Prediction of Healthy Pregnancy Outcomes in Women with Overweight and Obesity: The Role of Maternal Early-Pregnancy Metabolites

Overview

Journal Metabolites

Publisher MDPI

Date 2022 Jan 20

PMID 35050135

Authors

Rama J Wahab

Vincent W V Jaddoe

Romy Gaillard

Affiliations

Soon will be listed here.

Abstract

Women with obesity receive intensified antenatal care due to their increased risk of pregnancy complications, even though not all of these women develop complications. We developed a model based on maternal characteristics for prediction of healthy pregnancy outcomes in women with obesity or who are overweight. We assessed whether early-pregnancy metabolites improved prediction. In a population-based cohort study among a subsample of 1180 Dutch pregnant women with obesity or who are overweight, we developed a prediction model using 32 maternal socio-demographic, lifestyle, physical and pregnancy-related characteristics. We determined early-pregnancy amino acids, nonesterifed fatty acids, phospholipids and carnitines in blood serum using liquid chromatography-tandem mass spectrometry. A healthy pregnancy outcome was the absence of fetal death, gestational hypertension, preeclampsia, gestational diabetes, caesarian section, preterm birth, large-for-gestational-age at birth, macrosomia, postpartum weight retention and offspring overweight/obesity at 5 years. Maternal age, relationship status, parity, early-pregnancy body mass index, mid-pregnancy gestational weight gain, systolic blood pressure and estimated fetal weight were selected into the model using backward selection (area under the receiver operating characteristic curve: 0.65 (95% confidence interval 0.61 to 0.68)). Early-pregnancy metabolites did not improve model performance. Thus, in women with obesity or who are overweight, maternal characteristics can moderately predict a healthy pregnancy outcome. Maternal early-pregnancy metabolites have no incremental value in the prediction of a healthy pregnancy outcome.

References

McBride N, Yousefi P, White S, Poston L, Farrar D, Sattar N . Do nuclear magnetic resonance (NMR)-based metabolomics improve the prediction of pregnancy-related disorders? Findings from a UK birth cohort with independent validation. BMC Med. 2020; 18(1):366. PMC: 7681995. DOI: 10.1186/s12916-020-01819-z. View

Uhl O, Fleddermann M, Hellmuth C, Demmelmair H, Koletzko B . Phospholipid Species in Newborn and 4 Month Old Infants after Consumption of Different Formulas or Breast Milk. PLoS One. 2016; 11(8):e0162040. PMC: 5003354. DOI: 10.1371/journal.pone.0162040. View

Wahab R, Jaddoe V, Roest A, Toemen L, Gaillard R . Associations of Maternal Glycemia in the First Half of Pregnancy With Alterations in Cardiac Structure and Function in Childhood. Diabetes Care. 2020; 43(9):2272-2280. PMC: 7613757. DOI: 10.2337/dc19-2580. View

Verlohren S, Galindo A, Schlembach D, Zeisler H, Herraiz I, Moertl M . An automated method for the determination of the sFlt-1/PIGF ratio in the assessment of preeclampsia. Am J Obstet Gynecol. 2009; 202(2):161.e1-161.e11. DOI: 10.1016/j.ajog.2009.09.016. View

Jarvie E, Ramsay J . Obstetric management of obesity in pregnancy. Semin Fetal Neonatal Med. 2009; 15(2):83-8. DOI: 10.1016/j.siny.2009.10.001. View

Godfrey K, Reynolds R, Prescott S, Nyirenda M, Jaddoe V, Eriksson J . Influence of maternal obesity on the long-term health of offspring. Lancet Diabetes Endocrinol. 2016; 5(1):53-64. PMC: 5245733. DOI: 10.1016/S2213-8587(16)30107-3. View

Maack H, Larsson A, Axelsson O, Olovsson M, Wikstrom A, Poromaa I . Pregnancy in metabolic healthy and unhealthy obese women. Acta Obstet Gynecol Scand. 2020; 99(12):1640-1648. DOI: 10.1111/aogs.13929. View

Denison F, Aedla N, Keag O, Hor K, Reynolds R, Milne A . Care of Women with Obesity in Pregnancy: Green-top Guideline No. 72. BJOG. 2018; 126(3):e62-e106. DOI: 10.1111/1471-0528.15386. View

McKnight J, Satterfield M, Jobgen W, Smith S, Spencer T, Meininger C . Beneficial effects of L-arginine on reducing obesity: potential mechanisms and important implications for human health. Amino Acids. 2010; 39(2):349-57. DOI: 10.1007/s00726-010-0598-z. View

10.

Hu S, Han M, Rezaei A, Li D, Wu G, Ma X . L-Arginine Modulates Glucose and Lipid Metabolism in Obesity and Diabetes. Curr Protein Pept Sci. 2016; 18(6):599-608. DOI: 10.2174/1389203717666160627074017. View

11.

DeLong E, Delong D, Clarke-Pearson D . Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988; 44(3):837-45. View

12.

Wahab R, Jaddoe V, Voerman E, Ruijter G, Felix J, Marchioro L . Maternal Body Mass Index, Early-Pregnancy Metabolite Profile, and Birthweight. J Clin Endocrinol Metab. 2021; 107(1):e315-e327. PMC: 8684472. DOI: 10.1210/clinem/dgab596. View

13.

. ACOG Practice Bulletin No 156: Obesity in Pregnancy. Obstet Gynecol. 2015; 126(6):e112-e126. DOI: 10.1097/AOG.0000000000001211. View

14.

Catalano P, Shankar K . Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ. 2017; 356:j1. PMC: 6888512. DOI: 10.1136/bmj.j1. View

15.

Wu G, Bazer F, Davis T, Kim S, Li P, Rhoads J . Arginine metabolism and nutrition in growth, health and disease. Amino Acids. 2008; 37(1):153-68. PMC: 2677116. DOI: 10.1007/s00726-008-0210-y. View

16.

Blencowe H, Cousens S, Oestergaard M, Chou D, Moller A, Narwal R . National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012; 379(9832):2162-72. DOI: 10.1016/S0140-6736(12)60820-4. View

17.

Terstappen F, Tol A, Gremmels H, Wever K, Paauw N, Joles J . Prenatal Amino Acid Supplementation to Improve Fetal Growth: A Systematic Review and Meta-Analysis. Nutrients. 2020; 12(9). PMC: 7551332. DOI: 10.3390/nu12092535. View

18.

Relph S, Guo Y, Harvey A, Vieira M, Corsi D, Gaudet L . Characteristics associated with uncomplicated pregnancies in women with obesity: a population-based cohort study. BMC Pregnancy Childbirth. 2021; 21(1):182. PMC: 7934497. DOI: 10.1186/s12884-021-03663-2. View

19.

Ernst G, de Jonge L, Hofman A, Lindemans J, Russcher H, Steegers E . C-reactive protein levels in early pregnancy, fetal growth patterns, and the risk for neonatal complications: the Generation R Study. Am J Obstet Gynecol. 2011; 205(2):132.e1-12. DOI: 10.1016/j.ajog.2011.03.049. View

20.

Knight M . Sharper focus on uncomplicated pregnancy. BMJ. 2013; 347:f6470. DOI: 10.1136/bmj.f6470. View