Amniotic fluid insulin concentration as a predictor of obesity

Article Abstract:

Maternal metabolism may influence the developing child in a process called ''fuel-mediated teratogenesis'' (abnormal development); to learn more about this possibility, 56 children of diabetic women were studied six years after birth. Diabetics were chosen because this disorder involves profound changes in maternal metabolism. Of particular concern was the relationship between high levels of insulin in the amniotic fluid (in which the fetus floats) and obesity among the children six years later. The mothers had undergone amniocentesis (removal of a small amount of amniotic fluid) during weeks 32-38 of pregnancy. Twenty-six had pregestational diabetes mellitus (existing before pregnancy) and 30 had gestational diabetes mellitus (associated with pregnancy); all the pregestational diabetics and 18 from the other group took insulin several times daily. The symmetry index, calculated for the subjects at different ages, was expressed as a ratio between two quotients: the observed weight divided by the median weight for the age group (numerator) and the observed height divided by the median height for the age group (denominator). Results showed that the average symmetry index for the 56 babies at birth was 1.17; the index was strongly correlated with the concentration of insulin in amniotic fluid. At age six, this was still the case: children with higher symmetry indexes had been exposed to higher insulin concentrations in utero. The correlations persisted when statistical analyses were adjusted to control for maternal obesity and symmetry indexes. The higher symmetry index was the result of a disproportionately high weight; the children's height was not greater than expected for their age. The infants who became obese children (14 subjects) had been exposed to the highest levels of insulin. Although maternal insulin does not normally cross the placental barrier to the infant, some alteration takes place in the diabetic pregnancy that promotes increased insulin secretion by the fetus. The results indicate a relationship between body size and metabolic factors during development. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Causes of, Complications and side effects, Overweight persons, Obesity, Amniocentesis

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Prenatal and perinatal influences on long-term psychomotor development in offspring of diabetic mothers

Article Abstract:

Ketoacidosis in pregnancy could increase the risk of developmental abnormalities in the children of diabetic women. Researchers followed 196 diabetic pregnant women and their children before and after birth. Ninety-five women had diabetes prior to their pregnancy and 101 had gestational diabetes. All of the children received either a test of infant development at the age of two or tests of motor skills at 6, 8 or 9 years. Poor psychomotor development in the child was associated with elevated blood levels of beta-hydroxybutyrate during the mother's pregnancy. This chemical is a ketone, and indicates that the mother was not in good metabolic control. Poor psychomotor development was not associated with several complications of diabetic pregnancy including macrosomia, hypoglycemia or prematurity, nor was it associated with obesity in the child.

Health aspects, Risk factors, Metabolic regulation, Psychomotor disorders

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Metabolic response to meal eating and extended overnight fast in twin gestation

Article Abstract:

Women pregnant with twins may have an exaggerated starvation response to fasting compared with women carrying a single fetus. Ten women carrying twins and 10 carrying a single fetus fasted from 6 p.m. to noon the following day. Despite consuming more food during the day preceding the fast, the twin mothers had a greater increase in blood levels of ketones than singleton mothers. Ketones result from digestion of fat when glucose is unavailable. This is probably due to the increased metabolic demands of twin pregnancies.

Analysis, Physiological aspects, Food and nutrition, Pregnant women, Metabolism, Pregnancy, Multiple, Multiple pregnancy

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