The importance of maternal insulin resistance throughout pregnancy on neonatal adiposity

Rodrigo A Lima; Gernot Desoye; David Simmons; Roland Devlieger; Sander Galjaard; Rosa Corcoy; Juan M Adelantado; Fidelma Dunne; Jürgen Harreiter; Alexandra Kautzky-Willer; Peter Damm; Elisabeth R Mathiesen; Dorte M Jensen; Lise-Lotte T Andersen; Mette Tanvig; Annunziata Lapolla; Maria G Dalfra; Alessandra Bertolotto; Urszula Manta; Ewa Wender-Ozegowska; Agnieszka Zawiejska; David J Hill; Frank J Snoek; Judith G M Jelsma; Mireille van Poppel

doi:10.1111/ppe.12682

The importance of maternal insulin resistance throughout pregnancy on neonatal adiposity

Rodrigo A Lima, Gernot Desoye, David Simmons, Roland Devlieger, Sander Galjaard, Rosa Corcoy, Juan M Adelantado, Fidelma Dunne, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R Mathiesen, Dorte M Jensen, Lise-Lotte T Andersen, Mette Tanvig, Annunziata Lapolla, Maria G Dalfra, Alessandra Bertolotto, Urszula Manta, Ewa Wender-OzegowskaAgnieszka Zawiejska, David J Hill, Frank J Snoek, Judith G M Jelsma, Mireille van Poppel

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Abstract

BACKGROUND: Although previous studies evaluated the association of maternal health parameters with neonatal adiposity, little is known regarding the complexity of the relationships among different maternal health parameters throughout pregnancy and its impact on neonatal adiposity.

OBJECTIVES: To evaluate the direct and indirect associations between maternal insulin resistance during pregnancy, in women with obesity, and neonatal adiposity. In addition, associations between maternal fasting glucose, triglycerides (TG), non-esterified fatty acids (NEFA), and neonatal adiposity were also assessed.

METHODS: This is a longitudinal, secondary analysis of the DALI study, an international project conducted in nine European countries with pregnant women with obesity. Maternal insulin resistance (HOMA-IR), fasting glucose, TG, and NEFA were measured three times during pregnancy (<20, 24-28, and 35-37 weeks of gestation). Offspring neonatal adiposity was estimated by the sum of four skinfolds. Structural equation modelling was conducted to evaluate the direct and indirect relationships among the variables of interest.

RESULTS: Data on 657 mother-infant pairs (50.7% boys) were analysed. Neonatal boys exhibited lower mean sum of skinfolds compared to girls (20.3 mm, 95% CI 19.7, 21.0 vs 21.5 mm, 95% CI 20.8, 22.2). In boys, maternal HOMA-IR at <20 weeks was directly associated with neonatal adiposity (β = 0.35 mm, 95% CI 0.01, 0.70). In girls, maternal HOMA-IR at 24-28 weeks was only indirectly associated with neonatal adiposity, which implies that this association was mediated via maternal HOMA-IR, glucose, triglycerides, and NEFA during pregnancy (β = 0.26 mm, 95% CI 0.08, 0.44).

CONCLUSIONS: The timing of the role of maternal insulin resistance on neonatal adiposity depends on fetal sex. Although the association was time-dependent, maternal insulin resistance was associated with neonatal adiposity in both sexes.

Original language	English
Journal	Paediatric & Perinatal Epidemiology
Volume	35
Issue number	1
Pages (from-to)	83-91
ISSN	0269-5022
DOIs	https://doi.org/10.1111/ppe.12682
Publication status	Published - Jan 2021

Keywords

endocrinology
gynaecology
insulin
lipid metabolism
obesity

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10.1111/ppe.12682Licence: CC BY

Open Access VersionFinal published version, 421 KBLicence: CC BY

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Lima, R. A., Desoye, G., Simmons, D., Devlieger, R., Galjaard, S., Corcoy, R., Adelantado, J. M., Dunne, F., Harreiter, J., Kautzky-Willer, A., Damm, P., Mathiesen, E. R., Jensen, D. M., Andersen, L.-L. T., Tanvig, M., Lapolla, A., Dalfra, M. G., Bertolotto, A., Manta, U., ... van Poppel, M. (2021). The importance of maternal insulin resistance throughout pregnancy on neonatal adiposity. Paediatric & Perinatal Epidemiology, 35(1), 83-91. https://doi.org/10.1111/ppe.12682

