Association of maternal lipid levels with birth weight and cord blood insulin: a Bayesian network analysis

Jingya Wang; Yashu Kuang; Songying Shen; Malcolm James Price; Jinhua Lu; Naveed Sattar; Jianrong He; Marta Pittavino; Huimin Xia; G Neil Thomas; Xiu Qiu; Kar Keung Cheng; Krishnarajah Nirantharakumar

doi:10.1136/bmjopen-2022-064122

Association of maternal lipid levels with birth weight and cord blood insulin: a Bayesian network analysis

Jingya Wang^*, Yashu Kuang, Songying Shen, Malcolm James Price, Jinhua Lu, Naveed Sattar, Jianrong He, Marta Pittavino, Huimin Xia, G Neil Thomas, Xiu Qiu^*, Kar Keung Cheng, Krishnarajah Nirantharakumar^*

^*Corresponding author for this work

Applied Health Research

Research output: Contribution to journal › Article › peer-review

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Abstract

OBJECTIVE: To assess the independent association of maternal lipid levels with birth weight and cord blood insulin (CBI) level.

SETTING: The Born in Guangzhou Cohort Study, Guangzhou, China.

PARTICIPANTS: Women who delivered between January 2015 and June 2016 and with umbilical cord blood retained were eligible for this study. Those with prepregnancy health conditions, without an available fasting blood sample in the second trimester, or without demographic and glycaemic information were excluded. After random selection, data from 1522 mother-child pairs were used in this study.

EXPOSURES AND OUTCOME MEASURES: Additive Bayesian network analysis was used to investigate the interdependency of lipid profiles with other metabolic risk factors (prepregnancy body mass index (BMI), fasting glucose and early gestational weight gain) in association with birth weight and CBI, along with multivariable linear regression models.

RESULTS: In multivariable linear regressions, maternal triglyceride was associated with increased birth weight (adjusted β=67.46, 95% CI 41.85 to 93.06 g per mmol/L) and CBI (adjusted β=0.89, 95% CI 0.06 to 1.72 μU/mL per mmol/L increase), while high-density lipoprotein cholesterol was associated with decreased birth weight (adjusted β=-45.29, 95% CI -85.49 to -5.09 g per mmol/L). After considering the interdependency of maternal metabolic risk factors in the Network analysis, none of the maternal lipid profiles was independently associated with birth weight and CBI. Instead, prepregnancy BMI was the global strongest factor for birth weight and CBI directly and indirectly.

CONCLUSIONS: Gestational dyslipidaemia appears to be secondary to metabolic dysfunction with no clear association with metabolic adverse outcomes in neonates. Maternal prepregnancy overweight/obesity appears the most influential upstream metabolic risk factor for both maternal and neonatal metabolic health; these data imply weight management may need to be addressed from the preconception period and during early pregnancy.

Original language	English
Article number	e064122
Journal	BMJ open
Volume	12
Issue number	12
DOIs	https://doi.org/10.1136/bmjopen-2022-064122
Publication status	Published - 29 Dec 2022

Bibliographical note

Keywords

Pregnancy
Infant, Newborn
Humans
Female
Birth Weight
Obesity/complications
Fetal Blood/metabolism
Insulin
Diabetes, Gestational
Cohort Studies
Bayes Theorem
Blood Glucose/metabolism
Body Mass Index
Triglycerides
General endocrinology
1692
Epidemiology
Lipid disorders
Maternal medicine
1506
EPIDEMIOLOGY

