia), which therefore could explain the higher prevalence of metabolic syndrome in women with LO‐PE without a SGA infant than in those with LO‐PE and SGA in our study.…”

Section: Discussionmentioning

confidence: 71%

Metabolic syndrome and pre‐eclampsia

Hooijschuur

Ghossein‐Doha

Kroon

et al. 2019

Ultrasound in Obstet & Gyne

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Objective To evaluate the association between different pre‐eclampsia (PE) phenotypes and the development of metabolic syndrome postpartum, in order to identify the subgroup of formerly pre‐eclamptic women with a worse cardiovascular risk profile requiring tailored postpartum follow‐up. Methods This was a cohort study of 1102 formerly pre‐eclamptic women in whom cardiovascular and cardiometabolic evaluation was performed at least 3 months postpartum. Women were divided into four subgroups based on PE resulting in delivery before 34 weeks (early‐onset (EO)) or at or after 34 weeks (late onset (LO)) of gestation and whether they delivered a small‐for‐gestational‐age (SGA) neonate. Metabolic syndrome was diagnosed as the presence of hyperinsulinemia along with two or more of: body mass index ≥ 30 kg/m2; dyslipidemia; hypertension; and microalbuminuria or proteinuria. Data were compared between groups using ANOVA after Bonferroni correction. Odds ratios (OR) were calculated using logistic regression to determine the association between metabolic syndrome and the four subgroups. We constructed receiver–operating characteristics curves and computed the area under the curve (AUC) to quantify the ability of different obstetric variables to distinguish between women who developed metabolic syndrome and those who did not. Results The prevalence of metabolic syndrome was higher in women with EO‐PE and SGA (25.8%) than in those with EO‐PE without SGA (14.7%) (OR 2.01 (95% CI, 1.34–3.03)) and approximately five‐fold higher than in women with LO‐PE with SGA (5.6%) (OR 5.85 (95% CI, 2.60–13.10)). In women with LO‐PE, the prevalence of metabolic syndrome did not differ significantly between women with and those without SGA. Multivariate analysis revealed that a history of SGA, a history of EO‐PE and systolic blood pressure at the time of screening are the best predictors of developing metabolic syndrome postpartum. The AUC of the model combining these three variables was 74.6% (95% CI, 70.7–78.5%). The probability of the presence of metabolic syndrome was calculated as: P = 1/(1 + e–LP), where LP is linear predictor = –8.693 + (0.312 × SGA (yes = 1)) + (0.507 × EO‐PE (yes = 1)) + (0.053 × systolic blood pressure). Conclusions The incidence of metabolic syndrome postpartum was associated more strongly with EO‐PE in combination with SGA as compared with LO‐PE or EO‐PE without SGA. Both time of onset of PE and fetal growth affect the risk of metabolic syndrome after a pre‐eclamptic pregnancy. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

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Prediction of Neonates' Macrosomia with Maternal Lipid Profile of Healthy Mothers

Abstract: Maternal triglyceride levels may be a significant predictor of fetal size in late pregnancy but not in early pregnancy. Our study reinforces that this is true not only in the case of macrosomia (birth weight > 4500 g), but also for LGA.

Cited by 45 publications

References 16 publications

Association Between Maternal Glucose/Lipid Metabolism Parameters and Abnormal Newborn Birth Weight in Gestational Diabetes Complicated by Preeclampsia: A Retrospective Analysis of 248 Cases

Association Between Maternal Glucose/Lipid Metabolism Parameters and Abnormal Newborn Birth Weight in Gestational Diabetes Complicated by Preeclampsia: A Retrospective Analysis of 248 Cases

Clinical, ultrasound and molecular biomarkers for early prediction of large for gestational age infants in nulliparous women: An international prospective cohort study

Metabolic syndrome and pre‐eclampsia

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