Association of maternal lipid levels with birth weight and cord blood insulin: a Bayesian network analysis

Jingya Wang*, Yashu Kuang, Songying Shen, Malcolm James Price, Jinhua Lu, Naveed Sattar, Jianrong He, Marta Pittavino, Huimin Xia, G Neil Thomas, Xiu Qiu*, Kar Keung Cheng, Krishnarajah Nirantharakumar*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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OBJECTIVE: To assess the independent association of maternal lipid levels with birth weight and cord blood insulin (CBI) level.

SETTING: The Born in Guangzhou Cohort Study, Guangzhou, China.

PARTICIPANTS: Women who delivered between January 2015 and June 2016 and with umbilical cord blood retained were eligible for this study. Those with prepregnancy health conditions, without an available fasting blood sample in the second trimester, or without demographic and glycaemic information were excluded. After random selection, data from 1522 mother-child pairs were used in this study.

EXPOSURES AND OUTCOME MEASURES: Additive Bayesian network analysis was used to investigate the interdependency of lipid profiles with other metabolic risk factors (prepregnancy body mass index (BMI), fasting glucose and early gestational weight gain) in association with birth weight and CBI, along with multivariable linear regression models.

RESULTS: In multivariable linear regressions, maternal triglyceride was associated with increased birth weight (adjusted β=67.46, 95% CI 41.85 to 93.06 g per mmol/L) and CBI (adjusted β=0.89, 95% CI 0.06 to 1.72 μU/mL per mmol/L increase), while high-density lipoprotein cholesterol was associated with decreased birth weight (adjusted β=-45.29, 95% CI -85.49 to -5.09 g per mmol/L). After considering the interdependency of maternal metabolic risk factors in the Network analysis, none of the maternal lipid profiles was independently associated with birth weight and CBI. Instead, prepregnancy BMI was the global strongest factor for birth weight and CBI directly and indirectly.

CONCLUSIONS: Gestational dyslipidaemia appears to be secondary to metabolic dysfunction with no clear association with metabolic adverse outcomes in neonates. Maternal prepregnancy overweight/obesity appears the most influential upstream metabolic risk factor for both maternal and neonatal metabolic health; these data imply weight management may need to be addressed from the preconception period and during early pregnancy.

Original languageEnglish
Article numbere064122
JournalBMJ open
Issue number12
Publication statusPublished - 29 Dec 2022

Bibliographical note

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.


  • Pregnancy
  • Infant, Newborn
  • Humans
  • Female
  • Birth Weight
  • Obesity/complications
  • Fetal Blood/metabolism
  • Insulin
  • Diabetes, Gestational
  • Cohort Studies
  • Bayes Theorem
  • Blood Glucose/metabolism
  • Body Mass Index
  • Triglycerides
  • General endocrinology
  • 1692
  • Epidemiology
  • Lipid disorders
  • Maternal medicine
  • 1506


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