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dc.titleMismatch between poor fetal growth and rapid postnatal weight gain in the first 2 years of life is associated with higher blood pressure and insulin resistance without increased adiposity in childhood: the GUSTO cohort study
dc.contributor.authorOng Y.Y.
dc.contributor.authorSadananthan S.A.
dc.contributor.authorAris I.M.
dc.contributor.authorTint M.T.
dc.contributor.authorYuan W.L.
dc.contributor.authorHuang J.Y.
dc.contributor.authorChan Y.H.
dc.contributor.authorNg S.
dc.contributor.authorLoy S.L.
dc.contributor.authorVelan S.S.
dc.contributor.authorFortier M.V.
dc.contributor.authorGodfrey K.M.
dc.contributor.authorShek L.
dc.contributor.authorTan K.H.
dc.contributor.authorGluckman P.D.
dc.contributor.authorYap F.
dc.contributor.authorChoo J.T.L.
dc.contributor.authorLing L.H.
dc.contributor.authorTan K.
dc.contributor.authorChen L.
dc.contributor.authorKarnani N.
dc.contributor.authorChong Y.-S.
dc.contributor.authorEriksson J.G.
dc.contributor.authorWlodek M.E.
dc.contributor.authorChan S.-Y.
dc.contributor.authorLee Y.S.
dc.contributor.authorMichael N.
dc.identifier.citationOng Y.Y., Sadananthan S.A., Aris I.M., Tint M.T., Yuan W.L., Huang J.Y., Chan Y.H., Ng S., Loy S.L., Velan S.S., Fortier M.V., Godfrey K.M., Shek L., Tan K.H., Gluckman P.D., Yap F., Choo J.T.L., Ling L.H., Tan K., Chen L., Karnani N., Chong Y.-S., Eriksson J.G., Wlodek M.E., Chan S.-Y., Lee Y.S., Michael N. (2020). Mismatch between poor fetal growth and rapid postnatal weight gain in the first 2 years of life is associated with higher blood pressure and insulin resistance without increased adiposity in childhood: the GUSTO cohort study. International journal of epidemiology 49 (5) : 1591 - 1603. ScholarBank@NUS Repository.
dc.description.abstractBackground: Using longitudinal ultrasounds as an improved fetal growth marker, we aimed to investigate if fetal growth deceleration followed by rapid postnatal weight gain is associated with childhood cardiometabolic risk biomarkers in a contemporary well-nourished population. Methods: We defined fetal growth deceleration (FGD) as ultrasound-measured 2nd-3rd-trimester abdominal circumference decrease by ≥0.67 standard deviation score (SDS) and rapid postnatal weight gain (RPWG) as 0-2-year-old weight increase by ≥0.67 SDS. In the GUSTO mother-offspring cohort, we grouped 797 children into four groups of FGD-only (14.2%), RPWG-only (23.3%), both (mismatch, 10.7%) or neither (reference, 51.8%). Adjusting for confounders and comparing with the reference group, we tested associations of these growth groups with childhood cardiometabolic biomarkers: magnetic resonance imaging (MRI)-measured abdominal fat (n = 262), liver fat (n = 216), intramyocellular lipids (n = 227), quantitative magnetic resonance-measured overall body fat % (BF%) (n = 310), homeostasis model assessment of insulin resistance (HOMA-IR) (n = 323), arterial wall thickness (n = 422) and stiffness (n = 443), and blood pressure trajectories (ages 3-6 years). Results: Mean±SD birthweights were: FGD-only (3.11 ± 0.38 kg), RPWG-only (3.03 ± 0.37 kg), mismatch (2.87 ± 0.31 kg), reference (3.30 ± 0.36 kg). FGD-only children had elevated blood pressure trajectories without correspondingly increased BF%. RPWG-only children had altered body fat partitioning, higher BF% [BF = 4.26%, 95% confidence interval (CI) (2.34, 6.19)], HOMA-IR 0.28 units (0.11, 0.45)] and elevated blood pressure trajectories. Mismatch children did not have increased adiposity, but had elevated ectopic fat, elevated HOMA-IR [0.29 units (0.04,0.55)] and the highest blood pressure trajectories. Associations remained even after excluding small-for-gestational-age infants from analyses. Conclusions: Fetal growth deceleration coupled with rapid postnatal weight gain was associated with elevated childhood cardiometabolic risk biomarkers without correspondingly increased BF%. © 2020 The Author(s); all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
dc.publisherOxford University Press
dc.subjectblood pressure
dc.subjectbody composition
dc.subjectcardiometabolic risk
dc.subjectCohort study
dc.subjectfetal growth
dc.subjectinsulin resistance
dc.subjectpostnatal growth
dc.contributor.departmentDEAN'S OFFICE (MEDICINE)
dc.contributor.departmentDEPT OF BIOCHEMISTRY
dc.contributor.departmentDEPT OF MEDICINE
dc.contributor.departmentDEPT OF OBSTETRICS & GYNAECOLOGY
dc.contributor.departmentDEPT OF PAEDIATRICS
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.sourcetitleInternational journal of epidemiology
dc.description.page1591 - 1603
dc.grant.fundingagencyNational Medical Research Council
dc.description.seriesGUSTO (Growing up towards Healthy Outcomes)
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