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Maternal weight, blood lipids, and the offspring weight trajectories during infancy and early childhood in twin pregnancies

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Abstract

Background

The intrauterine environment has a profound and long-lasting influence on the health of the offspring. However, its impact on the postnatal catch-up growth of twin children remains unclarified. Therefore, this study aimed to explore the maternal factors in pregnancy associated with twin offspring growth.

Methods

This study included 3142 live twin children born to 1571 mothers from the Beijing Birth Cohort Study conducted from 2016 to 2021 in Beijing, China. Original and corrected weight-for-age standard deviation scores of the twin offspring from birth to 36 months of age were calculated according to the World Health Organization Child Growth Standards. The corresponding weight trajectories were identified by the latent trajectory model. Maternal factors in pregnancy associated with the weight trajectories of the twin offspring were examined after adjustment for potential confounders.

Results

Five weight trajectories of the twin children were identified, with 4.9% (154/3142) exhibiting insufficient catch-up growth, 30.6% (961/3142), and 46.8% (1469/3142) showing adequate catch-up growth from different birth weights, and 15.0% (472/3142) and 2.7% (86/3142) showing various degrees of excessive catch-up growth. Maternal short stature [adjusted odds ratio (OR) = 0.691, 95% confidence interval (CI) = 0.563–0.848, P = 0.0004] and lower total gestational weight gain (GWG) (adjusted OR = 0.774, 95% CI = 0.616–0.972, P = 0.03) were associated with insufficient catch-up growth of the offspring. Maternal stature (adjusted OR = 1.331, 95% CI = 1.168–1.518, P < 0.001), higher pre-pregnancy body mass index (BMI) (adjusted OR = 1.230, 95% CI = 1.090–1.387, P < 0.001), total GWG (adjusted OR = 1.207, 95% CI = 1.068–1.364, P = 0.002), GWG rate (adjusted OR = 1.165, 95% CI = 1.027–1.321, P = 0.02), total cholesterol (TC) (adjusted OR = 1.150, 95% CI = 1.018–1.300, P = 0.03) and low-density lipoprotein-cholesterol (LDL-C) (adjusted OR = 1.177, 95% CI = 1.041–1.330) in early pregnancy were associated with excessive growth of the offspring. The pattern of weight trajectories was similar between monochorionic and dichorionic twins. Maternal height, pre-pregnancy BMI, GWG, TC and LDL-C in early pregnancy were positively associated with excess growth in dichorionic twins, yet a similar association was observed only between maternal height and postnatal growth in monochorionic twins.

Conclusion

This study identified the effect of maternal stature, weight status, and blood lipid profiles during pregnancy on postnatal weight trajectories of the twin offspring, thereby providing a basis for twin pregnancy management to improve the long-term health of the offspring.

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Data availability

The dataset is available upon reasonable request to the corresponding author.

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Acknowledgements

We thank the participants for their contribution to the study and the medical staff for collecting clinical information and blood samples.

Funding

This work was supported by the Scientific Research Common Program of Beijing Municipal Commission of Education (KM202110025007), the National Natural Science Foundation of China (82171671), the National Key Research and Development (2016YFC1000304), and Beijing Hospitals Authority’ Ascent Plan (DFL20191402).

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China

    Wei Zheng, Ke-Xin Zhang, Xian-Xian Yuan, Jin-Ying Luo, Jia Wang, Wei Song, Sheng-Nan Liang, Xiao-Xin Wang, Cui-Mei Guo & Guang-Hui Li

  2. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China

    Wei Zheng, Ke-Xin Zhang, Xian-Xian Yuan, Jin-Ying Luo, Jia Wang, Wei Song, Sheng-Nan Liang, Xiao-Xin Wang, Cui-Mei Guo & Guang-Hui Li

  3. Obstetrics and Gynecology Department, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, China

    Jin-Ying Luo

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  1. Wei Zheng
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Contributions

ZW: conceptualization, formal analysis, funding acquisition, methodology, writing–original draft; ZKS: data curation, investigation, writing–review and editing; YXX: methodology, validation, writing–review & editing; LJY: data curation, investigation; WJ: data curation, investigation; SW: data curation, investigation; LSN: data curation, investigation; WXX: data curation, investigation; GCM: data curation, investigation; LGH: funding acquisition, project administration, resources, writing–review and editing.

Corresponding author

Correspondence to Guang-Hui Li.

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No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Ethical approval

The study was approved by the ethics committee of Beijing Obstetrics and Gynecology Hospital, Capital Medical University (2018-ky-009-01), and written informed consent were obtained from all the participants or their legal guardian.

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Supplementary file1 Supplementary Fig. 1 Study flow chart. (TIF 71 kb)

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Zheng, W., Zhang, KX., Yuan, XX. et al. Maternal weight, blood lipids, and the offspring weight trajectories during infancy and early childhood in twin pregnancies. World J Pediatr 19, 961–971 (2023). https://doi.org/10.1007/s12519-023-00703-z

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