Abstract：
The purpose of this study is to examine associations between maternal lipid profiles in pregnancy and offspring growth trajectories in a largely macrosomic cohort. This is a secondary analysis of the ROLO birth cohort (n = 293), which took place in the National Maternity Hospital, Dublin, Ireland. Infants were mostly macrosomic, with 55% having a birthweight > 4 kg. Maternal mean age was 32.4 years (SD 3.9 years), mean BMI was 26.1 kg/m2 (SD 4.4 kg/m2) and 48% of children born were males. Total cholesterol, high density lipoprotein cholesterol (HDL-cholesterol), low density lipoprotein cholesterol (LDL-cholesterol) and triglycerides were measured from fasting blood samples of mothers at 14 and 28 week gestation. The change in maternal lipid levels from early to late pregnancy was also examined. Offspring abdominal circumference and weight were measured at 20- and 34-week gestation, birth, 6 months, 2 years and 5 years postnatal. Linear spline multilevel models examined associations between maternal blood lipid profiles and offspring growth. We found some weak, significant associations between maternal blood lipids and trajectories of offspring growth. Significant findings were close to the null, providing limited evidence. For instance, 1 mmol/L increase in maternal triglycerides was associated with faster infant weight growth from 20- to 34-week gestation (0.01 kg/week, 95% CI - 0.02, - 0.001) and slower abdominal circumference from 2 to 5 years (0.01 cm/week, 95% CI - 0.02, - 0.001). These findings do not provide evidence of a clinically meaningful effect. Conclusion: These findings raise questions about the efficacy of interventions targeting maternal blood lipid profiles in pregnancies at risk of macrosomia. New studies on this topic are needed. What is Known: • Maternal fat accumulation during early pregnancy may potentially support fetal growth in the third trimester by providing a reserve of lipids that are broken down and transferred to the infant across the placental barrier. • There are limited studies exploring the impact of maternal lipid profiles on infant and child health using growth trajectories spanning prenatal to postnatal life. What is New: • Maternal blood lipid profiles were not associated with offspring growth trajectories of weight and abdominal circumference during pregnancy up to 5 years of age in a largely macrosomic cohort, as significant findings were close to the null, providing limited evidence for a clinically meaningful relationship. • Strengths of this work include the use of infant growth trajectories that span prenatal to postnatal life and inclusion of analyses of the change of maternal lipid levels from early to late pregnancy and their associations with offspring growth trajectories from 20-week gestation to 5 years of age.
摘要：
这项研究的目的是在一个很大的宏观队列中检查怀孕期间母体脂质分布与后代生长轨迹之间的关联。这是ROLO出生队列的二次分析(n=293)，发生在国立妇产医院，都柏林,爱尔兰。婴儿大多是宏观的，55%的人出生体重>4公斤。产妇平均年龄为32.4岁（SD3.9岁），平均BMI为26.1kg/m2(SD4.4kg/m2),出生儿童中48%为男性.总胆固醇,高密度脂蛋白胆固醇（HDL-胆固醇），从妊娠14周和28周的母亲的空腹血液样本中测量低密度脂蛋白胆固醇（LDL-胆固醇）和甘油三酸酯。还检查了从妊娠早期到妊娠晚期母体脂质水平的变化。在妊娠20周和34周测量后代腹围和体重，出生,6个月,产后2年和5年。线性样条多级模型检查了母体血脂谱与后代生长之间的关联。我们发现了一些微弱的，母体血脂与后代生长轨迹之间存在显着关联。重大发现接近零，提供有限的证据。例如,孕妇甘油三酯的1mmol/L增加与从20到34周妊娠的婴儿体重增长更快有关（0.01kg/周，95％CI-0.02，-0.001）和2至5年的腹围较慢（0.01厘米/周，95%CI-0.02，-0.001）。这些发现没有提供临床上有意义的效果的证据。结论：这些发现提出了有关针对孕妇血脂状况的干预措施在有巨大儿风险的妊娠中的有效性的疑问。需要对这一主题进行新的研究。已知的:•早期妊娠期间的母体脂肪积累可以通过提供脂质储备来潜在地支持妊娠晚期的胎儿生长,所述脂质储备被分解并穿过胎盘屏障转移至婴儿。•有有限的研究探索母亲的血脂对婴儿和儿童健康的影响使用生长轨迹跨越产前到产后生活。新增内容：•孕妇血脂谱与怀孕至5岁的后代体重和腹围的生长轨迹无关。由于重要的发现接近零，为有临床意义的关系提供了有限的证据。•这项工作的优势包括使用从产前到产后的婴儿生长轨迹，并纳入从妊娠早期到妊娠晚期的母体脂质水平变化的分析，以及它们与从妊娠20周到5岁的后代生长轨迹的关联。
