Maternal and fetal predictors of anthropometry in the first year of life in offspring of women with GDM

Maria-Christina Antoniou; Dan Yedu Quansah; Suzanne Mühlberg; Leah Gilbert; Amar Arhab; Sybille Schenk; Alain Lacroix; Bobby Stuijfzand; Antje Horsch; Jardena Jacqueline Puder

doi:10.3389/fendo.2023.1144195

Maternal and fetal predictors of anthropometry in the first year of life in offspring of women with GDM

Front Endocrinol (Lausanne). 2023 Mar 28:14:1144195. doi: 10.3389/fendo.2023.1144195. eCollection 2023.

Affiliations

¹ Unit of Pediatric Endocrinology and Diabetology, Pediatric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland.
² Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland.
³ Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
⁴ Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland.
⁵ Neonatology Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland.

Abstract

Introduction: Gestational Diabetes Mellitus (GDM) carries an increased risk for adverse perinatal and longer-term cardiometabolic consequences in offspring. This study evaluated the utility of maternal anthropometric, metabolic and fetal (cord blood) parameters to predict offspring anthropometry up to 1 year in pregnancies with GDM.

Materials and methods: In this prospective analysis of the MySweetheart study, we included 193/211 women with GDM that were followed up to 1 year postpartum. Maternal predictors included anthropometric (pre-pregnancy BMI, gestational weight gain (GWG), weight and fat mass at the 1^st GDM visit), and metabolic parameters (fasting insulin and glucose, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), Quantitative insulin-sensitivity check index (QUICKI), HbA1c, triglycerides, and high-density lipoprotein (HDL) at the 1^st visit and HbA1c at the end of pregnancy). Fetal predictors (N=46) comprised cord blood glucose and insulin, C-Peptide, HOMA-IR, triglycerides and HDL. Offspring outcomes were anthropometry at birth (weight/weight z-score, BMI, small and large for gestational age (SGA,LGA)), 6-8 weeks and 1 year (weight z-score, BMI/BMI z-score, and the sum of 4 skinfolds).

Results: In multivariate analyses, birth anthropometry (weight, weight z-score, BMI and/or LGA), was positively associated with cord blood HDL and HbA1c at the 1^st GDM visit, and negatively with maternal QUICKI and HDL at the 1^st GDM visit (all p ≤ 0.045). At 6-8 weeks, offspring BMI was positively associated with GWG and cord blood insulin, whereas the sum of skinfolds was negatively associated with HDL at the 1^st GDM visit (all p ≤0.023). At 1 year, weight z-score, BMI, BMI z-score, and/or the sum of skinfolds were positively associated with pre-pregnancy BMI, maternal weight, and fat mass at the 1^st GDM visit and 3^rd trimester HbA1c (all p ≤ 0.043). BMI z-score and/or the sum of skinfolds were negatively associated with cord blood C-peptide, insulin and HOMA-IR (all p ≤0.041).

Discussion: Maternal anthropometric, metabolic, and fetal metabolic parameters independently affected offspring anthropometry during the 1^st year of life in an age-dependent manner. These results show the complexity of pathophysiological mechanism for the developing offspring and could represent a base for future personalized follow-up of women with GDM and their offspring.

Keywords: cord blood; fetal metabolism; gestational diabetes; maternal metabolism; offspring anthropometry.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anthropometry
Birth Weight
Body Mass Index
C-Peptide
Diabetes, Gestational* / metabolism
Female
Glycated Hemoglobin
Humans
Infant, Newborn
Insulin
Insulin Resistance*
Pregnancy
Triglycerides

Substances

Glycated Hemoglobin
C-Peptide
Insulin
Triglycerides

Grants and funding

This study is funded by a project grant from the Swiss National Science Foundation (SNF 32003B_176119) and by an unrestricted educational grant from Novo Nordisk, the Gottfried und Julia Bangerter-Rhyner-Stiftung Foundation, and the Dreyfus Foundation. The funding bodies did not take part in the design of the study, the collection, analysis, interpretation of data or in the writing of the manuscript.