@article{8c83611428034b518f314d0236ec1562,

title = "The importance of maternal insulin resistance throughout pregnancy on neonatal adiposity",

abstract = "BACKGROUND: Although previous studies evaluated the association of maternal health parameters with neonatal adiposity, little is known regarding the complexity of the relationships among different maternal health parameters throughout pregnancy and its impact on neonatal adiposity.OBJECTIVES: To evaluate the direct and indirect associations between maternal insulin resistance during pregnancy, in women with obesity, and neonatal adiposity. In addition, associations between maternal fasting glucose, triglycerides (TG), non-esterified fatty acids (NEFA), and neonatal adiposity were also assessed.METHODS: This is a longitudinal, secondary analysis of the DALI study, an international project conducted in nine European countries with pregnant women with obesity. Maternal insulin resistance (HOMA-IR), fasting glucose, TG, and NEFA were measured three times during pregnancy (<20, 24-28, and 35-37 weeks of gestation). Offspring neonatal adiposity was estimated by the sum of four skinfolds. Structural equation modelling was conducted to evaluate the direct and indirect relationships among the variables of interest.RESULTS: Data on 657 mother-infant pairs (50.7% boys) were analysed. Neonatal boys exhibited lower mean sum of skinfolds compared to girls (20.3 mm, 95% CI 19.7, 21.0 vs 21.5 mm, 95% CI 20.8, 22.2). In boys, maternal HOMA-IR at <20 weeks was directly associated with neonatal adiposity (β = 0.35 mm, 95% CI 0.01, 0.70). In girls, maternal HOMA-IR at 24-28 weeks was only indirectly associated with neonatal adiposity, which implies that this association was mediated via maternal HOMA-IR, glucose, triglycerides, and NEFA during pregnancy (β = 0.26 mm, 95% CI 0.08, 0.44).CONCLUSIONS: The timing of the role of maternal insulin resistance on neonatal adiposity depends on fetal sex. Although the association was time-dependent, maternal insulin resistance was associated with neonatal adiposity in both sexes.",

keywords = "endocrinology, gynaecology, insulin, lipid metabolism, obesity",

author = "Lima, {Rodrigo A} and Gernot Desoye and David Simmons and Roland Devlieger and Sander Galjaard and Rosa Corcoy and Adelantado, {Juan M} and Fidelma Dunne and J{\"u}rgen Harreiter and Alexandra Kautzky-Willer and Peter Damm and Mathiesen, {Elisabeth R} and Jensen, {Dorte M} and Andersen, {Lise-Lotte T} and Mette Tanvig and Annunziata Lapolla and Dalfra, {Maria G} and Alessandra Bertolotto and Urszula Manta and Ewa Wender-Ozegowska and Agnieszka Zawiejska and Hill, {David J} and Snoek, {Frank J} and Jelsma, {Judith G M} and {van Poppel}, Mireille",

note = "{\textcopyright} 2020 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.",

year = "2021",

month = jan,

doi = "10.1111/ppe.12682",

language = "English",

volume = "35",

pages = "83--91",

journal = "Paediatric & Perinatal Epidemiology",

issn = "0269-5022",

publisher = "Wiley",

number = "1",

}

Lima, RA, Desoye, G, Simmons, D, Devlieger, R, Galjaard, S, Corcoy, R, Adelantado, JM, Dunne, F, Harreiter, J, Kautzky-Willer, A, Damm, P, Mathiesen, ER, Jensen, DM , Andersen, L-LT, Tanvig, M, Lapolla, A, Dalfra, MG, Bertolotto, A, Manta, U, Wender-Ozegowska, E, Zawiejska, A, Hill, DJ, Snoek, FJ, Jelsma, JGM & van Poppel, M 2021, 'The importance of maternal insulin resistance throughout pregnancy on neonatal adiposity', Paediatric & Perinatal Epidemiology, vol. 35, no. 1, pp. 83-91. https://doi.org/10.1111/ppe.12682

TY - JOUR

T1 - The importance of maternal insulin resistance throughout pregnancy on neonatal adiposity

