Metabolic risk factors in mothers and metabolic profile of neonates

Wang, Jingya ORCID: 0000-0003-1498-2693 (2019). Metabolic risk factors in mothers and metabolic profile of neonates. University of Birmingham. Ph.D.

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Abstract

High body-mass-index (BMI), hyperglycaemia, and hypercholesterolemia are the leading risk factors for mortality and morbidity worldwide. As obesity has become an epidemic in all age groups globally, more and more women enter pregnancy with obesity. Pregnant women with high BMI often present with excessive gestational weight gain, hyperglycaemia, and dyslipidaemia during pregnancy, therefore expose the foetus to unfavourable intrauterine environment. Although maternal obesity and gestational hyperglycaemia have been associated with a series of adverse pregnancy outcomes in previous literature, lifestyle interventions during pregnancy do not confer significant benefit for composite maternal and neonatal health outcomes. Meanwhile, gestational dyslipidaemia has been recognised as an ignored metabolic risk factor for adverse pregnancy outcomes. Therefore, the aim of this project is 1) to explore the association between gestational dyslipidaemia and neonatal adverse metabolic conditions; 2) to establish the most influential maternal metabolic risk factors for maternal and neonatal adverse metabolic conditions; 3) to investigate the metabolic profile in babies with different birthweight percentiles.

In this project, a comprehensive systematic review followed by a prospective cohort study and an exploratory study were conducted to address the above objectives. In summary, maternal lipid levels are secondary to maternal metabolic dysfunction with no clear causal links to adverse neonatal metabolic conditions, although it has strong associations with adverse birthweight outcomes. High maternal pre-pregnancy BMI is the most influential upstream metabolic risk factor for both maternal and neonatal metabolic health outcomes, therefore weight management should be addressed from the preconception period. The differential metabolic and inflammatory profile in small-for-gestational-age and large-for-gestational-age babies might be crucial for developing subsequent obesity, diabetes, and cardiovascular diseases. Tailored intervention strategies in babies with different birthweight percentiles are needed to prevent metabolic dysfunctions in adult life.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):