Maternal Nutritional and Water Homeostasis as a Presage of Fetal Birth Weight

  • Aleksandra Kozłowska
  • Anna M. Jagielska
  • Katarzyna M. Okręglicka
  • Michał Oczkowski
  • Damian Przekop
  • Dorota Szostak-Węgierek
  • Aneta Nitsch-Osuch
  • Mirosław Wielgoś
  • Dorota Bomba-OpońEmail author
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1176)


Birth weight is a key determinant of perinatal outcomes which affect physical development and metabolic function. In this study, we evaluated the potential role of maternal body composition and nutritional status in programing fetal birth weight. This was a longitudinal study that included 29 pregnant women and their full-term newborns. Maternal dietary energy and fluid intake and body adipose tissue were assessed. In addition, we measured the serum content of copeptin, aldosterone, and angiotensin II in maternal and umbilical cord blood. The measurements were done across the three trimesters of pregnancy, on average, at 11.6 weeks, 18.3 weeks, and 30.2 weeks. Each newborn’s birth weight was determined at the percentile line, using the World Health Organization (WHO) standards based on the gestational age, gender, and weight. We found no appreciable relation of fetal birth weight to the maternal dietary and fluid intakes, and the content of angiotensin II, aldosterone, or copeptin. However, birth weight correlated with increases in body adipose tissue in early pregnancy stages. Further, birth weight correlated positively with copeptin and adversely with angiotensin II in cord blood. We conclude that the present findings may be helpful in the assessment of a critical level of body adipose tissue in women of child-bearing age, above which the potential risk of macrosomia appears. The female population of child-bearing age needs a continual update on the nutritional knowledge to prevent modifiable maternal and fetal perinatal complications.


Angiotensin Birth weight Body adipose tissue Body composition Copeptin Newborns Nutrition Pregnancy Umbilical cord blood Water homeostasis 


Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by an institutional Ethics Committee.

Informed Consent

Written informed consent was obtained from all individual participants included in the study.


