Effect of Maternal Glycemia on Neonatal Adiposity in a Multiethnic Asian Birth Cohort

• Published in: The journal of clinical endocrinology and metabolism 2014-01, Vol.99 (1), p.240-247
• Main Authors: Aris, Izzuddin M, Soh, Shu E, Tint, Mya Thway, Liang, Shen, Chinnadurai, Amutha, Saw, Seang Mei, Rajadurai, Victor S, Kwek, Kenneth, Meaney, Michael J, Godfrey, Keith M, Gluckman, Peter D, Yap, Fabian K. P, Chong, Yap Seng, Lee, Yung Seng
• Format: Article
• Language: English
• Subjects: Adipose tissue; Adiposity - physiology; Adolescent; Adult; Anthropometry; Asians - statistics & numerical data; Biological and medical sciences; Birth weight; Birth Weight - physiology; Blood glucose; Blood Glucose - physiology; Body fat; Cohort Studies; Diabetes mellitus; Endocrinopathies; Fasting; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gestational age; Glucose; Glucose tolerance; Humans; Hyperglycemia; Hyperglycemia - complications; Hyperglycemia - epidemiology; Hyperglycemia - ethnology; Infant, Newborn; Infants; Male; Medical sciences; Mother-offspring interactions; Neonates; Offspring; Pregnancy; Pregnancy Complications - blood; Pregnancy Complications - epidemiology; Pregnancy Complications - ethnology; Prenatal Exposure Delayed Effects - blood; Prenatal Exposure Delayed Effects - epidemiology; Prenatal Exposure Delayed Effects - ethnology; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; Young Adult
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2013-2738

Context: Gestational hyperglycemia increases the risk of obesity and diabetes in offspring later in life. Objective: We examined the relationship between gestational glycemia and neonatal adiposity in a multiethnic cohort of Singaporean neonates. Design: A prospective mother-offspring cohort study recruited 1247 pregnant mothers (57.2% Chinese, 25.5% Malay, 17.3% Indian) and performed 75-g, 2-hour oral glucose tolerance tests at 26–28 weeks' gestation; glucose levels were available for 1081 participants. Neonatal anthropometry (birth weight, length, triceps, and subscapular skinfolds) was measured, and percentage body fat (%BF) was derived using our published equation. Associations of maternal glucose with excessive neonatal adiposity [large for gestational age; %BF; and sum of skinfolds (∑SFT) > 90th centile] were assessed using multiple logistic regression analyses. Results: Adjusting for potential confounders we observed strong positive continuous associations across the range of maternal fasting and 2-hour glucose in relation to excessive neonatal adiposity; each 1 SD increase in fasting glucose was associated with 1.31 [95% confidence interval (CI) 1.10–1.55], 1.72 (95% CI 1.31–2.27) and 1.64 (95% CI 1.32–2.03) increases in odds ratios for large for gestational age and %BF and ∑SFT greater than the 90th centile, respectively. Corresponding odds ratios for 2-hour glucose were 1.11 (95% CI 0.92–1.33), 1.55 (95% CI 1.10–2.20), and 1.40 (95% CI 1.10–1.79), respectively. The influence of high maternal fasting glucose on neonatal ∑SFT was less pronounced in Indians compared with Chinese (interaction P = .005). Conclusions: A continuous relationship between maternal glycemia and excessive neonatal adiposity extends across the range of maternal glycemia. Compared with Chinese infants, Indian infants may be less susceptible to excessive adiposity from high maternal glucose levels.