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Mismatch between poor fetal growth and rapid postnatal weight gain in the first 2 years of life Is associated with higher blood pressure and insulin resistance without increased adiposity in childhood: The GUSTO Cohort Study

Mismatch between poor fetal growth and rapid postnatal weight gain in the first 2 years of life Is associated with higher blood pressure and insulin resistance without increased adiposity in childhood: The GUSTO Cohort Study
Mismatch between poor fetal growth and rapid postnatal weight gain in the first 2 years of life Is associated with higher blood pressure and insulin resistance without increased adiposity in childhood: The GUSTO Cohort Study
Background: using longitudinal ultrasounds as an improved fetal growth marker, we aimed to investigate if fetal growth deceleration followed by rapid postnatal weight gain is associated with childhood cardiometabolic risk biomarkers in a contemporary well-nourished population.

Methods: we defined fetal growth deceleration (FGD) as ultrasound-measured 2nd-3rd-trimester abdominal circumference decrease by ≥0.67 standard deviation score [SDS] and rapid postnatal weight gain (RPWG) as 0-2-year-old weight increase by ≥0.67 SDS. In the GUSTO mother-offspring cohort, we grouped 797 children into 4 groups of FGD-only (14.2%), RPWG-only (23.3%), both (mismatch, 10.7%) or neither (reference, 51.8%). Adjusting for confounders and comparing to the reference group, we tested associations of these growth groups with childhood cardiometabolic biomarkers: MRI-measured abdominal fat (n=262), liver fat (n=216), intramyocellular lipids (n=227), Quantitative Magnetic Resonance-measured overall body fat % (BF%) (n=310), homeostasis model assessment of insulin resistance (HOMA-IR) (n=323), arterial wall thickness (n=422) and stiffness (n=443), and blood pressure trajectories (ages 3-6y).

Results: mean±SD birthweights were: FGD-only (3.11±0.38kg), RPWG-only (3.03±0.37kg), mismatch (2.87±0.31kg), reference (3.30±0.36kg). FGD-only children had elevated blood pressure trajectories without correspondingly increased BF%. RPWG-only children had altered body fat partitioning, higher BF% (B=4.26% 95%CI [2.34,6.19]), HOMA-IR (0.28units [0.11,0.45]), and elevated blood pressure trajectories. Mismatch children did not have increased adiposity, but had elevated ectopic fat, elevated HOMA-IR (0.29units [0.04,0.55]), and the highest blood pressure trajectories. Associations remained even after excluding small-for-gestational-age infants from analyses.

Conclusions: fetal growth deceleration coupled with rapid postnatal weight gain was associated with elevated childhood cardiometabolic risk biomarkers without correspondingly increased BF%.
0300-5771
Ong, Yi Ying
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Sadananthan, Suresh Anand
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Aris, Izzuddin M.
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Tint, Mya Thway
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Yuan, Wen Lun
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Huang, Jonathan Y.
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Chan, Yiong Huak
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Ng, Sharon
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Loy, See Ling
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Velan, Sendhil
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Fortier, Marielle V.
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Godfrey, Keith
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Tan, Kok Hian
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Gluckman, Peter D.
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Yap, Fabian
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Choo, Jonathan Tze Liang
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Ling, Lieng Hsi
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Tan, Karen
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Chen, Li
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Karnani, Neerja
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Chong, Yap-Seng
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Eriksson, Johan G.
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Wlodek, Mary E.
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Chan, Shiao-Yng
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Lee, Yung Seng
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Michael, Navin
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Ong, Yi Ying
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Sadananthan, Suresh Anand
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Aris, Izzuddin M.
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Tint, Mya Thway
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Yuan, Wen Lun
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Huang, Jonathan Y.
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Chan, Yiong Huak
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Ng, Sharon
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Loy, See Ling
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Velan, Sendhil
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Fortier, Marielle V.
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Godfrey, Keith
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Shek, Lynette
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Tan, Kok Hian
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Gluckman, Peter D.
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Yap, Fabian
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Choo, Jonathan Tze Liang
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Ling, Lieng Hsi
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Tan, Karen
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Chen, Li
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Karnani, Neerja
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Chong, Yap-Seng
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Eriksson, Johan G.
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Wlodek, Mary E.
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Chan, Shiao-Yng
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Lee, Yung Seng
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Michael, Navin
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Ong, Yi Ying, Sadananthan, Suresh Anand, Aris, Izzuddin M., Tint, Mya Thway, Yuan, Wen Lun, Huang, Jonathan Y., Chan, Yiong Huak, Ng, Sharon, Loy, See Ling, Velan, Sendhil, Fortier, Marielle V., Godfrey, Keith, Shek, Lynette, Tan, Kok Hian, Gluckman, Peter D., Yap, Fabian, Choo, Jonathan Tze Liang, Ling, Lieng Hsi, Tan, Karen, Chen, Li, Karnani, Neerja, Chong, Yap-Seng, Eriksson, Johan G., Wlodek, Mary E., Chan, Shiao-Yng, Lee, Yung Seng and Michael, Navin (2020) Mismatch between poor fetal growth and rapid postnatal weight gain in the first 2 years of life Is associated with higher blood pressure and insulin resistance without increased adiposity in childhood: The GUSTO Cohort Study. International Journal of Epidemiology, 49 (5). (doi:10.1093/ije/dyaa143).