  1. Abeysekera MV, Morris JA, Davis GK, O’Sullivan AJ (2016) Alterations in energy homeostasis to favour adipose tissue gain: a longitudinal study in healthy pregnant women. Aust N Z J Obstet Gynaecol 56:42–48CrossRefGoogle Scholar
  2. Alexander BT, Dasinger JH, Intapad S (2015) Fetal programming and cardiovascular pathology. Compr Physiol 5:997–1025CrossRefGoogle Scholar
  3. Bardosono S, Prasmusinto D, Hadiati DR, Purwaka BT, Morin C, Pohan R, Sunardi D, Chandra DN, Guelinckx I (2016) Fluid intake of pregnant and breastfeeding women in Indonesia: a cross-sectional survey with a seven-day fluid specific record. Nutrients 8:26–30CrossRefGoogle Scholar
  4. Barker DJ (1998) In utero programming of chronic disease. Clin Sci (Lond) 95:115–128CrossRefGoogle Scholar
  5. Bayard F, Ances IG, Tapper AJ, Weldon VV, Kowarski A, Migeon CJ (1970) Transplacental passage and fetal secretion of aldosterone. J Clin Invest 49:1389–1393CrossRefGoogle Scholar
  6. Beitins IZ, Bayard F, Levitsky L, Ances IG, Kowarski A, Migeon CJ (1972) Plasma aldosterone concentration at delivery and during the newborn period. J Clin Invest 51:386–394CrossRefGoogle Scholar
  7. Benzing J, Wellmann S, Achini F, Letzner J, Burkhardt T, Beinder E, Morgenthaler NG, Haagen U, Bucher HU, Buhrer C, Lapaire O, Szinnai G (2011) Plasma copeptin in preterm infants: a highly sensitive marker of fetal and neonatal stress. J Clin Endocrinol Metab 96:982–985CrossRefGoogle Scholar
  8. Briana DD, Baka S, Boutsikou M, Boutsikou T, Xagorari M, Gourgiotis D, Malamitsi–Puchner A (2016) Cord blood copeptin concentrations in fetal macrosomia. Metabolism 65:89–94CrossRefGoogle Scholar
  9. Briana DD, Boutsikou M, Boutsikou T, Dodopoulos T, Gourgiotis D, Malamitsi-Puchner A (2017) Plasma copeptin may not be a sensitive marker of perinatal stress in healthy full–term growth–restricted fetuses. J Matern Fetal Neonatal Med 30:705–709CrossRefGoogle Scholar
  10. Calkins K, Devaskar SU (2011) Fetal origins of adult disease. Curr Probl Pediatr Adolesc Health Care 41:158–176CrossRefGoogle Scholar
  11. Chou H, Wang L, Lu K, Chen C (2008) Effects of maternal undernutrition on renal angiotensin II and chymase in hypertensive offspring. Acta Histochem 110:497–504CrossRefGoogle Scholar
  12. Dufau ML, Villee DB (1969) Aldosterone biosynthesis by human fetal adrenal in vitro. Biochim Biophys Acta 176:637–640CrossRefGoogle Scholar
  13. Eriksson JG, Sandboge S, Salonen M, Kajantie E, Osmond C (2015) Maternal weight in pregnancy and offspring body composition in late adulthood: findings from the Helsinki Birth Cohort Study (HBCS). Ann Med 47:94–99CrossRefGoogle Scholar
  14. Guéant J, Namour F, Guéant–Rodriguez R, Daval JL (2013) Folate and fetal programming: a play in epigenomics? Trends Endocrinol Metab 24:279–289CrossRefGoogle Scholar
  15. Hulmán A, Witte DR, Kerenyi Z, Madarasz E, Tanczer T, Bosnyak Z, Szabo E, Ferencz V, Peterfalvi A, Tabak AG, Nyari TA (2015) Heterogeneous effect of gestational weight gain on birth weight: quantile regression analysis from a population–based screening. Ann Epidemiol 25:133–137CrossRefGoogle Scholar
  16. Institute of Medicine (US) and National Research Council (US) (2009) Committee to reexamine IOM pregnancy weight guidelines. In: Rasmussen KM, Yaktine AL (eds) Weight gain during pregnancy: reexamining the guidelines. National Academies Press (US), Washington, DCGoogle Scholar
  17. Jarosz-Lesz A, Maruniak–Chudek I (2015) Copeptin – stable C–terminal fragment of pre–provasopressin as a new stress marker in newborns. Postepy Hig Med Dosw 69:681–689CrossRefGoogle Scholar
  18. Katz FH, Kappas A (1967) The effects of estradiol and estriol on plasma levels of cortisol and thyroid hormone-binding globulins and on aldosterone and cortisol secretion rates in man. J Clin Invest 46:1768–1777CrossRefGoogle Scholar
  19. Koch L, Dabek MT, Frommhold D, Poeschl J (2011) Stable precursor fragments of vasoactive peptides in umbilical cord blood of term and preterm infants. Horm Res Paediatr 76:234–239CrossRefGoogle Scholar
  20. Kwon EJ, Kim YJ (2017) What is fetal programming: a lifetime health is under the control of in utero health. Obstet Gynecol Sci 60:506–519CrossRefGoogle Scholar
  21. Larciprete G, Valensise H, Vasapollo B, Altomare F, Sorge R, Casalino B, De Lorenzo A, Arduini D (2003) Body composition during normal pregnancy: reference ranges. Acta Diabetol 40:225–232CrossRefGoogle Scholar
