Association of maternal uric acid and cystatin C serum concentrations with maternal and neonatal cardiovascular risk markers and neonatal body composition: The Ulm SPATZ Health Study.

PURPOSE:In utero exposure to cardiometabolic risk factors may determine health related outcomes at birth and in later life. The aim of this analysis was to describe the relationship of maternal serum uric acid (SUA) and cystatin C with maternal and neonatal cardiometabolic risk markers and with birth weight and risk of small-for-gestational age (SGA) as well as large-for gestational age (LGA). MATERIAL AND METHODS:In the Ulm SPATZ Health Study, 934 singleton newborns and their mothers were recruited during their hospital stay in the University Medical Center Ulm between 04/2012 and 05/2013 (overall response 49%). The association between SUA and cystatin C (both in quartiles and as continuous measures) with risk for SGA as well as with LGA was quantified by means of multivariable logistic regression. RESULTS:Overall, n = 885 mother-newborn pairs were included in the final analysis. Most of the mothers were of German nationality (85%) and were between 26 and 35 years of age at delivery (69%). Maternal SUA was associated with maternal age, body mass index, alcohol consumption and history of hypertension as well as with many other maternal and neonate cardiovascular risk markers. Cystatin C was associated with parity. No clear association of SUA with SGA and LGA was observed in fully adjusted models. However, cystatin C was negatively associated with SGA with an odds ratio (OR) of 0.35 (95% CI: 0.16-0.77; p for trend 0.04) comparing the top quartile vs. the bottom quartile and was positively associated with LGA with an OR of 5.92 (95% CI: 2.27-15.44; p for trend <0.0001) after adjustment for covariates. CONCLUSIONS:We found a positive association of cystatin C with birth weight and a clearly increased risk for LGA with maternal increased cystatin C values in a population with fairly normal renal function

Distribution of uric acid and cystatin C with various sociodemographic and medical characteristics of the study population.

<p>Distribution of uric acid and cystatin C with various sociodemographic and medical characteristics of the study population.</p

Association of uric acid and cystatin C concentrations (categories, quartiles) with risk for small for gestational age (Panel A) and for large for gestational age (Panel B) by means of logistic regression.

<p>Association of uric acid and cystatin C concentrations (categories, quartiles) with risk for small for gestational age (Panel A) and for large for gestational age (Panel B) by means of logistic regression.</p

Splines representing OR for C SGA and LGA depending on cystatin C after full adjustment for covariates.

<p>The thick lines represent the OR, the thin lines the corresponding 95% confidence bands.</p

Association of maternal uric acid and cystatin C serum values with different maternal biomarkers after adjustment for age of mother (Spearman`s partial correlation coefficient (r, p-value)).

<p>Association of maternal uric acid and cystatin C serum values with different maternal biomarkers after adjustment for age of mother (Spearman`s partial correlation coefficient (r, p-value)).</p

Association of maternal uric acid and cystatin C serum values with different biomarkers from cord blood after adjustment for age of mother (Spearman`s partial correlation coefficient (r, p-value)).

<p>Association of maternal uric acid and cystatin C serum values with different biomarkers from cord blood after adjustment for age of mother (Spearman`s partial correlation coefficient (r, p-value)).</p

Flow chart of study population and final analysis population.

<p>Flow chart of study population and final analysis population.</p