Effect of maternal glycemia on neonatal adiposity in a multiethnic Asian birth cohort.
BACKGROUND
Gestational hyperglycemia increases the risk of obesity and diabetes in offspring later in life.


OBJECTIVE
We examined the relationship between gestational glycemia and neonatal adiposity in a multiethnic cohort of Singaporean neonates.


METHODS
A prospective mother-offspring cohort study recruited 1247 pregnant mothers (57.2% Chinese, 25.5% Malay, 17.3% Indian) and performed 75-g, 2-hour oral glucose tolerance tests at 26-28 weeks' gestation; glucose levels were available for 1081 participants. Neonatal anthropometry (birth weight, length, triceps, and subscapular skinfolds) was measured, and percentage body fat (%BF) was derived using our published equation. Associations of maternal glucose with excessive neonatal adiposity [large for gestational age; %BF; and sum of skinfolds (∑SFT)>90th centile] were assessed using multiple logistic regression analyses.


RESULTS
Adjusting for potential confounders we observed strong positive continuous associations across the range of maternal fasting and 2-hour glucose in relation to excessive neonatal adiposity; each 1 SD increase in fasting glucose was associated with 1.31 [95% confidence interval (CI) 1.10-1.55], 1.72 (95% CI 1.31-2.27) and 1.64 (95% CI 1.32-2.03) increases in odds ratios for large for gestational age and %BF and ∑SFT greater than the 90th centile, respectively. Corresponding odds ratios for 2-hour glucose were 1.11 (95% CI 0.92-1.33), 1.55 (95% CI 1.10-2.20), and 1.40 (95% CI 1.10-1.79), respectively. The influence of high maternal fasting glucose on neonatal ∑SFT was less pronounced in Indians compared with Chinese (interaction P=.005).


CONCLUSIONS
A continuous relationship between maternal glycemia and excessive neonatal adiposity extends across the range of maternal glycemia. Compared with Chinese infants, Indian infants may be less susceptible to excessive adiposity from high maternal glucose levels.
Departments of Paediatrics (I.M.A., S.E.S., Y.S.L.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Biostatistics (S.L.), Yong Loo Lin School of Medicine, and Saw Swee Hock School of Public Health (S.E.S., S.M.S.), National University of Singapore, Singapore 119228; Department of Neonatology (A.C.), National University Hospital, National University Health System, Singapore 119074; Departments of Neonatology (V.S.R.) Maternal-Fetal Medicine (K.K.), and Paediatric Endocrinology (F.K.P.Y.), KK Women's and Children's Hospital, Singapore 229899; Department of Psychiatry, Neurology, and Neurosurgery (M.J.M.), McGill University, Montréal, Québec, Canada H4H 1R3; Singapore Institute for Clinical Sciences (M.J.M., P.D.G., Y.S.L.), Agency for Science, Technology, and Research, Singapore 117609; MRC Lifecourse Epidemiology Unit and National Institute of Health Research Southampton Biomedical Research Centre (K.M.G.), University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton SO16 6YD, United Kingdom; and Liggins Institute (P.D.G.), University of Auckland, 1142 Auckland, New Zealand.
Izzuddin M
IM
Aris
Shu E
SE
Soh
Mya Thway
MT
Tint
Shen
S
Liang
Amutha
A
Chinnadurai
Seang Mei
SM
Saw
Victor S
VS
Rajadurai
Kenneth
K
Kwek
Michael J
MJ
Meaney
Keith M
KM
Godfrey
Peter D
PD
Gluckman
Fabian K P
FK
Yap
Yap Seng
YS
Chong
Yung Seng
YS
Lee
D050154:Adiposity / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D001724:Birth Weight / Q000502:physiology*; D001786:Blood Glucose / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000453:epidemiology / Q000208:ethnology; D011297:Prenatal Exposure Delayed Effects / Q000097:blood / Q000453:epidemiology / Q000208:ethnology; D055815:Young Adult
D001786:Blood Glucose