MATERNAL CARBOHYDRATE-METABOLISM AND ITS RELATIONSHIP TO FETAL GROWTHAND BODY-COMPOSITION

OBJECTIVE: Our purpose was to correlate maternal carbohydrate metaboli sm and parental morphometric measurements with neonatal birth weight, body composition, and placental weight. STUDY DESIGN: Sixteen singleto n (six control and 10 abnormal glucose tolerance) infants had placenta l weight, birth weight, and estimates of body composition performed wi thin 24 hours of birth. Independent variables considered were (1) mate rnal and paternal demographic and morphometric measures, (2) neonatal sex and gestational age, and (3) estimates of maternal carbohydrate me tabolism, including basal hepatic glucose production, insulin response , and insulin sensitivity. All metabolic measurements were performed b efore conception and in early (12 to 14 weeks) and late (34 to 36 week s) gestation. Best-fit stepwise regression analysis was used to relate the independent variables with placental weight, neonatal birth weigh t, fat-free mass, and fat mass. RESULTS: Insulin sensitivity in late g estation had the strongest correlation with placental weight (R(2) = 0 .28), neonatal birth weight (R(2) = 0.28), and fat-free mass (R(2) = 0 .33). In contrast, insulin sensitivity before conception had the best correlation with neonatal fat mass (R(2) = 0.15). Including all signif icant independent variables in the model improved the correlations for placental weight (R(2) = 0.58), birth weight (R(2) = 0.48), fat-free mass (R(2) = 0.53), and fat mass (R(2) = 0,46), CONCLUSION: Maternal i nsulin sensitivity had stronger correlations with fetoplacental growth in comparison with maternal demographic or morphometric factors.