Original Article
Intrahepatic Fat Is Increased in the Neonatal Offspring of Obese Women with Gestational Diabetes

https://doi.org/10.1016/j.jpeds.2012.11.017Get rights and content

Objectives

To assess precision magnetic resonance imaging in the neonate and determine whether there is an early maternal influence on the pattern of neonatal fat deposition in the offspring of mothers with gestational diabetes mellitus (GDM) and obesity compared with the offspring of normal-weight women.

Study design

A total of 25 neonates born to normal weight mothers (n = 13) and to obese mothers with GDM (n = 12) underwent magnetic resonance imaging for the measurement of subcutaneous and intra-abdominal fat and magnetic resonance spectroscopy for the measurement of intrahepatocellular lipid (IHCL) fat at 1-3 weeks of age.

Results

Infants born to obese/GDM mothers had a mean 68% increase in IHCL compared with infants born to normal-weight mothers. For all infants, IHCL correlated with maternal prepregnancy body mass index but not with subcutaneous adiposity.

Conclusion

Deposition of liver fat in the neonate correlates highly with maternal body mass index. This finding may have implications for understanding the developmental origins of childhood nonalcoholic fatty liver disease.

Section snippets

Methods

After written, informed parental consent was obtained, healthy, full-term infants were studied from 2 groups of mothers. Mothers were recruited during a 17-month period from prenatal care at either the University of Colorado Hospital or Denver Health. The first group consisted of infants born to mothers with a prepregnancy body mass index (BMI) <25 kg/m2 without GDM (normal-weight control). The second group included infants born to mothers with a prepregnancy BMI of >30 kg/m2 and who were

Results

Twenty-five infants from 12 mothers with obesity/GDM and 13 normal-weight mothers with normal glucose tolerance testing were studied. Pregnancy and infant characteristics are listed in Table I.26 Of the 12 obese/GDM mothers, 2 were class A1 (diet-controlled) GDM, and 10 were class A2 (requiring insulin or glyburide) GDM. Prepregnancy BMI (kg/m2) was greater in the obese/GDM group (40.1 vs 21.6, P < .05) by design. Obese/GDM mothers were older than normal-weight mothers (29.9 years vs 24.8

Discussion

Our results demonstrate that maternal prepregnancy BMI is associated with hepatic fat storage at 1-3 weeks of life across a cohort of infants born to both normal-weight and obese mothers with GDM. This relationship is consistent with findings reported by Modi et al.27 All of our obese mothers also had GDM, whereas <10% of mothers had GDM in the cohort described by Modi,27 suggesting that maternal obesity may be more important than the presence of GDM in predicting infant hepatic fat storage.

References (37)

  • C.E. McCurdy et al.

    Maternal high-fat diet triggers lipotoxicity in the fetal livers of nonhuman primates

    J Clin Invest

    (2009)
  • C. Druet et al.

    Independent effect of visceral adipose tissue on metabolic syndrome in obese adolescents

    Horm Res

    (2008)
  • M. Alvehus et al.

    The human visceral fat depot has a unique inflammatory profile

    Obesity (Silver Spring)

    (2010)
  • L. Pacifico et al.

    Nonalcoholic fatty liver disease and carotid atherosclerosis in children

    Pediatr Res

    (2008)
  • U.M. Schaefer-Graf et al.

    Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus

    Diabetes Care

    (2008)
  • N.A. Khan

    Role of lipids and fatty acids in macrosomic offspring of diabetic pregnancy

    Cell Biochem Biophys

    (2007)
  • R. Kelishadi et al.

    Cord blood lipid profile and associated factors: baseline data of a birth cohort study

    Paediatr Perinat Epidemiol

    (2007)
  • G. Di Cianni et al.

    Maternal triglyceride levels and newborn weight in pregnant women with normal glucose tolerance

    Diabet Med

    (2005)
  • Cited by (146)

    • The importance of nutrition in pregnancy and lactation: lifelong consequences

      2022, American Journal of Obstetrics and Gynecology
      Citation Excerpt :

      A “multiple-hit” pathogenic model has been suggested to explain the progressive liver damage that occurs among children with NAFLD.76 Data in humans demonstrated that liver fat is 68% higher in neonates born to mothers with obesity and GDM and is strongly correlated with maternal prepregnancy BMI and, perhaps, maternal triglycerides before subcutaneous fat stores are fully developed.77,78 Moreover, evidence from the national pediatric nonalcoholic steatohepatitis (NASH) network showed that high birthweight or LBW, even when adjusting for childhood BMI, doubles the risk of advanced fibrosis in youth with biopsy-confirmed NAFLD,79 suggesting that changes at birth may precede and possibly predict the rapid onset of NASH in at-risk youth for reasons that remain poorly understood.

    View all citing articles on Scopus

    Supported by National Institutes of Health (NIH)/National Center for Advancing Translational Sciences Colorado Clinical and Translational Sciences Institute. (UL1 TR000154 and 5 T32 DK067009 to D.B.), Children's Hospital Colorado Research Institute (to D.B.), NIH (5R01DK078645 [to L.B.] and DK504554 [J.F.]) Contents are the authors' sole responsibility and do not necessarily represent official NIH views. The authors declare no conflicts of interest.

    Contributed equally.

    View full text