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

Wang, J. et al. (2022) Association of maternal lipid levels with birth weight and cord blood insulin: a Bayesian network analysis. BMJ Open, 12(12), e064122. (doi: 10.1136/bmjopen-2022-064122) (PMID:36581404) (PMCID:PMC9806023)

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.

• Item Type: Articles
• Additional Information: This work was supported by National Natural Science Foundation of China [grant numbers 82173525 and 82273642]. JW was supported by the LiSiguang scholarship provided by the University of Birmingham and the China Scholarship Council jointly (award number: 201508060007).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Sattar, Professor Naveed
• Authors: Wang, J., Kuang, Y., Shen, S., Price, M. J., Lu, J., Sattar, N., He, J., Pittavino, M., Xia, H., Thomas, G.N., Qiu, X., Cheng, K. K., and Nirantharakumar, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: BMJ Open
• Publisher: BMJ Publishing Group
• ISSN: 2044-6055
• ISSN (Online): 2044-6055
• Published Online: 29 December 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in BMJ Open 12(12): e064122
• Publisher Policy: Reproduced under a Creative Commons License