Date of Presentation
5-4-2023 12:00 AM
College
School of Osteopathic Medicine
Poster Abstract
Background: There is convincing evidence that excessive gestational weight gain (GWG), based on the Institute of Medicine’s (IOM) 2009 guidelines, increases the risk of both maternal and neonatal complications.1-6 Although the association between excessive GWG and pre-eclampsia is well-established, the reason why this association exists remains unclear.
Methods: Previously collected data from a cohort of pregnant women in Camden, NJ between the years of 1998-2007 was used to examine the association between maternal serum biomarkers (C-peptide, IGF-1, Insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)) collected at entry (week 16) and 3rd trimester (week 28) and longitudinally assessed gestational weight gain (GWG) using the IOM guidelines. The relationship between excessive GWG and preeclampsia was also accessed. All analyses were run on SAS v.9.4 (SAS Institute, Inc., Cary, NC).
Results: This study included 2,418 pregnant women in Camden, NJ between the years 1998-2007. The average maternal age of the cohort was 21.99 (SD = 5.18). The cohort included Hispanic (45.86%), Black( 37.68%), White/Other( 16.46%). This was the first birth for 38.92% of the participants. The average pre-pregnancy BMI was 25.64 (SD = 6.22) and entry blood pressure was 112.20/70.17 (SD = 11.47/8.71). And 18.91% participants reported being smokers.
The odds of excessive gestational weight gain was significantly higher at 24, 28, 32 weeks and delivery for those in the highest level (the 4th quartile) compared to lower IGF-1 level (1st-3rd quartiles) (entry adjusted odds ratio: 1.586-1.843, 3rd trimester adjusted odds ratio: 1.505-1.765 ). The odds of excessive gestational weight gain was significantly higher at 24 and 32 weeks and delivery for those in the highest level (the 4th quartile) compared to other quartiles (1st-3rd quartiles) of C-peptide levels during the 3rd trimester (adjusted odds ratio: 1.332-1.467) . Individuals with excessive gestational weight gain at 28 weeks, 32 weeks and delivery had a 56% to 65% increased risk of developing pre-eclampsia compared to those with adequate gestational weight gain (adjusted odds ratio at 28 weeks: 1.561 [95% confidence interval: 1.029-2.369], adjusted odds ratio at 32 weeks: 1.653 [95% confidence interval: 1.078-2.534], adjusted odds ratio at delivery: 1.564 [95% confidence interval: 1.077-2.271]). Women with pre-eclampsia and excessive gestational weight gain at 24 weeks, 28 weeks, 32 weeks and delivery had the highest average levels of C-peptide and IGF-1 at entry to care. There were no consistent results with insulin and HOMA-IR at entry.
Conclusion: Higher levels of C-peptide and IGF-1 during 3rd trimester of pregnancy appear to be associated with excessive gestational weight gain and pre-eclampsia. Measures should be taken to monitor and control the levels of these biomarkers in pregnant women to reduce the risk of excessive GWG as well as gestational hypertension.
Keywords
Gestational Weight Gain, Pre-Eclampsia, Pregnancy Complications, C-Peptide, Insulin-Like Growth Factor I
Disciplines
Female Urogenital Diseases and Pregnancy Complications | Health Services Research | Medicine and Health Sciences | Nutritional and Metabolic Diseases | Obstetrics and Gynecology | Pathological Conditions, Signs and Symptoms | Women's Health
Document Type
Poster
Included in
Female Urogenital Diseases and Pregnancy Complications Commons, Health Services Research Commons, Nutritional and Metabolic Diseases Commons, Obstetrics and Gynecology Commons, Pathological Conditions, Signs and Symptoms Commons, Women's Health Commons
Association of Maternal Biomarkers with Gestational Weight Gain and Pre-Eclampsia
Background: There is convincing evidence that excessive gestational weight gain (GWG), based on the Institute of Medicine’s (IOM) 2009 guidelines, increases the risk of both maternal and neonatal complications.1-6 Although the association between excessive GWG and pre-eclampsia is well-established, the reason why this association exists remains unclear.
Methods: Previously collected data from a cohort of pregnant women in Camden, NJ between the years of 1998-2007 was used to examine the association between maternal serum biomarkers (C-peptide, IGF-1, Insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)) collected at entry (week 16) and 3rd trimester (week 28) and longitudinally assessed gestational weight gain (GWG) using the IOM guidelines. The relationship between excessive GWG and preeclampsia was also accessed. All analyses were run on SAS v.9.4 (SAS Institute, Inc., Cary, NC).
Results: This study included 2,418 pregnant women in Camden, NJ between the years 1998-2007. The average maternal age of the cohort was 21.99 (SD = 5.18). The cohort included Hispanic (45.86%), Black( 37.68%), White/Other( 16.46%). This was the first birth for 38.92% of the participants. The average pre-pregnancy BMI was 25.64 (SD = 6.22) and entry blood pressure was 112.20/70.17 (SD = 11.47/8.71). And 18.91% participants reported being smokers.
The odds of excessive gestational weight gain was significantly higher at 24, 28, 32 weeks and delivery for those in the highest level (the 4th quartile) compared to lower IGF-1 level (1st-3rd quartiles) (entry adjusted odds ratio: 1.586-1.843, 3rd trimester adjusted odds ratio: 1.505-1.765 ). The odds of excessive gestational weight gain was significantly higher at 24 and 32 weeks and delivery for those in the highest level (the 4th quartile) compared to other quartiles (1st-3rd quartiles) of C-peptide levels during the 3rd trimester (adjusted odds ratio: 1.332-1.467) . Individuals with excessive gestational weight gain at 28 weeks, 32 weeks and delivery had a 56% to 65% increased risk of developing pre-eclampsia compared to those with adequate gestational weight gain (adjusted odds ratio at 28 weeks: 1.561 [95% confidence interval: 1.029-2.369], adjusted odds ratio at 32 weeks: 1.653 [95% confidence interval: 1.078-2.534], adjusted odds ratio at delivery: 1.564 [95% confidence interval: 1.077-2.271]). Women with pre-eclampsia and excessive gestational weight gain at 24 weeks, 28 weeks, 32 weeks and delivery had the highest average levels of C-peptide and IGF-1 at entry to care. There were no consistent results with insulin and HOMA-IR at entry.
Conclusion: Higher levels of C-peptide and IGF-1 during 3rd trimester of pregnancy appear to be associated with excessive gestational weight gain and pre-eclampsia. Measures should be taken to monitor and control the levels of these biomarkers in pregnant women to reduce the risk of excessive GWG as well as gestational hypertension.