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Am J Perinatol 2022; 39(06): 584-591
DOI: 10.1055/s-0041-1740056
SMFM Fellowship Series Article

Neonatal Birthweight, Infant Feeding, and Childhood Metabolic Markers

Jessica Pippen 
1   Department of Obstetrics and Gynecology of The Ohio State University, Columbus, Ohio
,
Bethany Stetson
2   Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
,
Lindsay Doherty
3   Department of Obstetrics and Gynecology, The George Washington University Biostatistics Center, Washington, Dist. of Columbia
,
Michael W. Varner
4   Department of Obstetrics and Gynecology, The University of Utah Health Sciences Center, Salt Lake City, Utah
,
Brian M. Casey
5   Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Uma M. Reddy
6   Department of Obstetrics and Gynecology, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland
,
Ronald J. Wapner
7   Department of Obstetrics and Gynecology, Columbia University, New York, New York
,
Dwight J. Rouse
8   Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island
,
Alan T. N. Tita
9   University of Alabama at Birmingham, Birmingham, Alabama
,
John M. Thorp Jr
10   University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Edward K. Chien
11   MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio
,
George R. Saade
12   University of Texas Medical Branch, Galveston, Texas
,
Sean C. Blackwell
13   University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas
,
for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network › Author Affiliations Funding This study was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD27915, HD36801, HD34208, HD34116, HD40485, HD40500, HD27869, HD40560, HD40544, HD53097, HD40512, and HD40545) and the National Center for Advancing Translational Sciences (UL1TR001070 and UL1TR000439). Laboratory supplies funded by the Maternal Fetal Medicine Department Fund at The Ohio State University Wexner Medical Center. Comments and views of the authors do not necessarily represent views of the National Institutes of Health.
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Abstract

Objective Antenatal and early neonatal nutritional environment may influence later metabolic health. Infants of mothers with gestational diabetes mellitus (GDM) have higher risk for childhood obesity and metabolic syndrome (MetS). Leptin and adiponectin are known biomarkers for MetS and may guide interventions to reduce later obesity. We sought to examine the relationship between birthweight, early infancy feeding practices, and biomarkers for MetS in offspring of women with mild GDM.

Study Design Secondary analysis of a prospective observational follow-up study on the offspring of women who participated in a multicenter randomized treatment trial on mild GDM. Children were evaluated by research coordinators and biospecimens collected at the age of 5 to 10. Plasma concentrations of leptin and adiponectin were compared between large for gestational age (LGA) and average birthweight (AGA) infants, and according to whether solid foods were introduced early (<6 months of age) or at the recommended age (≥6 months of age). Multivariable analysis adjusted for fetal sex, race/ethnicity, and maternal body mass index.

Results Leptin and adiponectin were measured in 336 plasma samples. In bivariate analysis, compared with AGA children, LGA children had lower leptin (5.0 ng/mL [3.6–6.0] vs. 5.8 ng/mL [4.5 = 6.6], p = 0.01) and similar adiponectin (6.3 µg/mL [5.1–7.9] vs. 6.4 µg/mL [5.3–8.6], p = 0.49) concentrations. Maternal/child characteristics were similar between the early/delayed solid feeding groups. Leptin and adiponectin concentrations were similar in the early fed and delayed feeding groups (5.8 ng/mL [4.6–6.7] vs. 5.6 ng/mL [4.2–6.6], p = 0.50 and 6.4 µg/mL [5.4–8.1] vs. 6.4 µg/mL [5.1–8.8], p = 0.85, respectively). After controlling for covariates, children who were LGA and AGA at birth had similar leptin concentrations.

Conclusion Birthweight and early infancy feeding practice are not associated with alterations in leptin and adiponectin in children of women with mild GDM.

Key Points

  • Adipocytokines are markers of metabolic status.

  • Children of women with mild GDM may be at risk for MetS.

  • Biomarkers similar in LGA and AGA groups.

  • Biomarkers similar in early and delayed solid-fed groups.

  • Nonhuman milk does not modify effect of feeding practice.

Keywords

gestational diabetes - obesity - metabolic syndrome - breastfeeding - metabolism - infant feeding

Note

This study was presented in part at the 39th annual meeting of the Society for Maternal-Fetal Medicine, Las Vegas, NV, February 11–16, 2019.




Publication History

Received: 26 May 2021

Accepted: 03 October 2021

Article published online:
16 December 2021

© 2021. Thieme. All rights reserved.

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