Relationship between gestational weight gain with fetal body composition and organ volumes in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Dimensional Study: a prospective pregnancy cohort

IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS American Journal of Clinical Nutrition Pub Date : 2025-02-01 DOI:10.1016/j.ajcnut.2024.12.007
Kathryn A Wagner , Zhen Chen , Stefanie N Hinkle , Jessica L Gleason , Wesley Lee , William A Grobman , John Owen , Roger B Newman , Daniel W Skupski , Dian He , Seth Sherman , Robert E Gore-Langton , Cuilin Zhang , Jagteshwar Grewal , Katherine L Grantz
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Abstract

Background

Inadequate and excessive gestational weight gain (GWG) are associated with increased risk of newborn small- and large-for-gestational-age, respectively, and future offspring adiposity. However, the relationship between GWG and three-dimensional (3D) measures of fetal body composition and organ volumes, which may provide greater insight into fetal growth via measurement of soft tissue, remains unknown.

Objectives

The objective of this study was to examine the relationship between trimester-specific GWG and 3D fetal body composition and organ volume measurements.

Methods

In a diverse, US prospective pregnancy cohort, trimester-specific GWG was calculated as difference between maternal weight at beginning and end of each trimester, and categorized as inadequate, adequate, or excessive, per 2009 Institute of Medicine (IOM) guidelines. Up to five 3D ultrasound scans were completed across gestation, from which fetal body composition and organ volume measurements were obtained (n = 2675 pregnancies). The associations between trimester-specific GWG categories and 3D fetal body composition and organ volumes were assessed at 15, 29, and 39 weeks.

Results

Excessive compared with adequate GWG, in first and second trimesters was associated with larger abdominal circumference (n = 2430; 1st trimester: 1.29 cm, 95% CI: 0.74, 1.84; 2nd trimester: 2.98 cm, 95% CI: 1.62, 4.34) and abdominal area (n = 2401; 1st trimester: 22.04 mm2, 95% CI: 0.48, 43.60; 2nd trimester: 162.34 mm2, 95% CI: 76.25, 248.44), whereas excessive GWG in the first trimester was associated with larger arm subcutaneous tissue thickness (n = 1921; 0.01 cm, 95% CI: 0.00, 0.01). There was a trend toward increased fetal arm, thigh, kidney, and liver volumes and abdominal subcutaneous tissue, although differences did not reach the level of statistical significance for these structures.

Conclusions

Excessive GWG was associated with greater fetal size primarily manifested by a pattern of fat accumulation across the fetal arm and abdomen. Future studies should examine whether these fetal changes have functional implications for childhood adiposity and metabolic dysfunction.
This trial was registered at https://clinicaltrials.gov as NCT00912132 and NCT03266198
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来源期刊
CiteScore
12.40
自引率
4.20%
发文量
332
审稿时长
38 days
期刊介绍: American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.
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