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Aims To determine the association of maternal and fetal inflammatory factors with neonatal and infant adiposity Methods Data from 265 mother-child pairs at birth and 280 pairs at 6 months postnatal from a randomised control trial assessing the effect of a low glycaemic index diet on birth weight were analysed. Maternal TNF-alpha (TNFα) and Interleukin 6 (IL-6) were measured in early and late pregnancy and fetal levels from cord blood. Anthropometric measurements were recorded at birth and at 6 months. The sum of all skinfolds and the sum of Subscapular plus Triceps skinfolds [SS+TR] were used as markers of general adiposity and the ratio of SS/TR skinfolds as a marker of central adiposity. Results Maternal TNFα in early pregnancy was associated with neonatal anthropometry including biceps [p = 0.048], triceps [p = 0.027] and subscapular [p = 0.002] skinfold thicknesses. TNFα in early and late pregnancy correlated with general adiposity in the neonate [SS + TR p = 0.003, p = 0.008 respectively; Sum of skinfolds p = 0.011, p = 0.002 respectively] [Table 1]. Maternal early and late pregnancy TNFα was also associated with 6-month-old central adiposity [SS/TR ratio p = 0.002, p = 0.030, respectively]. Fetal TNFα did not exert a significant influence on neonatal anthropometry but was associated with infant triceps skinfold at 6 months. While fetal IL-6 was associated with birth length and waist:height ratio, maternal IL-6 was not significantly associated with adiposity. On multiple linear regression analysis, TNFα contributed significantly to the majority of the final models for both neonatal and infant anthropometry, however, the models themselves were not significant. Any associations between maternal or fetal IL-6 with neonatal and infant anthropometry were no longer significant in the multiple regression models. Conclusion Maternal TNFα significantly correlates with greater offspring adiposity at birth and 6 months and therefore may act as a potential antenatal indicator of a predisposition towards early childhood obesity.

Objectives Probiotics are live microorganisms which may confer health benefits on the host. Recent studies have demonstrated various beneficial effects of probiotics in pregnancy among healthy women. 1 The aim of this study was to investigate the effects of a probiotic capsule on maternal fasting glucose and pregnancy outcome in obese pregnant women. Methods This double-blind randomised controlled trial recruited pregnant women with a body mass index of 30.0–39.9kg/m 2 . Women were randomised to either a daily probiotic ( Lactobacillus salivarius UCC118) or placebo capsule from 24 to 28 week’s gestation. The primary outcome was a reduction in fasting glucose from pre to post-intervention and secondary outcomes were incidence of gestational diabetes and neonatal anthropometry. A sample size of 100 was required to detect a reduction in fasting glucose of 0.4 mmol/l with at least 80% power. Results Of 138 participants, 28 were excluded from analyses due to antibiotic usage and poor capsule compliance, leaving 110 women for final analysis. BMI was the only factor that differed between the intervention groups at baseline (32.9 ± 2.6 probiotic vs 34.0 ± 2.7kg/m 2 placebo, p = 0.044). Adjusting for BMI, no difference was noted in fasting glucose from pre- to post-intervention (-0.07 ± 0.41 probiotic vs –0.11 ± 0.27 mmol/l placebo, p = 0.295). There was also no difference in birth weight centile, incidence of gestational diabetes or other adverse pregnancy outcomes between the groups. Conclusion While previous studies of probiotics in healthy pregnant women showed some beneficial glycaemic effect, this randomised trial demonstrated no impact on fasting glucose or on obstetric outcomes in obese pregnancy. Reference 1Lindsay KL, Walsh CA, Brennan L, McAuliffe FM. Probitoics in pregnancy and maternal outcomes: A systematic review. J Mat Fet Neonat Med2013;26:772–8

Introduction Obesity is rapidly becoming prevalent amongst the obstetric population and has been linked to many complications such as gestational diabetes mellitus, preeclampsia and thromboembolism (1) . There is a paucity of literature examining the lifestyle habits of obese pregnant women, which may be contributing to such complications. Methods Sixty-two obese pregnant women (body mass index (BMI) 30.0–39.9 kg/m2; mean = 34 kg/m2) were matched by age and ethnicity to 124 non-obese pregnant women (BMI 20.0–29.9 kg/m2; mean = 25 kg/m2). A structured questionnaire was used to assess self-reported lifestyle habits. Results Based on self-reported walking and other activities, 39% of the obese group and 35% of the control group met current guidelines for exercise in pregnancy(2) (P = 0.589). The obese group were more aware of calories on food labels (63% vs 38%; P = 0.003) and were more likely to drink low fat milk (53% vs 28%; P = 0.005). Prior to pregnancy, the recommended upper limit for alcohol intake of 11 units or more per week was exceeded by a greater percentage of obese women (18% vs 4%; P = 0.004). Smoking during pregnancy was also more prevalent in the obese group (10% vs 1%; P = 0.003). Conclusion While obese women appeared to be more aware of certain healthier lifestyle choices, their alcohol intake exceeded that of the control group prior to pregnancy, which may have contributed to a greater calorie intake. Further research is needed into possible causes of maternal obesity, such as actual dietary intakes and food portion sizes. This could aid the development of more effective lifestyle interventions for pregnancy. References Dennedy, M.C & Dunne, F. (2010) The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcomes. Best Practice & Research Clinical Endocrinology & Metabolism 24:573–589. ACOG Commitee on Obstetric Practice (2002) Exercise during pregnancy and the post partum period. ACOG Committee Opinion no.267 . Obstet Gynecol 99:171–173 (reaffirmed in 2009).