  22. Lukaszyk E, Malyszko J (2015) Copeptin: pathophysiology and potential clinical impact. Adv Med Sci 60:335–341CrossRefGoogle Scholar
  23. Martinerie L, Pussard E, Floix-l’He’Lias PF, Cosson C, Boileau P, Lombe’s M (2009) Physiological partial aldosterone resistance in human newborns. Pediatr Res 66(3):323–328CrossRefGoogle Scholar
  24. Morgenthaler NG, Struck J, Jochberger S, Dünser MW (2008) Copeptin: clinical use of a new biomarker. Trends Endocrinol Metab 19:43–49CrossRefGoogle Scholar
  25. Most J, Marlatt KL, Altazan AD, Redman LM (2018) Advances in assessing body composition during pregnancy. Eur J Clin Nutr 72:645–656CrossRefGoogle Scholar
  26. Mulyani EY, Hardinsyah, Briawan D, Santoso BI (2017) Hydration status of pregnant women in West Jakarta. Asia Pac J Clin Nutr 26:26–30Google Scholar
  27. O’Connor C, O’Higgins AC, Segurado R, Turner MJ, Stuart B, Kennelly MM (2014) Maternal body composition and birth weight. Prenat Diagn 34:605–607CrossRefGoogle Scholar
  28. O’Higgins AC, Doolan A, McCartan T, Mullaney L, O’Connor C, Turner MJ (2018) Is birth weight the major confounding factor in the study of gestational weight gain?: an observational cohort study. BMC Pregnancy Childbirth 18:218CrossRefGoogle Scholar
  29. Robillard PY, Dekker G, Boukerrou M, Le Moullec N, Hulsey TC (2018) Relationship between pre–pregnancy maternal BMI and optimal weight gain in singleton pregnancies. Heliyon 4:e00615CrossRefGoogle Scholar
  30. Savard C, Lemieux S, Weisnagel SJ, Fontaine–Bisson B, Gagnon C, Robitaille J, Morisset AS (2018) Trimester-specific dietary intakes in a sample of French–Canadian pregnant women in comparison with national nutritional guidelines. Nutrients 10(6):768. Scholar
  31. Shephard RJ (1991) Body composition in biological anthropology. Cambridge University Press, CambridgeGoogle Scholar
  32. Stout SA, Espel EV, Sandman CA, Glynn LM, Davis EP (2015) Fetal programming of children’s obesity risk. Psychoneuroendocrinology 53:29–39CrossRefGoogle Scholar
  33. Svitok P, Senko T, Panakova Z, Olexova L, Krskova L, Okuliarova M, Zeman M (2017) Prenatal exposure to angiotensin II increases blood pressure and decreases salt sensitivity in rats. Clin Exp Hypertens 39:489–494CrossRefGoogle Scholar
  34. Toro-Ramos T, Sichieri R, Hoffman DJ (2016) Maternal fat mass at mid–pregnancy and birth weight in Brazilian women. Ann Hum Biol 43:212–218CrossRefGoogle Scholar
  35. Traversa S, Martineriea L, Boileaue P, Xuea Q, Lombèsa M, Pussard E (2018) Comparative profiling of adrenal steroids in maternal and umbilical cord blood. J Steroid Biochem Mol Biol 178:127–134CrossRefGoogle Scholar
  36. Villar J, Ismail LC, Victora CG, Ohuma EO, Bertino E, Altman DG, Lambert A, Papageorghiou AT, Carvalho M, Jaffer YA, Gravett MG, Purwar M, Frederick IO, Noble AJ, Pang R, Barros FC, Chumlea C, Bhutta ZA, Kennedy SH (2014) International standards for newborn weight, length, and head circumference by gestational age and sex: the newborn cross–sectional study of the Intergrowth-21 Project. Lancet 384:857–868CrossRefGoogle Scholar
  37. Wang KC, Brooks DA, Summers–Pearce B, Bobrovskaya L, Tosh DN, Duffield JA, Botting KJ, Zhang S, IC MM, Morrison JL (2015) Low birth weight activates the renin–angiotensin system, but limits cardiac angiogenesis in early postnatal life. Physiol Rep 3:1–16Google Scholar
  38. Wang Y, Mao J, Wang W, Qiou J, Yang L, Chen S (2017) Maternal fat free mass during pregnancy is associated with birth weight. Reprod Health 14:47CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Aleksandra Kozłowska
    • 1
  • Anna M. Jagielska
    • 1
  • Katarzyna M. Okręglicka
    • 1
  • Michał Oczkowski
    • 2
  • Damian Przekop
    • 3
  • Dorota Szostak-Węgierek
    • 4
  • Aneta Nitsch-Osuch
    • 1
  • Mirosław Wielgoś
    • 5
  • Dorota Bomba-Opoń
    • 5
    Email author
  1. 1.Department of Social Medicine and Public Health, First Faculty of MedicineWarsaw Medical UniversityWarsawPoland
  2. 2.Department of Dietetics, Chair of Nutritional Physiology, Faculty of Human Nutrition and Consumer SciencesWarsaw University of Life Sciences – SGGWWarsawPoland
  3. 3.Institute of EconometricsWarsaw School of EconomicsWarsawPoland
  4. 4.Department of Clinical Dietetics, Faculty of Health ScienceWarsaw Medical UniversityWarsawPoland
  5. 5.First Department of Obstetrics and GynecologyWarsaw Medical UniversityWarsawPoland

Personalised recommendations