title: Maternal corticotropin-releasing hormone levels during pregnancy and offspring adiposity.
abstract: 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.
authors.affiliation: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA. matthew_gillman@hms.harvard.edu
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.forename: Janet W
authors.initials: JW
authors.lastname: Rich-Edwards
authors.forename: Susanna
authors.initials: S
authors.lastname: Huh
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Majzoub
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
authors.forename: Elsie M
authors.initials: EM
authors.lastname: Taveras
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Rifas-Shiman
mesh_terms: 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
chemical_list: D003346:Corticotropin-Releasing Hormone