Gestational diabetes & diabetes in pregnancy
Novel Metabolic Subtypes in Pregnant Women and Risk of Early Childhood Obesity in Offspring
Authors' conclusion
In this cohort study, an unsupervised clustering approach revealed distinct metabolic subgroups of pregnant women. These subgroups exhibited differences in risk of offspring adiposity in early childhood. Such approaches have the potential to refine understanding of the in utero metabolic milieu, with utility for capturing variation in sociocultural, anthropometric, and biochemical risk factors for offspring adiposity.
Study context
- Population
- Pregnant women in the Healthy Start prebirth cohort (enrollment 2010–2014), University of Colorado Hospital obstetrics clinics, Aurora, Colorado; subtypes from 7 biomarkers and 2 indices at ≈17 gestational weeks; offspring followed to ≈5 years727 offspring with childhood data
- Participants
- 1,325 women
- Exposure
- Maternal metabolic subgroups vs reference subgroup
- Referencen = 438reference
- High high-density lipoprotein cholesterol (HDL-C)n = 355
- Dyslipidemic-high triglyceridesn = 182
- Dyslipidemic-high free fatty acids (FFA)n = 234
- Insulin resistant (IR)-hyperglycemicn = 116
- Outcome
- Offspring birthweight z score and neonatal FM%; in childhood, BMI percentile, FM%, BMI ≥95th percentile and FM% ≥95th percentile
- Follow-up
- ≈5 years of age
Methodological detailsprebirth cohort, k-means clustering, single-centre, Data analyzed March to December 2022
- Prebirth cohort
- K-means clustering
- Single-centre
- Data analyzed March to December 2022
Main finding
As reported in the abstract
Offspring FM% in childhood · approximately 5 years
Each group vs referenceDifference, % (95% CI)
IR-hyperglycemicgreater FM% with IR-hyperglycemic
4.27(1.94–6.59)
Dyslipidemic-high FFAgreater FM% with dyslipidemic-high FFA
1.96(0.45–3.47)
Observational data: associations, not effects.
Further findings
| Outcome | RR (95% CI) | |
|---|---|---|
| High FM% (≥95th percentile) in offspring · ≈5 yearsIR-hyperglycemicvs Reference | 8.7 (2.7–27.8) | |
| High FM% (≥95th percentile) in offspring · ≈5 yearsDyslipidemic-high FFAvs Reference | 3.4 (1.0–11.3) | |
| 0.050.21520Relative risk (log scale) |
High FM% (≥95th percentile) in offspring · ≈5 years
- Risk of greater magnitude than with prepregnancy obesity alone, GDM alone, or both
Original publication
Novel Metabolic Subtypes in Pregnant Women and Risk of Early Childhood Obesity in Offspring. JAMA Netw Open. Published 3 April 2023. doi:10.
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