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Fetal abdomen growth and the mother’s blood fat metabolites very early in pregnancy influence a child’s weight, body fat, vision and neurodevelopment at 2 years of age

A pregnant woman undergoes an ultrasound scan © MORU 2022. Photographer: Gerhard Jørén
A pregnant woman undergoes an ultrasound scan, part of SMRU’s long-running ongoing efforts to improve the standard of care for pregnant women from border communities.

The findings, published 26 Aug 2022 in the Lancet Diabetes & Endocrinology, could contribute to earlier identification of infants at risk of obesity - one of the world’s most pressing public health issues.

“This landmark study has provided valuable new insights into the biological origins of childhood obesity, which is one of the most pressing public health issues facing governments around the world. The findings could contribute to earlier identification of infants at risk of obesity. Policymakers must take notice of these findings in their efforts to prevent the oncoming epidemic of obesity with all its likely adverse social and economic consequences,” said study co-lead Stephen Kennedy, Professor of Reproductive Medicine at the University of Oxford.

Led by researchers at the University of Oxford, UK, in collaboration with the University of California, Berkeley, USA, the INTERBIO-21st Study included significant contributions from MORU’s Shoklo Malaria Research Unit (SMRU), in Mae Sot, Thailand.

This study took advantage of the unique setting at SMRU that provides maternal and infant care in a research environment, prefect for longitudinal studies. This is rather unique in marginalized populations in the Tropics, and it contributed to this study by including mothers that are exposed to multiple infectious agents, including malaria. Verena Carrara conducted the infant follow up with her team while Prof. Rose McGready is responsible for the Maternal & Child Health department at SMRU, and SMRU Director Prof. François Nosten contributed to the study design.

Supported by a grant from the Bill & Melinda Gates Foundation, the INTERBIO-21st Study monitored the growth inside the womb of over 3,500 babies in six countries (Brazil, Kenya, Pakistan, South Africa, Thailand, and the United Kingdom) using serial fetal ultrasound scans throughout pregnancy, and analysed blood samples taken from the women early in pregnancy and from the umbilical cord at birth. They then monitored the growth and development of the infants until 2 years of age.

They found that maternal fat metabolism as early as the 5th month of pregnancy, and the growth of the fetal abdomen growth patterns of fetal abdominal growth associated with maternal lipid metabolites that track newborn growth, adiposity and development into childhood. These fetal growth patterns are also associated with blood flow and nutrient transfer by the placenta, demonstrating a complex interaction between maternal and fetal nutrition early in pregnancy that influences postnatal weight and eventually adult health.

The paper complements work published by the same groups in 2021 that identified fetal head growth trajectories that are associated with different developmental, behavioural, visual and growth outcomes at 2 years of age. Very importantly, in both studies, the same critical time period close to the 5th month of pregnancy is the starting point for accelerated or decelerated fetal growth that is sustained into early childhood.

Read the full INTERBIO-21st Fetal Study news story on the University of Oxford WHR website.

This story also features on the main University of Oxford website

- Text courtesy of University of Oxford Press Office, with edits by John Bleho.

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