Advertisement

Current Diabetes Reports

, Volume 1, Issue 1, pp 71–77 | Cite as

Maternal factors that determine neonatal size and body fat

  • Patrick M. Catalano
  • John P. Kirwan
Article

Abstract

These data are a review of previously published data. Initially, body composition was estimated in 186 neonates. Fatfree mass (FFM), which constituted 86% of birth weight, accounted for 83% of the variance in birth weight; fat mass (FM), which constituted 14% of birth weight, accounted for 46% of the variance in birth weight. Male neonates were an average of 175 g heavier than females. FFM was greater among males compared with females (P = 0.0001). Using stepwise logistic regression, 29% of the variance in birth weight, 30% in FFM, and 17% in FM was accounted for. Independent variables included maternal height, pregravid weight, weight gain during pregnancy, education, parity, paternal height and weight, neonatal sex, and gestational age. Including maternal insulin sensitivity explained 48% of the variance in birth weight, 53% in FFM, and 46% in FM. There was a positive correlation between weight gain and birth weight in control subjects but a negative correlation in subjects with gestational diabetes mellitus. Lastly, the roles of insulin, insulin-like growth factors, and leptin were examined in relation to fetoplacental growth and body composition. The assessment of fetal/neonatal body composition may improve the understanding of the effect of differential factors on fetal growth. Factors associated with accretion of fetal adipose tissue in late gestation are less well understood compared with birth weight and FFM. Additional studies of maternal glucose and lipid metabolism are needed to better evaluate fetal growth.

