MATERNAL ADIPOSITY, INSULIN SENSITIVITY AND INFLAMMATION, AND INFANT ADIPOSITY: ASSOCIATIONS WITH OFFSPRING AUTONOMIC NERVOUS SYSTEM DEVELOPMENT

Abstract

Objective: The prevalence of maternal overweight and obesity is high and the impact is far reaching. Recent studies suggest that fetal exposure to maternal obesity is related to poor neurodevelopmental outcomes in childhood. However, limited data have been collected on the developing fetus. Studies also suggest that the adverse effect was mediated through insulin resistance (IR) and inflammation. We investigated if maternal pre-pregnancy BMI, gestational weight gain (GWG) and newborn adiposity, were associated with fetal autonomic nervous development as indicated by fetal heart rate variability (HRV) and newborn behavior. We also investigated if maternal IR and inflammation were associated with fetal HRV. Material and methods: A total of 48 mother-offspring pairs were analyzed. Short-term (SD1) and overall (SD2) fetal HRV were measured at 32 and 36 weeks of pregnancy using fetal magnetocardiogram. Maternal plasma levels of glucose, insulin, and inflammatory cytokines (TNF-α and IL-6) were analyzed from maternal peripheral blood collected at 36 weeks of pregnancy. Newborn body composition was measured using air-displacement plethysmography (PeaPod®). Multiple linear regression models predicted fetal HRV measures (SD1 and SD2 at 36 week, and SD1 and SD2 change between 32 and 36 week) and NBAS clusters from maternal and newborn factors. Infant gender and pre-pregnancy BMI were included as confounders. Results: In the adjusted regression model, greater GWG was associated with greater SD1 (β=0.442; R2=0.19; p=0.003) and with SD1 change (β =0.511; R2=0.27; p=0.007). Lower newborn %fat was associated with greater SD2 change, but the association was diminished in the adjusted model (β=-0.426; R2=0.17; p=0.055). No correlation was found between any of NBAS cluster scores and maternal or infant predictors, and between fetal HRV and maternal IR and blood inflammatory markers. Conclusions: Greater GWG was associated with better fetal autonomic nervous development, while greater newborn %fat was associated with poorer fetal autonomic nervous development. Further studies are needed to elucidate the impact of maternal and fetal/newborn adiposity on fetal neurodevelopment.