Open Access Research article

Effect of maternal obesity with and without gestational diabetes on offspring subcutaneous and preperitoneal adipose tissue development from birth up to year-1

Kirsten Uebel12, Karina Pusch4, Kurt Gedrich3, Karl-Theo M Schneider5, Hans Hauner24 and Bernhard L Bader124*

Author Affiliations

1 PhD Graduate School ‘Nutritional adaptation and epigenetic mechanisms’, ZIEL - Research Center for Nutrition and Food Sciences, Technische Universität München, Freising-Weihenstephan, Germany

2 Clinical Nutritional Medicine Unit, ZIEL - Research Center for Nutrition and Food Sciences, Technische Universität München, Freising-Weihenstephan, Germany

3 Biochemistry Unit, ZIEL - Research Center for Nutrition and Food Sciences, Technische Universität München, Freising-Weihenstephan, Germany

4 Else Kröner-Fresenius-Center for Nutritional Medicine, Wissenschaftszentrum Weihenstephan, Klinikum rechts der Isar, Uptown München Campus D, Technische Universität München, Munich, Germany

5 Abteilung für Geburtshilfe und Perinatalmedizin der Frauenklinik, Technische Universität München, Munich, Germany

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BMC Pregnancy and Childbirth 2014, 14:138  doi:10.1186/1471-2393-14-138

Published: 11 April 2014

Abstract

Background

Maternal obesity and gestational diabetes mellitus (GDM) may independently influence offspring fat mass and metabolic disease susceptibility. In this pilot study, body composition and fat distribution in offspring from obese women with and without GDM and lean women were assessed within the 1st year of life, and maternal and newborn plasma factors were related to offspring adipose tissue distribution.

Methods

Serum and plasma samples from pregnant obese women with (n = 16) or without (n = 13) GDM and normoglycemic lean women (n = 15) at 3rd trimester and offspring cord plasma were used for analyzing lipid profiles, insulin and adipokine levels. At week-1 and 6, month-4 and year-1, offspring anthropometrics and skinfold thickness (SFT) were measured and abdominal subcutaneous (SCA) and preperitoneal adipose tissue (PPA) were determined by ultrasonography.

Results

Cord insulin was significantly increased in the GDM group, whereas levels of cord leptin, total and high molecular weight (HMW) adiponectin were similar between the groups. Neonates of the GDM group showed significantly higher SFT and fat mass until week-6 and significantly increased SCA at week-1 compared to the lean group that persisted as strong trend at week-6. Interestingly, PPA in neonates of the GDM group was significantly elevated at week-1 compared to both the lean and obese group. At month-4 and year-1, significant differences in adipose tissue growth between the groups were not observed. Multiple linear regression analyses revealed that cord insulin levels are independently related to neonatal PPA that showed significant relation to PPA development at year-1. Maternal fasted C-peptide and HMW adiponectin levels at 3rd trimester emerged to be determinants for PPA at week-1.

Conclusion

Maternal pregravid obesity combined with GDM leads to newborn hyperinsulinemia and increased offspring fat mass until week-6, whereas pregravid obesity without GDM does not. This strongly suggests the pivotal role of GDM in the adverse offspring outcome. Maternal C-peptide and HMW adiponectin levels in pregnancy emerge to be predictive for elevated PPA in newborns and might be indicative for the obesity risk at later life. Altogether, the findings from our pilot study warrant evaluation in long-term studies.

Trial registration

German Clinical Trials Register DRKS00004370

Keywords:
Gestational diabetes mellitus; Maternal obesity; Fetal programming; Adiponectin; Insulin; C-peptide; Skinfold thickness; Ultrasonography; Subcutaneous adipose tissue; Preperitoneal adipose tissue