Fetal and infant growth and cardiovascular risk factors in women

TLDR

The study investigates whether women’s cardiovascular risk factors are associated with fetal and infant growth. The authors measured glucose, insulin, proinsulin, blood pressure, lipid profiles, fibrinogen, and factor VII in 297 Hertfordshire women born 1923–1930, using a standard oral glucose tolerance test and fasting blood samples. Women born with lower birth weight had lower fasting glucose, insulin, proinsulin, blood pressure, triglycerides, and higher HDL, and those who became obese exhibited the highest cardiovascular risk factor levels, indicating that reduced fetal growth is linked to insulin resistance and adverse lipid and blood pressure profiles, while infant growth rates did not predict risk in women.

Abstract

To examine whether cardiovascular risk factors in women are related to fetal and infant growth.Follow up study of women born 1923-30 whose birth weights and weights at one year were recorded.Hertfordshire.297 women born and still living in East Hertfordshire.Plasma glucose and insulin concentrations during a standard oral glucose tolerance test; fasting plasma proinsulin and 32-33 split proinsulin concentrations; blood pressure; fasting serum total, low density lipoprotein and high density lipoprotein cholesterol, triglyceride, and apolipoprotein A I and B concentrations; and plasma fibrinogen and factor VII concentrations.Fasting plasma concentrations of glucose, insulin, and 32-33 split proinsulin fell with increasing birth weight (P = 0.04, P = 0.002, and P = 0.0002 respectively, when current body mass index was allowed for). Glucose and insulin concentrations 120 minutes after an oral glucose load showed similar trends (P = 0.03 and P = 0.02). Systolic blood pressure, waist:hip ratio, and serum triglyceride concentrations also fell with increasing birth weight (P = 0.08, P = 0.07, and P = 0.07 respectively), while serum high density lipoprotein cholesterol concentrations rose (P = 0.04). At each birth weight women who currently had a higher body mass index had higher levels of risk factors.In women, as in men, reduced fetal growth leads to insulin resistance and the associated disorders: raised blood pressure and high serum triglyceride and low serum high density lipoprotein cholesterol concentrations. The highest values of these coronary risk factors occur in people who were small at birth and became obese. In contrast with men, low rates of infant growth did not predict levels of risk factors in women.