AU - Lima, Rodrigo A

AU - Desoye, Gernot

AU - Simmons, David

AU - Devlieger, Roland

AU - Galjaard, Sander

AU - Corcoy, Rosa

AU - Adelantado, Juan M

AU - Dunne, Fidelma

AU - Harreiter, Jürgen

AU - Kautzky-Willer, Alexandra

AU - Damm, Peter

AU - Mathiesen, Elisabeth R

AU - Jensen, Dorte M

AU - Andersen, Lise-Lotte T

AU - Tanvig, Mette

AU - Lapolla, Annunziata

AU - Dalfra, Maria G

AU - Bertolotto, Alessandra

AU - Manta, Urszula

AU - Wender-Ozegowska, Ewa

AU - Zawiejska, Agnieszka

AU - Hill, David J

AU - Snoek, Frank J

AU - Jelsma, Judith G M

AU - van Poppel, Mireille

PY - 2021/1

Y1 - 2021/1

N2 - BACKGROUND: Although previous studies evaluated the association of maternal health parameters with neonatal adiposity, little is known regarding the complexity of the relationships among different maternal health parameters throughout pregnancy and its impact on neonatal adiposity.OBJECTIVES: To evaluate the direct and indirect associations between maternal insulin resistance during pregnancy, in women with obesity, and neonatal adiposity. In addition, associations between maternal fasting glucose, triglycerides (TG), non-esterified fatty acids (NEFA), and neonatal adiposity were also assessed.METHODS: This is a longitudinal, secondary analysis of the DALI study, an international project conducted in nine European countries with pregnant women with obesity. Maternal insulin resistance (HOMA-IR), fasting glucose, TG, and NEFA were measured three times during pregnancy (<20, 24-28, and 35-37 weeks of gestation). Offspring neonatal adiposity was estimated by the sum of four skinfolds. Structural equation modelling was conducted to evaluate the direct and indirect relationships among the variables of interest.RESULTS: Data on 657 mother-infant pairs (50.7% boys) were analysed. Neonatal boys exhibited lower mean sum of skinfolds compared to girls (20.3 mm, 95% CI 19.7, 21.0 vs 21.5 mm, 95% CI 20.8, 22.2). In boys, maternal HOMA-IR at <20 weeks was directly associated with neonatal adiposity (β = 0.35 mm, 95% CI 0.01, 0.70). In girls, maternal HOMA-IR at 24-28 weeks was only indirectly associated with neonatal adiposity, which implies that this association was mediated via maternal HOMA-IR, glucose, triglycerides, and NEFA during pregnancy (β = 0.26 mm, 95% CI 0.08, 0.44).CONCLUSIONS: The timing of the role of maternal insulin resistance on neonatal adiposity depends on fetal sex. Although the association was time-dependent, maternal insulin resistance was associated with neonatal adiposity in both sexes.

AB - BACKGROUND: Although previous studies evaluated the association of maternal health parameters with neonatal adiposity, little is known regarding the complexity of the relationships among different maternal health parameters throughout pregnancy and its impact on neonatal adiposity.OBJECTIVES: To evaluate the direct and indirect associations between maternal insulin resistance during pregnancy, in women with obesity, and neonatal adiposity. In addition, associations between maternal fasting glucose, triglycerides (TG), non-esterified fatty acids (NEFA), and neonatal adiposity were also assessed.METHODS: This is a longitudinal, secondary analysis of the DALI study, an international project conducted in nine European countries with pregnant women with obesity. Maternal insulin resistance (HOMA-IR), fasting glucose, TG, and NEFA were measured three times during pregnancy (<20, 24-28, and 35-37 weeks of gestation). Offspring neonatal adiposity was estimated by the sum of four skinfolds. Structural equation modelling was conducted to evaluate the direct and indirect relationships among the variables of interest.RESULTS: Data on 657 mother-infant pairs (50.7% boys) were analysed. Neonatal boys exhibited lower mean sum of skinfolds compared to girls (20.3 mm, 95% CI 19.7, 21.0 vs 21.5 mm, 95% CI 20.8, 22.2). In boys, maternal HOMA-IR at <20 weeks was directly associated with neonatal adiposity (β = 0.35 mm, 95% CI 0.01, 0.70). In girls, maternal HOMA-IR at 24-28 weeks was only indirectly associated with neonatal adiposity, which implies that this association was mediated via maternal HOMA-IR, glucose, triglycerides, and NEFA during pregnancy (β = 0.26 mm, 95% CI 0.08, 0.44).CONCLUSIONS: The timing of the role of maternal insulin resistance on neonatal adiposity depends on fetal sex. Although the association was time-dependent, maternal insulin resistance was associated with neonatal adiposity in both sexes.

KW - endocrinology

KW - gynaecology

KW - insulin

KW - lipid metabolism

KW - obesity

U2 - 10.1111/ppe.12682

DO - 10.1111/ppe.12682

M3 - Journal article

C2 - 32352590

SN - 0269-5022

VL - 35

SP - 83

EP - 91

JO - Paediatric & Perinatal Epidemiology

JF - Paediatric & Perinatal Epidemiology

IS - 1

ER -

The importance of maternal insulin resistance throughout pregnancy on neonatal adiposity

Abstract

Keywords

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