Maternal corticotropin-releasing hormone levels during pregnancy and offspring adiposity.
OBJECTIVE
Animal models suggest that fetal exposure to glucocorticoids can program adiposity, especially central adiposity, later in life. We examined associations of maternal corticotropin-releasing hormone (CRH) levels in the late 2nd trimester of pregnancy, a marker of fetal glucocorticoid exposure, with child adiposity at age 3 years.


METHODS
We analyzed data from 199 participants in Project Viva, a prospective cohort study of pregnant women and their children, At age 3 years, the main outcomes were age-sex-specific BMI z score and the sum of subscapular (SS) and triceps (TR) skinfold thicknesses to represent overall adiposity, and ratio of SS to TR (SS:TR) to represent central adiposity.


RESULTS
Mean (standard deviation) maternal 2nd trimester log CRH was 4.94 (0.56) pg/mL. At age 3, mean (standard deviation) for BMI z score was 0.52 (1.02); for SS + TR, 16.51 (3.94) mm; and for SS:TR, 0.67 (0.17). Log CRH was mildly inversely correlated with birth weight (r = -0.08), chiefly because of its association with length of gestation (r = -0.21) rather than fetal growth (r = -0.004). After adjustment for sociodemographic factors, maternal smoking, BMI, and gestational weight gain, fetal growth, length of gestation, breastfeeding duration, and (for SS:TR only) child's 3-year BMI, each increment of 1 unit of log CRH was associated with a reduction in BMI z score [-0.43; 95% confidence interval (CI), -0.73, -0.14; p = 0.004] and possible reduction in SS + TR (-1.10; 95% CI, -2.33, 0.14; p = 0.08). In contrast, log CRH was associated with higher SS:TR (0.07; 95% CI, 0.02, 0.13; p = 0.007).


CONCLUSIONS
Fetal exposure to glucocorticoids, although associated with an overall decrease in body size, may cause an increase in central adiposity.
Gillman
Matthew W
MW
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA. matthew_gillman@hms.harvard.edu
Rich-Edwards
Janet W
JW
Huh
Susanna
S
Majzoub
Joseph A
JA
Oken
Emily
E
Taveras
Elsie M
EM
Rifas-Shiman
Sheryl L
SL
D050154:Adiposity; D015992:Body Mass Index; D002675:Child, Preschool; D015331:Cohort Studies; D003346:Corticotropin-Releasing Hormone / Q000097:blood*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008425:Maternal Behavior; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy / Q000097:blood*; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D012885:Skinfold Thickness
D003346:Corticotropin-Releasing Hormone