Fellow's Research: Obesity and diabetes during pregnancy independently lead to higher fat deposition in newborns
01 Jan 2020
A MAASTHI research team member measuring skin fold thickness (for assessing adiposity) of a newborn using Holtain skin fold calipers
Dr Giridhara R Babu, Intermediate Fellow, Public Health Foundation of India, IIPHH-Bengaluru campus.
Our recent study provides evidence, for the first time, that obesity can be as harmful as diabetes during pregnancy in terms of higher fat deposition (adiposity) in newborn children. These findings are from a large cohort study of women and children belonging to lower socioeconomic status in urban public hospitals in South India (Bangalore).
Adiposity in children places them at higher risk of diabetes and other chronic diseases later as young adults. It is known that diabetes during pregnancy, known as Gestational Diabetes Mellitus (GDM), results in adiposity in children. However, it is unclear in India as to whether and to what degree does obesity in pregnancy result in adiposity in children. Also, the nature of interaction between obesity and diabetes in pregnancy leading to adverse outcomes in newborns in India is unknown. Majority of the known findings are from studies carried out in high-income countries with limited evidence from India.
We aimed to understand if maternal obesity and GDM can independently lead to newborn adiposity. Also, we wanted to examine whether GDM could be responsible for obese mothers delivering newborns with adiposity.
Mrs. Maithili, a member of MAASTHI research team, interviewing a study respondent about her diet at the public hospital
We examined a cohort of 1,120 pregnant women aged 18 years and above (the mean age was 24 years) who delivered in three government hospitals in Bengaluru between April 2016 to February 2019. Obesity in pregnancy and in newborns was assessed by measuring fat deposition under the skin, as skin-fold thickness in millimeter (mm). We diagnosed GDM by administering a 75 grams oral glucose tolerance test, in accordance with World Health Organization (WHO) recommendations.
We found that obesity in pregnancy results in 216% higher chance of developing adiposity in newborns. Also, GDM results in 221% higher chance of development of higher fat deposition in newborns. We found that GDM can account for 25.2% of the association between maternal obesity and adiposity in newborns.
Our study is representative of pregnant women in India from low- and middle-income status who use public hospitals in urban areas. These findings can inform policy to initiate interventions for obesity prevention in women. Also, screening and management of diabetes in pregnancy should be enforced in all the public hospitals. These efforts can together contribute to reducing childhood obesity in India.
Do Gestational Obesity and Gestational Diabetes Have an Independent Effect on Neonatal Adiposity? Results of Mediation Analysis from a Cohort Study in South India. Giridhara R Babu, Deepa R, Lewis MG, Lobo E, Krishnan A, Ana Y, Katon JG, Enquobahrie DA, Arah OA, Kinra S, Murthy GVS. Clinical Epidemiology. December 2019. Volume 11, Pages 1067-1080. doi: https://doi.org/10.2147/CLEP.S222726
Image credits: MAASTHI team, IIPHH-Bengaluru