Fetal size, lipid metabolism and their relation to maternal adipokines.

Background. Obesity and excessive weight gain during pregnancy are related to increased fetal size and perinatal complications. Pregnancy induces several physiological metabolic alterations to ensure an optimal supply to the fetus. Gestational diabetes (GDM) is mainly responsible for the development of LGA fetuses, but an increasing number of these fetuses are born from non-diabetic mothers with underlying metabolic alterations. Maternal fat mass, throughout serum adipokines (Adpk), such as adiponectin (AD) and visfatin (VIS), is related to fetal growth via insulin resistance. The exact mechanisms are yet to be elucidated. Fetal size and weight are established by ultrasound biometry. Objective. We hypothesize that serum concentrations of AD and VIS are related to fetal growth via fat mass and insulin resistance. We investigated the relationship between Adpk, maternal lipid metabolism and fetal size estimated by ultrasound in mid gestation. Study design: 70 pregnant women were investigated during pregnancy, evaluating their blood levels of glucose, cholesterol and triglycerides. A glucose tolerance test was performed at 24-28 weeks of pregnancy, serums levels of Adpk and biometry were measured in the 2nd trimester. Results. Maternal serum AD inversely correlated with pre-pregnancy BMI, overweight and obese women showing lower levels. Fetal weight inversely correlated with serum AD. We found disparity in circulating maternal VIS between normal and overweight women and neonatal weight. Conclusion. The connection between maternal serum adiponectin and visfatin and the presence of lipid and glucose metabolic alterations support the hypothesis that perturbation of adipokine homeostasis plays a role in GDM and abnormal fetal growth. [ABSTRACT FROM AUTHOR]