title: Maternal, fetal and perinatal alterations associated with obesity, overweight and gestational diabetes: an observational cohort study (PREOBE).
abstract: BACKGROUND
  Maternal overweight, obesity, and gestational diabetes (GD) have been negatively associated with offspring development. Further knowledge regarding metabolic and nutritional alterations in these mother and their offspring are warranted.
  
  
  METHODS
  In an observational cohort study we included 331 pregnant women from Granada, Spain. The mothers were categorized into four groups according to BMI and their GD status; overweight (n:56), obese (n:64), GD (n:79), and healthy normal weight controls (n:132). We assessed maternal growth and nutritional biomarkers at 24 weeks (n = 269), 34 weeks (n = 310) and at delivery (n = 310) and the perinatal characteristics including cord blood biomarkers.
  
  
  RESULTS
  Obese and GD mothers had significantly lower weight gain during pregnancy and infant birth weight, waist circumference, and placental weight were higher in the obese group, including a significantly increased prevalence of macrosomia. Except for differences in markers of glucose metabolism (glucose, HbA1c, insulin and uric acid) we found at some measures that overweight and/or obese mothers had lower levels of transferrin saturation, hemoglobin, Vitamin B12 and folate and higher levels of C-reactive protein, erythrocyte sedimentation rate, ferritin, and cortisol. GD mothers had similar differences in hemoglobin and C-reactive protein but higher levels of folate. The latter was seen also in cord blood.
  
  
  CONCLUSIONS
  We identified several metabolic alterations in overweight, obese and GD mothers compared to controls. Together with the observed differences in infant anthropometrics, these may be important biomarkers in future research regarding the programming of health and disease in children.
  
  
  BACKGROUND
  The trial was registered at clinicaltrials.gov, identifier ( NCT01634464 ).
authors.affiliation: Centre of Excellence for Paediatric Research EURISTIKOS, Department of Paediatrics, School of Medicine, University of Granada, Avda. De Madrid 11, 18012, Granada, Spain. staffan.berglund@umu.se.|Department of Clinical Sciences, Pediatrics, Umeå University, 901 85, Umeå, Sweden. staffan.berglund@umu.se.
authors.forename: Staffan K
authors.initials: SK
authors.lastname: Berglund
authors.affiliation: Centre of Excellence for Paediatric Research EURISTIKOS, Department of Paediatrics, School of Medicine, University of Granada, Avda. De Madrid 11, 18012, Granada, Spain. luzmaga@ugr.es.
authors.forename: Luz
authors.initials: L
authors.lastname: García-Valdés
authors.affiliation: Centre of Excellence for Paediatric Research EURISTIKOS, Department of Paediatrics, School of Medicine, University of Granada, Avda. De Madrid 11, 18012, Granada, Spain. fjtespinola@yahoo.es.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Torres-Espinola
authors.affiliation: Centre of Excellence for Paediatric Research EURISTIKOS, Department of Paediatrics, School of Medicine, University of Granada, Avda. De Madrid 11, 18012, Granada, Spain. msegura@ugr.es.
authors.forename: M Teresa
authors.initials: MT
authors.lastname: Segura
authors.affiliation: Centre of Excellence for Paediatric Research EURISTIKOS, Department of Paediatrics, School of Medicine, University of Granada, Avda. De Madrid 11, 18012, Granada, Spain. mcriszald@gmail.com.
authors.forename: Cristina
authors.initials: C
authors.lastname: Martínez-Zaldívar
authors.affiliation: Centre of Excellence for Paediatric Research EURISTIKOS, Department of Paediatrics, School of Medicine, University of Granada, Avda. De Madrid 11, 18012, Granada, Spain. mariajaguilar@telefonica.net.
authors.forename: María J
authors.initials: MJ
authors.lastname: Aguilar
authors.affiliation: Department of Pharmacology, University of Granada, Avda. de la Investigación 11, 18016, Granada, Spain. aagil@ugr.es.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Agil
authors.affiliation: Department of Legal Medicine, University of Granada, Avda. de la Investigación 11, 18016, Granada, Spain. jlorente@ugr.es.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Lorente
authors.affiliation: Department of Obstetrics and Gynaecology, University of Granada, Avda. de la Investigación 11, 18016, Granada, Spain. jflorido@ugr.es.
authors.forename: Jesús
authors.initials: J
authors.lastname: Florido
authors.affiliation: Department of Obstetrics and Gynaecology, University of Granada, Avda. de la Investigación 11, 18016, Granada, Spain. carmenpadvin@gmail.com.
authors.forename: Carmen
authors.initials: C
authors.lastname: Padilla
authors.affiliation: Centre of Excellence for Paediatric Research EURISTIKOS, Department of Paediatrics, School of Medicine, University of Granada, Avda. De Madrid 11, 18012, Granada, Spain. signealtmae@ugr.es.|Department of Paediatrics, University of Granada, Avda. de la Investigación 11, 18016, Granada, Spain. signealtmae@ugr.es.
authors.forename: Signe
authors.initials: S
authors.lastname: Altmäe
authors.affiliation: Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Institute of Food Sciences, José Antonio Novais 10, 28040, Madrid, Spain. amarcos@ictan.csic.es.
authors.forename: Acensión
authors.initials: A
authors.lastname: Marcos
authors.affiliation: Department of Nutrition and Bromatology, University of Barcelona, Joan XXIII 27-31, 08028, Barcelona, Spain. mclopez@ub.edu.
authors.forename: M Carmen
authors.initials: MC
authors.lastname: López-Sabater
authors.affiliation: Centre of Excellence for Paediatric Research EURISTIKOS, Department of Paediatrics, School of Medicine, University of Granada, Avda. De Madrid 11, 18012, Granada, Spain. ccampoy@ugr.es.|Department of Paediatrics, University of Granada, Avda. de la Investigación 11, 18016, Granada, Spain. ccampoy@ugr.es.
authors.forename: Cristina
authors.initials: C
authors.lastname: Campoy
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D055815:Young Adult; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight / Q000502:physiology; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000503:physiopathology; D005320:Fetal Macrosomia / Q000453:epidemiology; D009765:Obesity / Q000503:physiopathology; D050177:Overweight / Q000503:physiopathology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D039401:Prenatal Nutritional Physiological Phenomena / Q000502:physiology; D013030:Spain / Q000453:epidemiology; D015430:Weight Gain / Q000502:physiology
chemical_list: D015415:Biomarkers