Record type: Article

Abstract

Background: using longitudinal ultrasounds as an improved fetal growth marker, we aimed to investigate if fetal growth deceleration followed by rapid postnatal weight gain is associated with childhood cardiometabolic risk biomarkers in a contemporary well-nourished population.

Methods: we defined fetal growth deceleration (FGD) as ultrasound-measured 2nd-3rd-trimester abdominal circumference decrease by ≥0.67 standard deviation score [SDS] and rapid postnatal weight gain (RPWG) as 0-2-year-old weight increase by ≥0.67 SDS. In the GUSTO mother-offspring cohort, we grouped 797 children into 4 groups of FGD-only (14.2%), RPWG-only (23.3%), both (mismatch, 10.7%) or neither (reference, 51.8%). Adjusting for confounders and comparing to the reference group, we tested associations of these growth groups with childhood cardiometabolic biomarkers: MRI-measured abdominal fat (n=262), liver fat (n=216), intramyocellular lipids (n=227), Quantitative Magnetic Resonance-measured overall body fat % (BF%) (n=310), homeostasis model assessment of insulin resistance (HOMA-IR) (n=323), arterial wall thickness (n=422) and stiffness (n=443), and blood pressure trajectories (ages 3-6y).

Results: mean±SD birthweights were: FGD-only (3.11±0.38kg), RPWG-only (3.03±0.37kg), mismatch (2.87±0.31kg), reference (3.30±0.36kg). FGD-only children had elevated blood pressure trajectories without correspondingly increased BF%. RPWG-only children had altered body fat partitioning, higher BF% (B=4.26% 95%CI [2.34,6.19]), HOMA-IR (0.28units [0.11,0.45]), and elevated blood pressure trajectories. Mismatch children did not have increased adiposity, but had elevated ectopic fat, elevated HOMA-IR (0.29units [0.04,0.55]), and the highest blood pressure trajectories. Associations remained even after excluding small-for-gestational-age infants from analyses.

Conclusions: fetal growth deceleration coupled with rapid postnatal weight gain was associated with elevated childhood cardiometabolic risk biomarkers without correspondingly increased BF%.

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Accepted/In Press date: 20 July 2020
e-pub ahead of print date: 20 August 2020

Identifiers

Local EPrints ID: 442200
URI: http://eprints.soton.ac.uk/id/eprint/442200
ISSN: 0300-5771
PURE UUID: a0a3d15e-e828-4c3f-84f6-52906c2d76e2
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 08 Jul 2020 16:31
Last modified: 07 Oct 2021 04:01

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Contributors

Author: Yi Ying Ong
Author: Suresh Anand Sadananthan
Author: Izzuddin M. Aris
Author: Mya Thway Tint
Author: Wen Lun Yuan
Author: Jonathan Y. Huang
Author: Yiong Huak Chan
Author: Sharon Ng
Author: See Ling Loy
Author: Sendhil Velan
Author: Marielle V. Fortier
Author: Keith Godfrey ORCID iD
Author: Lynette Shek
Author: Kok Hian Tan
Author: Peter D. Gluckman
Author: Fabian Yap
Author: Jonathan Tze Liang Choo
Author: Lieng Hsi Ling
Author: Karen Tan
Author: Li Chen
Author: Neerja Karnani
Author: Yap-Seng Chong
Author: Johan G. Eriksson
Author: Mary E. Wlodek
Author: Shiao-Yng Chan
Author: Yung Seng Lee
Author: Navin Michael

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