title: Can Fetal Limb Soft Tissue Measurements in the Third Trimester Predict Neonatal Adiposity?
abstract: OBJECTIVE
  Neonatal adiposity is associated with chronic metabolic sequelae such as diabetes and obesity. Identifying fetuses at risk for excess neonatal body fat may lead to research aimed at limiting nutritional excess in the prenatal period. We sought to determine whether fetal arm and leg soft tissue measurements at 28 weeks' gestation were predictive of neonatal percent body fat METHODS : In this prospective observational cohort study of singleton term pregnancies, we performed sonography at 28 and 36 weeks' gestation, including soft tissue measurements of the fetal arm and thigh (fractional limb volume and cross-sectional area). We estimated the neonatal body composition (percent body fat) using anthropometric measurements and air displacement plethysmography. We estimated Spearman correlations between sonographic findings and percent body fat and performed modeling to predict neonatal percent body fat using maternal characteristics and sonographic findings.
  
  
  RESULTS
  Our analysis of 44 women yielded a mean maternal age of 30 years, body mass index of 26 kg/m(2), and birth weight of 3382 g. Mean neonatal percent body fat was 8.1% by skin folds at birth and 12.2% by air displacement plethysmography 2 weeks after birth. Fractional thigh volume measurements at 28 weeks yielded the most accurate model for predicting neonatal percent body fat (R(2) = 0.697; P = .001), outperforming models that used abdominal circumference (R(2)= 0.516) and estimated fetal weight (R(2)= 0.489).
  
  
  CONCLUSIONS
  Soft tissue measurements of the fetal thigh at 28 weeks correlated better with neonatal percent body fat than currently used sonographic measurements. After validation in a larger cohort, our models may be useful for prenatal intervention strategies aimed at the prevention of excess fetal fat accretion and, potentially, optimization of long-term metabolic health.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, Colorado USA gaeamoore@gmail.com.
authors.forename: Gaea S
authors.initials: GS
authors.lastname: Moore
authors.affiliation: Department of Biostatics and Informatics, Colorado School of Public Health, Aurora, Colorado USA.
authors.forename: Amanda A
authors.initials: AA
authors.lastname: Allshouse
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, Colorado USA.
authors.forename: Barbra M
authors.initials: BM
authors.lastname: Fisher
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, Colorado USA.
authors.forename: Bronwen F
authors.initials: BF
authors.lastname: Kahn
authors.affiliation: Department of Medicine, Division of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado USA, College of Nursing, University of Colorado, Boulder, Colorado USA.
authors.forename: Teri L
authors.initials: TL
authors.lastname: Hernandez
authors.affiliation: Department of Pediatrics, Division of Neonatology, University of Colorado School of Medicine, Aurora, Colorado USA.
authors.forename: Melanie S
authors.initials: MS
authors.lastname: Reece
authors.affiliation: Department of Pediatrics, Division of Neonatology, University of Colorado School of Medicine, Aurora, Colorado USA.
authors.forename: Regina M
authors.initials: RM
authors.lastname: Reynolds
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, Texas USA.
authors.forename: Wesley
authors.initials: W
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, Colorado USA, Department of Medicine, Division of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado USA.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Barbour
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, Colorado USA.
authors.forename: Henry L
authors.initials: HL
authors.lastname: Galan
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000196:embryology; D000328:Adult; D001132:Arm / Q000000981:diagnostic imaging / Q000196:embryology; D015331:Cohort Studies; D005260:Female; D020567:Fetal Weight / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007866:Leg / Q000000981:diagnostic imaging / Q000196:embryology; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal
keywords: air displacement plethysmography; body fat; fractional limb volume; obesity; obstetric ultrasound; sonography