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Pregnancies complicated by gestational diabetes and fetal growth restriction: an analysis of maternal and fetal body composition using magnetic resonance imaging

Journal of Perinatology volume 43, pages 44–51 (2023)Cite this article

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Abstract

Introduction

Maternal body composition may influence fetal body composition.

Objective

The objective of this pilot study was to investigate the relationship between maternal and fetal body composition.

Methods

Three pregnant women cohorts were studied: healthy, gestational diabetes (GDM), and fetal growth restriction (FGR). Maternal body composition (visceral adipose tissue volume (VAT), subcutaneous adipose tissue volume (SAT), pancreatic and hepatic proton-density fat fraction (PDFF) and fetal body composition (abdominal SAT and hepatic PDFF) were measured using MRI between 30 to 36 weeks gestation.

Results

Compared to healthy and FGR fetuses, GDM fetuses had greater hepatic PDFF (5.2 [4.2, 5.5]% vs. 3.2 [3, 3.3]% vs. 1.9 [1.4, 3.7]%, p = 0.004). Fetal hepatic PDFF was associated with maternal SAT (r = 0.47, p = 0.02), VAT (r = 0.62, p = 0.002), and pancreatic PDFF (r = 0.54, p = 0.008). When controlling for maternal SAT, GDM increased fetal hepatic PDFF by 0.9 ([0.51, 1.3], p = 0.001).

Conclusion

In this study, maternal SAT, VAT, and GDM status were positively associated with fetal hepatic PDFF.

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Fig. 1: Fetal body composition measurements on MRI.
Fig. 2: Maternal body composition measurements on a proton-density fat fraction (PDFF) map from free-breathing MRI.
Fig. 3: Relationship between fetal hepatic proton-density fat fraction (PDFF) (%) and maternal visceral fat volume (mm3) utilizing Spearmen correlation.

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Data availability

The data that supports the findings of this study are available from the corresponding author upon reasonable request and may require institutional data agreements.

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Acknowledgements

The authors would like to acknowledge Dr. Carla Janzen, Dr. Michelle Tsai, Dr. Alexandra Havard, Dr. Ilina Pluym, and Dr. Thalia Wong who assisted with recruitment and provided insight into maternal data. The authors would also like to thank the MRI technologists at University of California Los Angeles for assisting with the study.

Funding

KMS received research support from University of California Los Angeles Children’s Discovery Institute. HHW and KLC received funding from NIH/NIDDK R01-124417-01.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology & Developmental Biology, University of California Los Angeles, Los Angeles, CA, USA

    Katie M. Strobel & Kara L. Calkins

  2. Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA

    Sevgi Gokce Kafali, Shu-Fu Shih, Rinat Masamed & Holden H. Wu

  3. University of California Los Angeles, Los Angeles, CA, USA

    Alexandra M. Artura

  4. Department of Medicine, Biostatistics and Computational Medicine, University of California Los Angeles, Los Angeles, CA, USA

    David Elashoff

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Contributions

KMS, HHW, and KLC conceptualized and designed the study. KMS recruited and consented all subjects. KMS, SS, SGK, AA, and RM assisted with data collection and interpretation. KMS performed all the data analysis under guidance of DE. KMS wrote the initial draft of the manuscript. All authors edited and approved the final draft of the manuscript. KLC had the primary responsibility for the final content.

Corresponding author

Correspondence to Kara L. Calkins.

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Competing interests

KLC has received research support from Fresenius Kabi. KLC has served as an advisor for Fresenius Kabi, Mead Johnson, Baxter, and Prolacta. KLC serves as an institutional principal investigator, with no salary funding, for a consortium database sponsored by Mead Johnson. HHW receives research support from Siemens Medical Solutions USA.

Ethics approval and consent to participate

The University of California Los Angeles Institutional review board approved the study. Each participant participated with informed consent. The study was performed in accordance with Declaration of Helsinki.

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Strobel, K.M., Kafali, S.G., Shih, SF. et al. Pregnancies complicated by gestational diabetes and fetal growth restriction: an analysis of maternal and fetal body composition using magnetic resonance imaging. J Perinatol 43, 44–51 (2023). https://doi.org/10.1038/s41372-022-01549-5

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