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Maternal Non-glycemic Contributors to Fetal Growth in Obesity and Gestational Diabetes: Spotlight on Lipids

  • Linda A. Barbour
  • Teri L. Hernandez
Diabetes and Pregnancy (M-F Hivert and CE Powe, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Diabetes and Pregnancy

Abstract

Purpose of Review

Excess fetal growth is increasingly recognized as a risk factor for childhood obesity, and mounting evidence supports that maternal glucose is not the only driver. This review focuses on the role of clinically applicable maternal non-glycemic contributors to excess fetal growth, particularly lipids, in addition to amino acids (AA), insulin resistance, inflammation, maternal nutrition, and gestational weight gain (GWG) in obesity and gestational diabetes mellitus (GDM).

Recent Findings

Lipids, specifically triglycerides and free fatty acids, appear to be strong contributors to excess fetal fat accretion and adiposity at birth, particularly in obese pregnancies, which account for the largest number of large-for-gestational-age infants. Maternal pre-pregnancy body mass index (BMI), GWG, insulin resistance, inflammation, and glucose, lipid, and AA concentrations have both independent and interacting effects on fetal growth, operating both early and late in pregnancy. All are sensitive to maternal nutrition.

Summary

Early vs. later gestational exposure to excess maternal fuels in fasting and postprandial conditions may differentially impact fetoplacental outcomes. Compelling evidence suggests that targeting interventions early in pregnancy beyond glucose may be critical to improve fetal growth patterns.

Keywords

Maternal obesity Insulin resistance Gestational diabetes Lipids Fetal growth Newborn fat 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. 1.Department of Medicine, Division of Endocrinology, Metabolism, and DiabetesUniversity of Colorado, Anschutz Medical CampusAuroraUSA
  2. 2.Department of Obstetrics and Gynecology, Division of Maternal-Fetal MedicineUniversity of Colorado, Anschutz Medical CampusAuroraUSA
  3. 3.College of NursingUniversity of Colorado, Anschutz Medical CampusAuroraUSA

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