Maternal Overweight and Obesity: Effect on Fetal Growth and Adiposity
Date
2022
Authors
Poprzeczny, Amanda Josephine
Editors
Advisors
Dodd, Jodie M
Louise, Jennie
Grivell, Rosalie M
Louise, Jennie
Grivell, Rosalie M
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Thesis
Citation
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Abstract
Background: Maternal overweight and obesity are associated with well-documented maternal and infant risks, including high infant birth weight and delivery of an infant large for gestational age. However, less is known about the impact of maternal BMI on fetal growth and adiposity, and growth and adiposity trajectories. There is limited information regarding the effects of antenatal interventions to limit gestational weight gain on fetal growth and adiposity. Methods: This thesis examines the effect of maternal BMI on fetal growth and adiposity, antenatal contributors to fetal growth and adiposity, and the effect of antenatal interventions on fetal growth and adiposity using data from a set of three harmonised randomised trials conducted between June 2008 and April 2017. Women were invited to attend for a research ultrasound at 28 and 36 weeks of gestation, where fetal biometry and adiposity measures were obtained. The analyses reported in this thesis investigate: 1. The effect of maternal BMI, across the BMI spectrum, on fetal growth and adiposity; 2. Whether this effect is mediated by (diagnosed and treated) GDM; 3. How fetal growth and adiposity is altered among infants born LGA; and 4. The effect of antenatal interventions to limit gestational weight gain on fetal growth and adiposity. Results: The analyses reported in this thesis find that: 1. Maternal BMI exerts a strong, continuous positive effect on fetal growth and adiposity measures, from as early as 20 weeks’ gestation; 2. Among women who are overweight or obese, there is no evidence of a mediated effect by diagnosed and treated GDM; 3. Infants born LGA demonstrate larger fetal biometry and adiposity measures from as early as 20 weeks’ gestation; and 4. There is no evidence that the antenatal interventions investigated in this thesis are sufficient to alter fetal growth and adiposity. Conclusions: Overall, the findings presented in this thesis suggest fetal growth patterns are determined early in pregnancy, and any antenatal interventions to prevent the effects of maternal overweight and obesity on fetal growth will need to be commenced earlier in pregnancy, or prior to conception, to be effective in preventing the intergenerational inheritance of overweight and obesity.
School/Discipline
Adelaide Medical School
Dissertation Note
Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2022
Provenance
This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals