title: Effect of maternal weight, adipokines, glucose intolerance and lipids on infant birth weight among women without gestational diabetes mellitus.
abstract: BACKGROUND
  The delivery of excess maternal nutrients to the fetus is known to increase the risk of macrosomia, even among infants of women without gestational diabetes mellitus. With the current obesity epidemic, maternal adiposity and its associated effects on circulating adipokines and inflammatory proteins may now have a greater impact on fetal growth. We sought to evaluate the independent effects of maternal glycemia, lipids, obesity, adipokines and inflammation on infant birth weight.
  
  
  METHODS
  We included 472 women who underwent an oral glucose tolerance test in late pregnancy and were found not to have gestational diabetes; 104 (22.0%) had gestational impaired glucose tolerance. We also measured fasting levels of insulin, low-and high-density lipoprotein cholesterol, triglycerides, leptin, adiponectin and C-reactive protein. Obstetric outcomes were assessed at delivery.
  
  
  RESULTS
  The mean birth weight was 3481 g (standard deviation 493 g); 68 of the infants were large for gestational age. On multiple linear regression analysis, positive determinants of birth weight were length of gestation, male infant, weight gain during pregnancy up to the time of the oral glucose tolerance test, body mass index (BMI) before pregnancy and impaired glucose tolerance in pregnancy. Leptin, adiponectin and C-reactive protein levels were each negatively associated with birth weight. On logistic regression analysis, the significant metabolic predictors of having a large-for-gestational-age infant were BMI before pregnancy (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.05-1.27, per 1 kg/m(2) increase), weight gain during pregnancy up to the time of the oral glucose tolerance test (OR 1.12, 95% CI 1.05-1.19, per 1 kg increase) and leptin level (OR 0.50, 95% CI 0.30-0.82, per 1 standard deviation change).
  
  
  CONCLUSIONS
  Among women without gestational diabetes, maternal adiposity and leptin levels were the strongest metabolic determinants of having a large-for-gestational-age infant rather than glucose intolerance and lipid levels.
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ont.
authors.forename: Ravi
authors.initials: R
authors.lastname: Retnakaran
authors.forename: Chang
authors.initials: C
authors.lastname: Ye
authors.forename: Anthony J G
authors.initials: AJ
authors.lastname: Hanley
authors.forename: Philip W
authors.initials: PW
authors.lastname: Connelly
authors.forename: Mathew
authors.initials: M
authors.lastname: Sermer
authors.forename: Bernard
authors.initials: B
authors.lastname: Zinman
authors.forename: Jill K
authors.initials: JK
authors.lastname: Hamilton
mesh_terms: D054392:Adipokines / Q000097:blood; D050154:Adiposity / Q000502:physiology*; D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005320:Fetal Macrosomia / Q000503:physiopathology; D018149:Glucose Intolerance / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D020738:Leptin / Q000097:blood*; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D009035:Mothers; D011247:Pregnancy
chemical_list: D054392:Adipokines; D020738:Leptin; D008055:Lipids; D002097:C-Reactive Protein