Keywords

Birth Weight Gestational Diabetes Mellitus Obstet Gynecol Fetal Growth Normal Glucose Tolerance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Love EJ, Kinch R: Factors influencing the birth weight in normal pregnancy. Am J Obstet Gynecol 1965, 91:342–349.PubMedGoogle Scholar
  2. 2.
    Niswander KR, Singer J, Westphal M, Weiss W: Weight gain during pregnancy and prepregnancy weight. Obstet Gynecol 1969, 33:482–491.PubMedGoogle Scholar
  3. 3.
    Ounsteid M, Ounsteid C: On Fetal Growth Rate (Its Variations and Their Consequences). Suffolk: Lavenham Press; 1973.Google Scholar
  4. 4.
    Seidman DS, Ever-Hadini P, Stevenson DK, et al.: Birth order and birth weight reexamined. Obstet Gynecol 1988, 72:158–162.PubMedGoogle Scholar
  5. 5.
    Thompson AM, Billewicz WZ, Hytten FE: The assessment of fetal growth. J Obstet Gynaecol Br Commonw 1968, 75:903–916.Google Scholar
  6. 6.
    Sparks J: Human intrauterine growth and nutrient accretion. Semin Perinatol 1984, 18:74–93.Google Scholar
  7. 7.
    Silverman BL, Rizzo TA, Green OC, et al.: Long-term prospective evaluation of offspring of diabetic mothers. Diabetes 1991, 40:121–125.PubMedGoogle Scholar
  8. 8.
    Silverman BL, Rizzo TA, Cho NH, Metzgar BE: Long-term effects of the intrauterine environment. Diabetes 1998, 21:142–149.Google Scholar
  9. 9.
    Stein Z, Susser M: The Dutch Famine, 1944–45, and the productive process effects on six indices at birth. Pediatr Res 1975, 9:70–76.PubMedGoogle Scholar
  10. 10.
    Ravelli A: Exposure to the Dutch famine and glucose tolerance and obesity at age 50 [thesis]. Amsterdam: University of Amsterdam; 1999.Google Scholar
  11. 11.
    Lechtig A, Habicht JP, Delgado H, et al.: Effect of food supplementation during pregnancy and birth weight. Pediatrics 1975, 56:508–520.PubMedGoogle Scholar
  12. 12.
    Humphreys R: An analysis of the maternal and foetal weight factors in normal pregnancy. J Obstet Gynaecol Br Emp 1954, 61:764–771.PubMedGoogle Scholar
  13. 13.
    Abrams BF, Laros RK: Prepregnancy weight, weight gain, and birth weight. Am J Obstet Gynecol 1986, 154:503–509.PubMedGoogle Scholar
  14. 14.
    McKeown T, Gibson JR: Observations on all births (23,970) in Birmington, 1947: II: birthweight. Br J Soc Med 1951, 5:98.PubMedGoogle Scholar
  15. 15.
    Morton NE: The inheritance of human birth weight. Ann Hum Genet 1955, 20:125–134.PubMedGoogle Scholar
  16. 16.
    Walton A, Hammond S: Maternal effects on growth and conformation in Shire horse-Shetland pony crosses. Proc R Soc Lond B Biol Sci 1938, 125B:311–335.Google Scholar
  17. 17.
    Catalano PM, Tyzbir ED, Allen SR, et al.: Evaluation of fetal growth by estimation on neonatal body composition. Obstet Gynecol 1992, 79:46–50.PubMedGoogle Scholar
  18. 18.
    Dauncy MJ, Gandy G, Gairdner D: Assessment of total body fat from skinfold thickness measurements. Arch Dis Child 1977, 52:223–227.Google Scholar
  19. 19.
    Fiorotto M, Klish W: Total body electrical conductivity measurements in the neonate. Clin Perinatol 1991, 18:11–27.Google Scholar
  20. 20.
    Moulton C: Age and chemical development in mammals. J Biol Chem 1923, 57:79–97.Google Scholar
  21. 21.
    Catalano PM, Drago NM, Amini S: Factors affecting fetal growth and body composition. Am J Obstet Gynecol 1995, 172:1459–1463.PubMedCrossRefGoogle Scholar
  22. 22.
    Reyes FI, Winter JSD, Faiman C: Studies on human sexual development: I: fetal gonadal and adrenal sex steroids. J Clin Endocrinol Metab 1973, 37:74–78.PubMedCrossRefGoogle Scholar
  23. 23.
    Belisle S, Tulchinsky D: Amniotic Fluid Hormones. Philadelphia: WB Saunders; 1980.Google Scholar
  24. 24.
    Lindsay CA, Thomas AJ, Catalano P: The effect of smoking tobacco on neonatal body composition. Am J Obstet Gynecol 1997, 177:1124–1128.PubMedCrossRefGoogle Scholar
  25. 25.
    Kirtz-Silverstein D, Barrett-Connor E, Wingard D: The effect of parity on the later development of non-insulin-dependent diabetes mellitus or impaired glucose tolerance. N Engl J Med 1989, 321:214–219.Google Scholar
  26. 26.
    Catalano PM, Drago NM, Amini S: Maternal carbohydrate metabolism and its relationship to fetal growth and body composition. Am J Obstet Gynecol 1995, 172:1464–1470.PubMedCrossRefGoogle Scholar
  27. 27.
    Caruso A, Paradisi G, Ferrazzani S: Effect of maternal carbohydrate metabolism in fetal growth. Obstet Gynecol 1998, 92:8–12.PubMedCrossRefGoogle Scholar
  28. 28.
    Langer O, Levy J, Brustman L, et al.: Glycemic control in gestational diabetes mellitus — how tight is tight enough: small for gestational age versus large for gestational age. Am J Obstet Gynecol 1989, 161:645–653.Google Scholar
  29. 29.
    Jovanovic-Peterson L, Peterson CM, Reed GF, et al.: Maternal postprandial glucose levels and infant birth weight: The Diabetes in Early Pregnancy Study. Am J Obstet Gynecol 1991, 164:103–111.PubMedGoogle Scholar
  30. 30.
    Coombs CA, Gavin LA, Gunderson E, et al.: Relationship of fetal macrosomia to maternal postprandial glucose control during pregnancy. Diabetes Care 1992, 15:1251–1257.CrossRefGoogle Scholar
  31. 31.
    Tallarigo L, Giampietro O, Penno G, et al.: Relation of glucose tolerance to complications of pregnancy in nondiabetic women. N Engl J Med 1986, 315:989–992.PubMedCrossRefGoogle Scholar
