Maternal early pregnancy dietary glycemic index and load, fetal growth, and the risk of adverse birth outcomes

Purpose: Maternal hyperglycemia is associated with adverse birth outcomes. Maternal dietary glycemic index and load influence postprandial glucose concentrations. We examined the associations of maternal early pregnancy dietary glycemic index and load with fetal growth and risks of adverse birth outcomes. Methods: In a population-based cohort study of 3471 pregnant Dutch women, we assessed dietary glycemic index and load using a food frequency questionnaire at median 13.4 (95% range 10.6; 21.2) weeks gestation. We measured fetal growth in mid- and late-pregnancy by ultrasound and obtained birth outcomes from medical records. Results: Mean maternal early pregnancy dietary glycemic index and load were 57.7 (SD 3.3, 95% range 52.8; 63.5) and 155 (SD 47, 95% range 87; 243), respectively. Maternal early pregnancy dietary glycemic index was not associated with fetal growth parameters. A higher maternal early pregnancy dietary glycemic load was associated with a higher fetal abdominal circumference and estimated fetal weight in late-pregnancy (p values < 0.05), but not with mid-pregnancy or birth growth characteristics. A higher maternal early pregnancy dietary glycemic index was associated with a lower risk of a large-for-gestational-age infant (p value < 0.05). Maternal early pregnancy glycemic index and load were not associated with other adverse birth outcomes. Conclusion: Among pregnant women without an impaired glucose metabolism, a higher early pregnancy dietary glycemic load was associated with higher late-pregnancy fetal abdominal circumference and estimated fetal weight. No consistent associations of maternal dietary glycemic index and load with growth parameters in mid-pregnancy and at birth were present. A higher glycemic index was associated with a lower risk of a large-for-gestational-age infant

Maternal Glucose Concentrations in Early Pregnancy and Cardiometabolic Risk Factors in Childhood

Objective: This study aimed to examine the associations of maternal early-pregnancy glucose and insulin concentrations with offspring cardiometabolic risk factors and fat distribution. Methods: In a population-based prospective cohort study among 3,737 mothers and their children, random maternal glucose and insulin concentrations were measured at a median gestational age of 13.2 (95% range 10.5-17.1) weeks. Childhood fat, blood pressure, and blood concentrations of lipids, glucose, and insulin at the age of 10 years were measured. Results: Higher maternal early-pregnancy glucose and insulin concentrations were associated with a higher risk of childhood overweight, and higher maternal early-pregnancy insulin concentrations were associated with an increased childhood risk of clustering of cardiometabolic risk factors (all P < 0.05). These associations were explained by maternal prepregnancy BMI. Independent of maternal prepregnancy BMI, one SD score (SDS) higher maternal early-pregnancy glucose and insulin concentrations were associated with higher childhood glucose (0.08 SDS, 95% CI: 0.04-0.11) and insulin concentrations (0.07 SDS, 95% CI: 0.03-0.10), but not with childhood blood pressure, lipids, and fat measures. Conclusions: These results suggest that maternal early-pregnancy random glucose and insulin concentrations are associated with childhood glucose a

Smoking cessation in early-pregnancy, gestational weight gain and subsequent risks of pregnancy complications

Objective: Smoking cessation is associated with weight gain. We first examined the associations of smoking cessation in early-pregnancy with gestational weight gain and subsequently evaluated the risks of pregnancy complications among women who quit smoking in early-pregnancy according to their gestational weight gain. Methods: In a population-based prospective cohort study among 7,389 women, we measured weight in each pregnancy period. Information on smoking and pregnancy complications was obtained from questionnaires and medical records. Results: As compared to continued smoking during pregnancy, smoking cessation in early-pregnancy was not associated with gestational weight gain. Smoking cessation in early-pregnancy was associated with decreased risks of delivering small-for-gestational-age infants (Odds Ratio (OR) 0.52 (95 % Confidence Interval (CI) 0.37, 0.75)), but with increased risks of pre-eclampsia (OR 2.07 (95 % CI 1.01, 4.27)) and delivering large-for-gestational-age infants (OR 2.11 (95 % CI 1.45, 3.09)). Among women who quit smoking in early-pregnancy with >12 kg weight gain, the risks of pre-eclampsia and delivering large-for-gestational-age infants were slightly increased. Conclusion: As compared to continued smoking during pregnancy, smoking cessation in early-pregnancy is not associated with increased gestational weight gain. Among women who quit smoking in early-pregnancy, higher gestational weight gain does not strongly affect their risks of pregnancy complications

Early-pregnancy Glucose Metabolism and Childhood Health: From associations to prediction

Early-pregnancy is a crucial period for the development of offspring health and disease. In this thesis is described that a su

Maternal Early-Pregnancy Glucose Concentrations and Liver Fat Among School-Age Children

Background and Aims: Gestational diabetes seems to be associated with offspring NAFLD. We hypothesized that maternal glucose concentrations across the full range may have persistent effects on offspring liver fat accumulation. Approach and Results: In a multiethnic, population-based, prospective cohort study among 2,168 women and their offspring, maternal early-pregnancy glucose concentrations were measured at a median of 13.1 weeks’ gestation (95% CI, 9.6-17.2). Liver fat fraction was measured at 10 years by MRI. NAFLD was defined as liver fat fraction ≥5.0%. We performed analyses among all mothers with different ethnic backgrounds and those of European ancestry only. The multiethnic group had a median maternal early-pregnancy glucose concentration of 4.3 mmol/L (interquartile range, 3.9-4.9) and a 2.8% (n = 60) prevalence of NAFLD. The models adjusted for child age and sex only showed that in the multiethnic group, higher maternal early-pregnancy glucose concentrations were associated with higher liver fat accumulation and higher odds of NAFLD, but these associations attenuated into nonsignificance after adjustment for potential confounders. Among mothers of European ancestry only, maternal early-pregnancy glucose concentrations were associated with increased odds of NAFLD (OR, 1.95; 95% CI, 1.32; 2.88, after adjustment for confounders) per 1-mmol/L increase in maternal early-pregnancy glucose concentration. These associations were not explained by maternal prepregnancy and childhood body mass index, visceral fat, and metabolic markers. Conclusions: In this study, maternal early-pregnancy glucose concentrations were only among mothers of European ancestry associated with offspring NAFLD. The associations of higher maternal early-pregnancy glucose concentrations with offspring NAFLD may differ between ethnic groups.</p