title: Maternal diet but not gestational weight gain predicts central adiposity accretion in utero among pregnant adolescents.
abstract: BACKGROUND
  Modifiable risk factors during pregnancy, such as diet and weight gain, are associated with fetal birth weight but little is known about how these factors influence fetal fat acquisition in utero among pregnant adolescents.
  
  
  OBJECTIVE
  To determine whether maternal pre-pregnancy BMI (ppBMI), gestational weight gain (GWG) and dietary intake during pregnancy influence fetal fat accretion in utero.
  
  
  METHODS
  Longitudinal data were obtained from 121 pregnant adolescents enrolled in a study designed to identify determinants of maternal and fetal bone changes across gestation. Adolescents (ages 13-18 years) completed up to three study visits during early, mid- and late gestation. Maternal anthropometrics, 24 h dietary recalls and measures of fetal biometry were obtained at each visit. Fetal abdominal wall thickness (abdominal subcutaneous fat thickness, AbFat), a measure of fetal subcutaneous fat, was calculated by sonography at each visit. Statistical determinants of AbFat during late pregnancy were explored using simple and multiple regression.
  
  
  RESULTS
  During late pregnancy (34.8±2.0 weeks; range 31.0-40.6 weeks of gestation), the median (inter-quartile range) fetal AbFat and GWG were 0.44 (0.39, 0.55) cm and 14.6 (9.5, 18.3) kg, respectively. After adjusting for infant birth weight, variables significantly associated with fetal AbFat included gestational age (P<0.0001, 95% confidence interval, CI: 0.01, 0.03), maternal race (P=0.029, 95% CI: -0.04, -0.002) and dietary intake of added sugar (P=0.025, 95% CI: 1.42e-6, 2.06e-5). Fetal AbFat had a significant positive quadratic relationship with total maternal dietary sugar intake such that both low and high extremes of sugar consumption were associated with significantly higher fetal AbFat. Birth weight was not significantly associated with maternal intake of added sugars.
  
  
  CONCLUSIONS
  Extreme sugar intakes among pregnant adolescents may lead to increased accumulation of fetal abdominal fat with little net effect on birth weight. This finding suggests that increased sugar consumption during pregnancy promotes shifts in fetal body composition.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Whisner
authors.affiliation: Pediatric Nutrition, University of Colorado Denver, Aurora, CO, USA.
authors.forename: B E
authors.initials: BE
authors.lastname: Young
authors.affiliation: The University of Rochester School of Medicine, Rochester, NY, USA.
authors.forename: E K
authors.initials: EK
authors.lastname: Pressman
authors.affiliation: The University of Rochester School of Medicine, Rochester, NY, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Queenan
authors.affiliation: The University of Rochester School of Medicine, Rochester, NY, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Cooper
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
authors.forename: K O
authors.initials: KO
authors.lastname: O'Brien
mesh_terms: D000293:Adolescent; D001724:Birth Weight; D001823:Body Composition; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D019422:Dietary Sucrose / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena; D056128:Obesity, Abdominal / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000517:prevention & control*; D037841:Pregnant People; D012307:Risk Factors; D015430:Weight Gain
chemical_list: D004040:Dietary Carbohydrates; D019422:Dietary Sucrose