title: Maternal fuels and metabolic measures during pregnancy and neonatal body composition: the healthy start study.
abstract: BACKGROUND
  The impact of specific maternal fuels and metabolic measures during early and late gestation on neonatal body composition is not well defined.
  
  
  OBJECTIVE
  To determine how circulating maternal glucose, lipids, and insulin resistance in the first and second halves of pregnancy influence neonatal body composition.
  
  
  METHODS
  A prospective pre-birth cohort enrolling pregnant women, the Healthy Start Study, was conducted, in which fasting maternal serum samples were collected twice during pregnancy to measure glucose, insulin, hemoglobin A1c, triglyceride, total cholesterol, high-density lipoprotein, and free fatty acids. Neonatal body composition was measured with air displacement plethysmography.
  
  
  METHODS
  An observational epidemiology study of pregnant women attending obstetric clinics at the University of Colorado, Anschutz Medical Center.
  
  
  METHODS
  This analysis includes 804 maternal-neonate pairs.
  
  
  RESULTS
  A strong positive linear relationship between maternal estimated insulin resistance (homeostasis model of assessment for insulin resistance) in the first half of pregnancy and neonatal fat mass (FM) and FM percentage (FM%) was detected, independent of prepregnancy body mass index (BMI). In the second half of pregnancy, positive linear relationships between maternal glucose levels and offspring FM and FM% were observed, independent of prepregnancy BMI. An inverse relationship was detected between high-density lipoprotein in the first half of pregnancy and FM, independent of prepregnancy BMI. Free fatty acid levels in the second half of pregnancy were positively associated with higher birth weight, independent of prepregnancy BMI.
  
  
  CONCLUSIONS
  Maternal insulin resistance in the first half of pregnancy is highly predictive of neonatal FM%, whereas maternal glycemia, even within the normal range, is an important driver of neonatal adiposity in later pregnancy, independent of prepregnancy BMI. Our data provide additional insights on potential maternal factors responsible for fetal fat accretion and early development of adiposity.
authors.affiliation: Colorado School of Public Health (T.L.C., A.L.S., J.T.B., D.H.G., M.M., C.H., D.D.), Aurora, Colorado 80045; University of Colorado Hospital (M.K.), Aurora, Colorado 80045; and University of Colorado School of Medicine (J.E.F.), Aurora, Colorado 80045.
authors.forename: Tessa L
authors.initials: TL
authors.lastname: Crume
authors.forename: Allison L
authors.initials: AL
authors.lastname: Shapiro
authors.forename: John T
authors.initials: JT
authors.lastname: Brinton
authors.forename: Deborah H
authors.initials: DH
authors.lastname: Glueck
authors.forename: Mercedes
authors.initials: M
authors.lastname: Martinez
authors.forename: Mary
authors.initials: M
authors.lastname: Kohn
authors.forename: Curtis
authors.initials: C
authors.lastname: Harrod
authors.forename: Jacob E
authors.initials: JE
authors.lastname: Friedman
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
mesh_terms: D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D015331:Cohort Studies; D004734:Energy Metabolism; D005260:Female; D006262:Health; D006801:Humans; D007231:Infant, Newborn / Q000378:metabolism*; D007328:Insulin / Q000097:blood; D008431:Maternal-Fetal Exchange / Q000502:physiology*; D011247:Pregnancy / Q000378:metabolism*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin