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Nulliparity is associated with subtle adverse metabolic outcomes in overweight/obese mothers and their offspring
Univ Auckland, Liggins Inst, Auckland, New Zealand.;Univ Colombo, Fac Med, Dept Paediat, Colombo, Sri Lanka..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand.;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand..ORCID iD: 0000-0003-1226-1956
Univ Auckland, Dept Stat, Auckland, New Zealand..
Univ Auckland, Dept Obstet & Gynaecol, Auckland, New Zealand..
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2017 (English)In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 87, no 5, p. 545-551Article in journal (Refereed) Published
Abstract [en]

Background: We aimed to evaluate metabolic outcomes in overweight/obese nulliparous and multiparous women and their offspring.

Study design: Seventy-two overweight and obese women who participated in a randomized controlled trial of exercise in pregnancy were included in the study, comparing 18 nulliparous and 54 multiparous women and their singleton offspring. Women were assessed at 19 and 36 weeks of gestation. Fetal growth was measured using standard obstetric ultrasound techniques. Cord blood was collected at birth. Maternal and offspring body composition was assessed using DXA similar to 2 weeks after delivery.

Results: Nulliparous women had higher HbA1c in the third trimester of pregnancy than multiparous women (5.48% vs 5.29%; P=.002) and were more insulin-resistant based on the surrogate marker sex hormone-binding globulin (354 vs 408 nmol/L; P=.047). Nulliparous women also had higher levels of the inflammatory marker tumour necrosis factor-alpha (4.74 vs 3.62 pg/mL; P=.025). At birth, the offspring of nulliparous women were on average 340 g (P=.013) and 0.69 standard deviation scores (P=.026) lighter than those born of multiparous women. Cord blood data showed lower insulin-like growth factor-II (P=.026) and higher IGF binding protein-1 (P=.002) levels in the offspring of nulliparous women. In addition, a less favourable metabolic profile was observed in the offspring of nulliparous women, as indicated by higher triglyceride (P<.001) and interleukin-6 (P=.039) concentrations.

Conclusions: Infants born of nulliparous overweight and obese women appear to be exposed to a less favourable metabolic environment in utero, with evidence of subtle adverse metabolic outcomes at birth compared to infants of overweight/obese multiparous women.

Place, publisher, year, edition, pages
2017. Vol. 87, no 5, p. 545-551
Keywords [en]
birth order, fetal programming, metabolic markers, parity, pregnancy
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-340688DOI: 10.1111/cen.13426ISI: 000413762200018PubMedID: 28727231OAI: oai:DiVA.org:uu-340688DiVA, id: diva2:1179782
Available from: 2018-02-02 Created: 2018-02-02 Last updated: 2018-02-02Bibliographically approved

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Derraik, Jose G. B.
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