Abstract
Objective: Maternal obesity and metabolic health affect pregnancy outcomes. We examined whether maternal metabolic profiles are associated with placental and fetal hemodynamics. Study Design: In a population-based prospective cohort study among 1175 women we examined the associations of an adverse maternal metabolic profile in early pregnancy with placental, fetal cerebral and cardiac hemodynamic development. We obtained maternal pre-pregnancy BMI by questionnaire and measured blood pressure, cholesterol, triglycerides and glucose concentrations at a median gestational age of 12.6 (95 % range 9.6–17.1) weeks. An adverse maternal metabolic profile was defined as ≥4 risk factors. Placental and fetal hemodynamics were measured by pulsed-wave-Doppler at a median gestational age of 30.3 (95 % range 28.8–32.3) weeks. Results: An adverse maternal metabolic profile was associated with a 0.29 Z-score higher (95 %CI 0.08−0.50) fetal cerebral middle artery pulsatility index (PI), but not with placental or fetal cardiac hemodynamic patterns. When the individual components of an adverse maternal metabolic profile were assessed, we observed that higher maternal total cholesterol and triglyceride concentrations were associated with a higher cerebral middle artery PI (Z-score, 0.09 (95 %CI 0.02−0.15), 0.09 (95 %CI 0.03−0.15) per Z-score increase). Higher total and HDL maternal cholesterol concentrations were also associated with a higher aorta ascendens peak systolic velocity (PSV) Z-score, 0.08 (95 %CI 0.01−0.14)), and a larger left cardiac output (Z-score, 0.08 (95 %CI 0.00−0.15), respectively). Conclusion: An adverse maternal metabolic profile, especially higher cholesterol and triglycerides concentrations, are associated with increased fetal cerebral vascular resistance and larger fetal aorta ascendens diameter, PSV and left cardiac output, but not with placental vascular resistance indices. Further studies are needed to identify long-term consequences of the observed associations.
| Original language | English |
|---|---|
| Pages (from-to) | 51-58 |
| Number of pages | 8 |
| Journal | European Journal of Obstetrics, Gynecology and Reproductive Biology |
| Volume | 257 |
| DOIs | |
| Publication status | Published - Feb 2021 |
Bibliographical note
Funding Information:The Generation R Study is financially supported by the Erasmus Medical Center, Rotterdam, the Erasmus University Rotterdam and the Netherlands Organization for Health Research and Development. VWVJ received a grant from the Netherlands Organization for Health Research and Development (NWO, ZonMw-VIDI 016.136.361) and a European Research Council Consolidator Grant (ERC-2014-CoG-648916). RG received funding from the Dutch Heart Foundation (grant number 2017T013), the Dutch Diabetes Foundation (grant number 2017.81.002) and the Netherlands Organization for Health Research and Development (ZonMW, grant number 543003109).
Funding Information:
The Generation R Study is financially supported by the Erasmus Medical Center, Rotterdam , the Erasmus University Rotterdam and the Netherlands Organization for Health Research and Development . VWVJ received a grant from the Netherlands Organization for Health Research and Development (NWO, ZonMw-VIDI 016.136.361) and a European Research Council Consolidator Grant ( ERC-2014-CoG-648916 ). RG received funding from the Dutch Heart Foundation (grant number 2017T013 ), the Dutch Diabetes Foundation (grant number 2017.81.002 ) and the Netherlands Organization for Health Research and Development (ZonMW, grant number 543003109 ).
Publisher Copyright:
© 2020 Elsevier B.V.
