Nulliparity is associated with subtle adverse metabolic outcomes in overweight/obese mothers and their offspring

Abstract

Background

We aimed to evaluate metabolic outcomes in overweight/obese nulliparous and multiparous women and their offspring.

Study design

Seventy-two overweight and obese women who participated in a randomized controlled trial of exercise in pregnancy were included in the study, comparing 18 nulliparous and 54 multiparous women and their singleton offspring. Women were assessed at 19 and 36 weeks of gestation. Fetal growth was measured using standard obstetric ultrasound techniques. Cord blood was collected at birth. Maternal and offspring body composition was assessed using DXA ~2 weeks after delivery.

Results

Nulliparous women had higher HbA1c in the third trimester of pregnancy than multiparous women (5.48 vs 5.29%; p=0.002), and were more insulin resistant based on the surrogate marker sex hormone binding globulin (354 vs 408 nmol/l; p=0.047). Nulliparous women also had higher levels of the inflammatory marker TNF-α (4.74 vs 3.62 pg/ml; p=0.025). At birth, the offspring of nulliparous women were on average 340 g (p=0.013) and 0.69 SDS (p=0.026) lighter than those born of multiparous women. Cord blood data showed lower IGF-II (p=0.026) and higher IGFBP-1 (p=0.002) levels in the offspring of nulliparous women. In addition, a less favourable metabolic profile was observed in the offspring of nulliparous women, as indicated by higher triglyceride (p<0.001) and interleukin-6 (p=0.039) concentrations.

Conclusions

Infants born of nulliparous overweight and obese women appear to be exposed to a less favourable metabolic environment in utero, with evidence of subtle adverse metabolic outcomes at birth compared to infants of overweight/obese multiparous women.

This article is protected by copyright. All rights reserved.

http://ift.tt/2ubyrbH