Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study
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Abstract
OBJECTIVE: To examine associations of neonatal adiposity with maternal glucose levels and cord serum C-peptide in a multicenter multinational study, the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study, thereby assessing the Pederson hypothesis linking maternal glycemia and fetal hyperinsulinemia to neonatal adiposity. RESEARCH DESIGN AND METHODS: Eligible pregnant women underwent a standard 75-g oral glucose tolerance test between 24 and 32 weeks gestation (as close to 28 weeks as possible). Neonatal anthropometrics and cord serum C-peptide were measured. Associations of maternal glucose and cord serum C-peptide with neonatal adiposity (sum of skin folds >90th percentile or percent body fat >90th percentile) were assessed using multiple logistic regression analyses, with adjustment for potential confounders, including maternal age, parity, BMI, mean arterial pressure, height, gestational age at delivery, and the baby's sex. RESULTS: Among 23,316 HAPO Study participants with glucose levels blinded to caregivers, cord serum C-peptide results were available for 19,885 babies and skin fold measurements for 19,389. For measures of neonatal adiposity, there were strong statistically significant gradients across increasing levels of maternal glucose and cord serum C-peptide, which persisted after adjustment for potential confounders. In fully adjusted continuous variable models, odds ratios ranged from 1.35 to 1.44 for the two measures of adiposity for fasting, 1-h, and 2-h plasma glucose higher by 1 SD. CONCLUSIONS: These findings confirm the link between maternal glucose and neonatal adiposity and suggest that the relationship is mediated by fetal insulin production and that the Pedersen hypothesis describes a basic biological relationship influencing fetal growth.
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The record
- Venue
- Diabetes
- Topic
- Gestational Diabetes Research and Management
- Field
- Medicine
- Canadian institutions
- —
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNational Center for Research ResourcesNational Institute of Child Health and Human DevelopmentFeinberg School of MedicineNovo NordiskKarolinska InstitutetNational Institutes of HealthSackler Faculty of Medicine, Tel-Aviv UniversityQueen's UniversityQueen's University BelfastBrown UniversityDiabetes UKRoyal College of Physicians of EdinburghCase Western Reserve UniversityKaiser PermanenteNorthwestern UniversityUniversity of WarwickAmerican Diabetes Association
- Keywords
- MedicineHyperinsulinemiaPregnancyGestationConfoundingGestational ageInternal medicineEndocrinologyFetusObstetricsGestational diabetesInsulinInsulin resistance
- Has abstract in OpenAlex
- yes