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

@article{cc2b203af6354d2ebeb2041361aca948,

title = "Association of maternal lipid levels with birth weight and cord blood insulin: a Bayesian network analysis",

abstract = "OBJECTIVE: To assess the independent association of maternal lipid levels with birth weight and cord blood insulin (CBI) level.SETTING: The Born in Guangzhou Cohort Study, Guangzhou, China.PARTICIPANTS: Women who delivered between January 2015 and June 2016 and with umbilical cord blood retained were eligible for this study. Those with prepregnancy health conditions, without an available fasting blood sample in the second trimester, or without demographic and glycaemic information were excluded. After random selection, data from 1522 mother-child pairs were used in this study.EXPOSURES AND OUTCOME MEASURES: Additive Bayesian network analysis was used to investigate the interdependency of lipid profiles with other metabolic risk factors (prepregnancy body mass index (BMI), fasting glucose and early gestational weight gain) in association with birth weight and CBI, along with multivariable linear regression models.RESULTS: In multivariable linear regressions, maternal triglyceride was associated with increased birth weight (adjusted β=67.46, 95% CI 41.85 to 93.06 g per mmol/L) and CBI (adjusted β=0.89, 95% CI 0.06 to 1.72 μU/mL per mmol/L increase), while high-density lipoprotein cholesterol was associated with decreased birth weight (adjusted β=-45.29, 95% CI -85.49 to -5.09 g per mmol/L). After considering the interdependency of maternal metabolic risk factors in the Network analysis, none of the maternal lipid profiles was independently associated with birth weight and CBI. Instead, prepregnancy BMI was the global strongest factor for birth weight and CBI directly and indirectly.CONCLUSIONS: Gestational dyslipidaemia appears to be secondary to metabolic dysfunction with no clear association with metabolic adverse outcomes in neonates. Maternal prepregnancy overweight/obesity appears the most influential upstream metabolic risk factor for both maternal and neonatal metabolic health; these data imply weight management may need to be addressed from the preconception period and during early pregnancy.",

keywords = "Pregnancy, Infant, Newborn, Humans, Female, Birth Weight, Obesity/complications, Fetal Blood/metabolism, Insulin, Diabetes, Gestational, Cohort Studies, Bayes Theorem, Blood Glucose/metabolism, Body Mass Index, Triglycerides, General endocrinology, 1692, Epidemiology, Lipid disorders, Maternal medicine, 1506, EPIDEMIOLOGY",

author = "Jingya Wang and Yashu Kuang and Songying Shen and Price, {Malcolm James} and Jinhua Lu and Naveed Sattar and Jianrong He and Marta Pittavino and Huimin Xia and Thomas, {G Neil} and Xiu Qiu and Cheng, {Kar Keung} and Krishnarajah Nirantharakumar",

note = "{\textcopyright} Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2022",

month = dec,

day = "29",

doi = "10.1136/bmjopen-2022-064122",

language = "English",

volume = "12",

journal = "BMJ open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

number = "12",

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TY - JOUR

T1 - Association of maternal lipid levels with birth weight and cord blood insulin

