Mediators of lifestyle intervention effects on neonatal adiposity: are we missing a piece of the puzzle?

Rodrigo Antunes Lima*, Gernot Desoye, on behalf of the DALI Core Investigator Group, David Simmons, Mireille Nicoline Maria van Poppel, Roland Devlieger, Sander Galjaard, Rosa Corcoy, Juan M. Adelantado, Fidelma Dunne, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R. Mathiesen, Dorte M. Jensen, Lise Lotte Andersen, Mette Tanvig, Annunziata Lapolla, Maria Grazia Dalfra, Alessandra BertolottoEwa Wender-Ozegowska, Agnieszka Zawiejska, David J. Hill, Frank J. Snoek, Judith G.M. Jelsma

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


We evaluated possible mediators underlying lifestyle intervention effects on neonatal adiposity, assessed with sum of skinfolds and cord blood leptin. This is a secondary analysis of the DALI study, a randomised controlled trial in nine European countries. Pregnant women with a pre-pregnancy body mass index of ≥29 kg/m2 were randomly assigned to counselling for healthy eating (HE), physical activity (PA), HE&PA combined, or to usual care. We considered five maternal metabolic factors at 24–28 and 35–37 weeks of gestation, and four cord blood factors as possible mediators of the effect of combined HE&PA counselling on neonatal adiposity. From all potential mediators, the intervention only affected cord blood non-esterified fatty acids (NEFA), which was higher in the HE&PA group compared to UC (0.068 (mmol/L), 95% CI: 0.004 to 0.133). Cord blood NEFA did not mediate the HE&PA intervention effects on neonatal sum of skinfolds or cord blood leptin, based on an indirect effect on skinfolds of 0.018 (mm), 95% CI: −0.217 to 0.253 and an indirect effect on leptin of −0.143 (μg/l), 95% CI: −0.560 to 0.273. The Dali study observed reductions in neonatal adiposity in pregnant women with obesity, but we were not able to identify the underlying metabolic pathway.

Original languageEnglish
Pages (from-to)522-525
Number of pages4
JournalPediatric Research
Issue number3
Publication statusPublished - Feb 2022

Bibliographical note

This work was supported by European Union 7th framework (FP7/ 2007–2013) under Grant Agreement no. 242187. In the Netherlands, additional funding was provided by the Netherlands Organisation for Health Research and Development (ZonMw) (grant 200310013). In Poland, additional funding was obtained from Polish Ministry of Science (grants 2203/7, PR/2011/2). In Denmark, additional funding was provided by Odense University Free Research Fund. In Spain, additional funding was provided by CAIBER (1527-B-226). The funders had no role in any aspect of the study beyond funding.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.


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