title: Low birth weight and elevated head-to-abdominal circumference ratio are associated with elevated fetal glycated serum protein concentrations.
abstract: OBJECTIVE
  To analyze the association between low birth weight, head-to-abdominal circumference ratio, and insulin resistance in early life.
  
  
  RESULTS
  Glycated serum proteins (GSPs) were quantified at delivery in 612 Chinese mother/child pairs serving as a surrogate of maternal and fetal glycemia. Differential ultrasound examination of the fetal's body (head circumference, biparietal diameter, pectoral diameter, abdominal circumference, and femur length) was done in average 1 week prior to delivery. Multivariable regression analysis considering gestational age at delivery, the child's sex, maternal BMI, maternal age at delivery, maternal body weight, and pregnancy-induced hypertension revealed that fetal GSP was inversely associated with birth weight (R² = 0.416; P < 0.001). Fetal GSP was furthermore positively associated with the head-to-abdominal circumference ratio, whereas the maternal GSP was negatively correlated with the offspring's head-to-abdominal circumference ratio (R² = 0.285; P = 0.010 and R² = 0.261; P = 0.020, respectively). The increased head-to-abdominal circumference ratio in newborns with higher fetal GSP is mainly due to a reduced abdominal circumference rather than reduced growth of the brain.
  
  
  CONCLUSIONS
  The disproportional intrauterine growth is in line with the concept of so-called brain sparing, a mechanism maintaining the intrauterine growth of the brain at the expense of trunk growth. Our data suggest that the low birth weight phenotype, linked to cardiovascular diseases like hypertension in later life, might be a phenotype of disproportional intrauterine growth retardation and early life insulin resistance.
authors.affiliation: Department of Obstetrics and Gynecology, First Affiliated Hospital of Jinan University, Guangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Zi-Neng
authors.initials: ZN
authors.lastname: Wang
authors.forename: Ludwig
authors.initials: L
authors.lastname: Schlemm
authors.forename: Thiemo
authors.initials: T
authors.lastname: Pfab
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Xiao
authors.forename: You-Peng
authors.initials: YP
authors.lastname: Chen
authors.forename: Berthold
authors.initials: B
authors.lastname: Hocher
mesh_terms: D000005:Abdomen; D000328:Adult; D001798:Blood Proteins / Q000378:metabolism*; D002508:Cephalometry; D015331:Cohort Studies; D005260:Female; D006031:Glycosylation; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008875:Middle Aged; D011247:Pregnancy
chemical_list: D001798:Blood Proteins