T2 - a Bayesian network analysis

AU - Wang, Jingya

AU - Kuang, Yashu

AU - Shen, Songying

AU - Price, Malcolm James

AU - Lu, Jinhua

AU - Sattar, Naveed

AU - He, Jianrong

AU - Pittavino, Marta

AU - Xia, Huimin

AU - Thomas, G Neil

AU - Qiu, Xiu

AU - Cheng, Kar Keung

AU - Nirantharakumar, Krishnarajah

N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2022/12/29

Y1 - 2022/12/29

N2 - OBJECTIVE: To assess the independent association of maternal lipid levels with birth weight and cord blood insulin (CBI) level.SETTING: The Born in Guangzhou Cohort Study, Guangzhou, China.PARTICIPANTS: Women who delivered between January 2015 and June 2016 and with umbilical cord blood retained were eligible for this study. Those with prepregnancy health conditions, without an available fasting blood sample in the second trimester, or without demographic and glycaemic information were excluded. After random selection, data from 1522 mother-child pairs were used in this study.EXPOSURES AND OUTCOME MEASURES: Additive Bayesian network analysis was used to investigate the interdependency of lipid profiles with other metabolic risk factors (prepregnancy body mass index (BMI), fasting glucose and early gestational weight gain) in association with birth weight and CBI, along with multivariable linear regression models.RESULTS: In multivariable linear regressions, maternal triglyceride was associated with increased birth weight (adjusted β=67.46, 95% CI 41.85 to 93.06 g per mmol/L) and CBI (adjusted β=0.89, 95% CI 0.06 to 1.72 μU/mL per mmol/L increase), while high-density lipoprotein cholesterol was associated with decreased birth weight (adjusted β=-45.29, 95% CI -85.49 to -5.09 g per mmol/L). After considering the interdependency of maternal metabolic risk factors in the Network analysis, none of the maternal lipid profiles was independently associated with birth weight and CBI. Instead, prepregnancy BMI was the global strongest factor for birth weight and CBI directly and indirectly.CONCLUSIONS: Gestational dyslipidaemia appears to be secondary to metabolic dysfunction with no clear association with metabolic adverse outcomes in neonates. Maternal prepregnancy overweight/obesity appears the most influential upstream metabolic risk factor for both maternal and neonatal metabolic health; these data imply weight management may need to be addressed from the preconception period and during early pregnancy.

AB - OBJECTIVE: To assess the independent association of maternal lipid levels with birth weight and cord blood insulin (CBI) level.SETTING: The Born in Guangzhou Cohort Study, Guangzhou, China.PARTICIPANTS: Women who delivered between January 2015 and June 2016 and with umbilical cord blood retained were eligible for this study. Those with prepregnancy health conditions, without an available fasting blood sample in the second trimester, or without demographic and glycaemic information were excluded. After random selection, data from 1522 mother-child pairs were used in this study.EXPOSURES AND OUTCOME MEASURES: Additive Bayesian network analysis was used to investigate the interdependency of lipid profiles with other metabolic risk factors (prepregnancy body mass index (BMI), fasting glucose and early gestational weight gain) in association with birth weight and CBI, along with multivariable linear regression models.RESULTS: In multivariable linear regressions, maternal triglyceride was associated with increased birth weight (adjusted β=67.46, 95% CI 41.85 to 93.06 g per mmol/L) and CBI (adjusted β=0.89, 95% CI 0.06 to 1.72 μU/mL per mmol/L increase), while high-density lipoprotein cholesterol was associated with decreased birth weight (adjusted β=-45.29, 95% CI -85.49 to -5.09 g per mmol/L). After considering the interdependency of maternal metabolic risk factors in the Network analysis, none of the maternal lipid profiles was independently associated with birth weight and CBI. Instead, prepregnancy BMI was the global strongest factor for birth weight and CBI directly and indirectly.CONCLUSIONS: Gestational dyslipidaemia appears to be secondary to metabolic dysfunction with no clear association with metabolic adverse outcomes in neonates. Maternal prepregnancy overweight/obesity appears the most influential upstream metabolic risk factor for both maternal and neonatal metabolic health; these data imply weight management may need to be addressed from the preconception period and during early pregnancy.

KW - Pregnancy

KW - Infant, Newborn

KW - Humans

KW - Female

KW - Birth Weight

KW - Obesity/complications

KW - Fetal Blood/metabolism

KW - Insulin

KW - Diabetes, Gestational

KW - Cohort Studies

KW - Bayes Theorem

KW - Blood Glucose/metabolism

KW - Body Mass Index

KW - Triglycerides

KW - General endocrinology

KW - 1692

KW - Epidemiology

KW - Lipid disorders

KW - Maternal medicine

KW - 1506

KW - EPIDEMIOLOGY

U2 - 10.1136/bmjopen-2022-064122

DO - 10.1136/bmjopen-2022-064122

M3 - Article

C2 - 36581404

SN - 2044-6055

VL - 12

JO - BMJ open

JF - BMJ open

IS - 12

M1 - e064122

ER -

Association of maternal lipid levels with birth weight and cord blood insulin: a Bayesian network analysis

Abstract

Bibliographical note

Keywords

UN SDGs

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