Cord Blood FGF-21 and GDF-15 Levels Are Affected by Maternal Exposure to Moderate to Severe Anemia and Malaria

• Published in: Journal of the Endocrine Society 2023-10, Vol.7 (10), p.bvad120-bvad120
• Main Authors: Hjort, Line, Wewer Albrechtsen, Nicolai J, Minja, Daniel, Rasmussen, Christine, Møller, Sofie Lykke, Lusingu, John, Theander, Thor, Bygbjerg, Ib Christian, Schmiegelow, Christentze, Grunnet, Louise Groth
• Format: Article
• Language: English
• Subjects: Anemia; Clinical; Communicable diseases; Epidemiology; Ethylenediaminetetraacetic acid; Fibroblast growth factors; Hemoglobin; Infants (Newborn); Malaria; Pregnancy; Pregnant women; Type 2 diabetes; World health
• ISSN: 2472-1972; 2472-1972
• DOI: 10.1210/jendso/bvad120

Abstract Context Anemia and malaria are global health problems affecting >50% of pregnant women in sub-Saharan Africa and are associated with intrauterine growth restriction. The hormones fibroblast growth factor 21 (FGF-21) and growth differentiation factor 15 (GDF-15) are involved in metabolic regulation and are expressed in the placenta. No studies exist on FGF-21 and GDF-15 responses to exposures of malaria and anemia in pregnancy. Objective and Methods Using a prospective, longitudinal pregnancy and birth cohort of women with an average age of 26 years from a rural region in northeastern Tanzania, we examined if FGF-21 and GDF-15 levels in maternal blood at week 33 ± 2 (n = 301) and in cord blood at birth (n = 353), were associated with anemia and malaria exposure at different time points in pregnancy and with neonatal anthropometry. Results Among mothers at gestation week 33 ± 2, lower FGF-21 levels were observed after exposure to malaria in the first trimester, but not anemia, whereas GDF-15 levels at week 33 ± 2 were not associated with malaria nor anemia. In cord blood, moderate to severe anemia at any time point in pregnancy was associated with higher levels of FGF-21, whereas malaria exposure in the third trimester was associated with lower FGF-21 levels in cord blood. Negative associations were observed between cord blood FGF-21 and GDF-15 levels and neonatal skinfold thicknesses and birthweight. Conclusion Our results suggest that moderate to severe anemia throughout pregnancy associates with higher FGF-21 levels, and malaria in last trimester associates with lower FGF-21 levels, in the neonates, thereby potentially affecting the future cardiometabolic health of the child.