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Cited by 439Gestational Diabetes Research and ManagementBirth, Development, and HealthDiabetes, Cardiovascular Risks, and Lipoproteins

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Maternal Lipids as Strong Determinants of Fetal Environment and Growth in Pregnancies With Gestational Diabetes Mellitus

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Schaefer-Graf, Ute M., Graf, Kristof, Kulbacka, Irina, Kjos, Siri L., Dudenhausen, Joachim, Vetter, Klaus, Herrera, Emilio·2008·Diabetes Care
DOI 10.2337/dc08-0039PMC PMC2518359
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Abstract

OBJECTIVE: To determine the contribution of maternal glucose and lipids to intrauterine metabolic environment and fetal growth in pregnancies with gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: In 150 pregnancies, serum triglycerides (TGs), cholesterol, free fatty acids (FFAs), glycerol, insulin, and glucose were determined in maternal serum and cord blood during the 3rd trimester. Maternal glucose values came from oral glucose tolerance testing and glucose profiles. Measurements of fetal abdominal circumference (AC) were performed simultaneously with maternal blood sampling and birth weight, and BMI and neonatal fat mass were obtained following delivery. RESULTS: Maternal TGs and FFAs correlated with fetal AC size (at 28 weeks: triglycerides, P = 0.001; FFAs, P = 0.02), and at delivery they correlated with all neonatal anthropometric measures (FFA: birth weight, P = 0.002; BMI, P = 0.001; fat mass, P = 0.01). After adjustment for confounding variables, maternal FFAs and TGs at delivery remained the only parameters independently related to newborns large for gestational age (LGA) (P = 0.008 and P = 0.04, respectively). Maternal FFA levels were higher in mothers with LGA newborns than in those with appropriate for gestational age (AGA) newborns (362.8 +/- 101.7 vs. 252.4 +/- 10.1, P = 0.002). Maternal levels of TGs, FFAs, and glycerol at delivery correlated with those in cord blood (P = 0.003, P = 0.004, and P = 0.005, respectively). Fetal triglyceride and cholesterol levels were negatively correlated with newborn birth weight (P = 0.001), BMI (P = 0.004), and fat mass (P = 0.001). TGs were significantly higher in small for gestational age (SGA) newborns compared with AGA or LGA newborns, while insulin-to-glucose ratio and FFAs were the highest in LGA newborns. CONCLUSIONS: In well-controlled GDM pregnancies, maternal lipids are strong predictors for fetal lipids and fetal growth. Infants with abnormal growth seem to be exposed to a distinct intrauterine environment compared with those with appropriate growth.

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Figure 1 Correlation of maternal serum FFA with fetal growth and fetal FFA. A: Maternal FFA at study entry, ∼28 weeks of gestation, and fetal abdominal circumference at study entry. B: Maternal FFA close to delivery and neonatal fat mass. C: Maternal FFA close to delivery and fetal FFA measured in cord blood serum.
Figure 1 Correlation of maternal serum FFA with fetal growth and fetal FFA. A: Maternal FFA at study entry, ∼28 weeks of gestation, and fetal abdominal circumference at study entry. B: Maternal FFA close to delivery and neonatal fat mass. C: Maternal FFA close to delivery and fetal FFA measured in cord blood serum.CC BY-NC-ND · PubMed Central
Figure 2 Correlation of cord blood serum TGs and cholesterol with birth weight and neonatal fat mass.
Figure 2 Correlation of cord blood serum TGs and cholesterol with birth weight and neonatal fat mass.CC BY-NC-ND · PubMed Central

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Metadata

Authors
Schaefer-Graf, U. M., Graf, K., Kulbacka, I., Kjos, S. L., Dudenhausen, J., Vetter, K., & Herrera, E.
Affiliations
  • Vivantes Klinikum (DE)
  • Deutsches Herzzentrum der Charité (DE)
  • University of California, Los Angeles (US)
  • Humboldt-Universität zu Berlin (DE)
  • Department of Biochemistry and Molecular Biology, Universidad San Pablo-CEU, Madrid, Spain
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2008-09-01
Volume
31
Issue
9
Pages
1858-1863
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc08-0039
PMC
PMC2518359
OpenAlex
W2148974709
Cited by
439
References
27
Citations by year
2026: 9 · 2025: 17 · 2024: 17 · 2023: 26 · 2022: 27 · 2021: 33 · 2020: 33 · 2019: 27 · 2018: 39 · 2017: 25 · 2016: 37 · 2015: 23 · 2014: 29 · 2013: 31 · 2012: 18
FWCI
17.65
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Diabetes Care (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
gestational diabetes mellitus, free fatty acids, maternal triglycerides, fetal growth, fetal abdominal circumference, cord blood lipids, large for gestational age, small for gestational age, birth weight, neonatal fat mass, insulin/glucose ratio, glycerol
MeSH terms
Adult, Fatty Acids, Nonesterified, Female, Fetal Blood, Fetus, Gestational Age, Glucose Tolerance Test, Humans, Infant, Newborn, Lipids, Parity, Pregnancy, Pregnancy Trimester, Third, Triglycerides, Body Mass Index, Diabetes, Gestational, Delivery, Obstetric, Fetal Development

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