  32. 32.
    Catalano PM, Tyzbir ED, Roman NM: Longitudinal changes in insulin release and insulin resistance in non-obese pregnant women. Am J Obstet Gynecol 1991, 165:1667–1672.PubMedGoogle Scholar
  33. 33.
    Greene GW, Smiliklas-Wright H, Scholl TO, Karp R: Post partum weight change: how much of the weight gained during pregnancy will be lost after delivery? Obstet Gynecol 1988, 71:701–707.PubMedGoogle Scholar
  34. 34.
    Knopp RH, Magee MS, Walden CE, et al.: Prediction of infant birth weight by GDM screening tests. Diabetes Care 1992, 15:1605–1613.PubMedCrossRefGoogle Scholar
  35. 35.
    Knopp RH, Bergelin RO, Wahl PW, Walden C: Relationships of infant birth size to maternal lipoproteins, apoproteins, fuels, hormones, clinical chemistries, and body weight at 36 weeks gestation. Diabetes 1985, 34:71–77.PubMedGoogle Scholar
  36. 36.
    Ogburn PL, Goldstein M, Walker J, Stonestreet BS: Prolonged hyperinsulinemia reduces plasma fatty acid levels in the major lipid groups in fetal sheep. Am J Obstet Gynecol 1989, 161:728–732.PubMedGoogle Scholar
  37. 37.
    Kleigman R, Gross T, Morton S, Dunnington R: Intrauterine growth and post natal fasting metabolism in infants of obese mothers. J Pediatr 1984, 104:601–607.CrossRefGoogle Scholar
  38. 38.
    Gillmer MDG, Beard RW, Oakley NW, et al.: Diurnal plasma free fatty acid profiles in normal and diabetic pregnancies. BMJ 1977, 2:670–673.PubMedGoogle Scholar
  39. 39.
    Dancis J, Jansen V, Kayden HJ, et al.: Transfer across perfused human placenta II free fatty acids. Pediatr Res 1973, 7:192–197.PubMedCrossRefGoogle Scholar
  40. 40.
    Cajal JR, Pocovi M, Romero MA, et al.: Plasma lipids and high density lipoprotein cholesterol in maternal and umbilical vessels in twin pregnancies. Artery 1988, 15:109–117.Google Scholar
  41. 41.
    Hendricks W, Stammers JP, Hull D: The transfer of free fatty acids across the human placenta. Br J Obstet Gynecol 1985, 92:945–952.Google Scholar
  42. 42.
    Coleman R: The role of the placenta in lipid metabolism and transport. Semin Perinatol 1985, 13:180–191.Google Scholar
  43. 43.
    Ruyle M, Connor WE, Anderson GJ, Lowensohn R: Placental transfer of essential fatty acids in humans: venous-arterial difference for docosahexaenoic acid in fetal umbilical erythrocytes. Proc Natl Acad Sci U S A 1990, 87:7902–7906.PubMedCrossRefGoogle Scholar
  44. 44.
    Catalano PM, Roman NM, Tyzbir ED, et al.: Weight gain in women with gestational diabetes. Obstet Gynecol 1993, 81:523–528.PubMedGoogle Scholar
  45. 45.
    Catalano PM, Bernstein IM, Wolfe RR, et al.: Subclinical abnormalities of glucose metabolism in subjects with previous gestational diabetes. Am J Obstet Gynecol 1986, 155:1255–1262.PubMedGoogle Scholar
  46. 46.
    Hill DJ, Petrik J, Arany E: Growth factors and the regulation of fetal growth. Diabetes Care 1998, 21:B60-B69. The roles of IGF-I and -II and binding proteins are reviewed, along with the roles of IGFs in fetal growth and on fetal pancreatic islet cell development.PubMedGoogle Scholar
  47. 47.
    Roth S, Abernathy MP, Lee WH, et al.: Insulin-like growth factors I and II peptide and messenger RNA levels in macrosomic infants of diabetic pregnancies. J Soc Gynecol Investig 1996, 3:78–84.PubMedCrossRefGoogle Scholar
  48. 48.
    Masuzaki H, Ogawa Y, Sagawa N, et al.: Nonadipose tissue production of leptin: leptin as a novel placenta-derived hormone in humans. Nat Med 1997, 3:1029–1033.PubMedCrossRefGoogle Scholar
  49. 49.
    Clapp JF, Kiess W: Cord blood leptin reflects fetal fat mass. J Soc Gynecol Investig 1998, 5:300–303.PubMedCrossRefGoogle Scholar
  50. 50.
    Bodner J, Ebenbichler CF, Wolf HJ, et al.: Leptin receptor in human term placenta: in situ hybridization and immunohistochemical localization. Placenta 1999, 20:677–682.PubMedCrossRefGoogle Scholar
  51. 51.
    Lepercq J, Cauzac M, Lahlou N, et al.: Overexpression of placental leptin in diabetic pregnancies: a critical role for insulin. Diabetes 1998, 47:847–850.PubMedCrossRefGoogle Scholar
  52. 52.
    Mise H, Sagawa N: Augmented placental production of leptin in preeclampsia: possible involvement of placental hypoxia. Clin Endocrinol Metab 1998, 83:3225–3229.CrossRefGoogle Scholar
  53. 53.
    Saladin R, Staels B: Regulation of ob gene expression in rodents and humans. Horm Metab Res 1996, 28:638–641.PubMedCrossRefGoogle Scholar
  54. 54.
    Fruhbeck G, Salvador J: Relation between leptin and the regulation of glucose metabolism. Diabetologia 2000, 43:3–12.PubMedCrossRefGoogle Scholar
  55. 55.
    Szanto I, Kahn C: Selective interaction between leptin and insulin signaling pathways in a hepatic cell line. Proc Natl Acad Sci U S A 2000, 97:2355–2360.PubMedCrossRefGoogle Scholar
  56. 56.
    Boileau P, Cauzac M, Pereira MA, et al.: Characterization of placental insulin signaling pathways: role of MAPK and Akt/PKB phosphorylation. Diabetes 2000, 49:A3.Google Scholar

Copyright information

© Current Science Inc 2001

Authors and Affiliations

  • Patrick M. Catalano
    • 1
  • John P. Kirwan
    • 1
  1. 1.Department of Reproductive BiologyMetroHealth Medical CenterClevelandUSA

Personalised recommendations