Background: Maternal nutrition during pregnancy is a strong determinant of fetal size, body composition and future health. A few studies have measured detailed neonatal anthropometry and body composition. We studied the association between maternal pregnancy measurements and neonatal size and body composition in GDM and NGT pregnancies.

Methods: Mothers from antenatal clinics were tested with 75gm OGTT (IADPSG criteria). Maternal demographic, anthropometric, and nutritional (vit B12, folate, homocysteine) and metabolic (glucose, insulin, lipids) measurements were obtained. Detailed neonatal anthropometry and body composition (DXA) were measured. We studied maternal predictors of neonatal size and composition by adjusting for socio economic status (SES), gestation at delivery and sex of baby.

Results: We studied 398 pregnancies (234 NGT, 164 GDM). GDM mothers were older, more affluent, obese, and had higher triglycerides but lower HDL and total cholesterol concentrations compared to NGT mothers. Neonates of GDM mothers were heavier and more adipose (skinfolds, DXA body fat%) but 25% were SGA (INTERGROWTH). In addition to the conventional predictors (maternal size, adiposity and weight gain), we found novel associations of neonatal size (birthweight and length) with maternal folate (direct) and homocysteine (inverse) and of neonatal adiposity with maternal glucose and insulin resistance (direct), and HDL cholesterol and disposition index (inverse).

Conclusion: Our results highlight a role for maternal micronutrient nutrition, fuels and insulin resistance in influencing neonatal size and body composition. These findings expand the concept of ‘fuel mediated teratogenesis’ (Freinkel, 1980) to ‘dual teratogenesis’ (Yajnik, 2009) and offer additional opportunities to improve fetal growth and body composition. Increasing dietary methyl donors may be useful in addition to controlling maternal insulin resistance may reduce fetal adiposity.

Disclosure

M.K. Deshmukh: None. A.A. Bhalerao: None. D.A. Raut: None. N.S. Memane: None. R. Kamat: None. D. Bhat: None. H. Damle: None. S.S. Wagle: None. C.S. Yajnik: None.

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