Abstract:
Background: Gestational weight gain (GWG) has critical implications for maternal and child health. Inflammation
and angiogenesis are implicated in various aspects of maternal metabolism that may play a role in gestational weight
gain. The associations of inflammatory, angiogenic, and metabolic pathways with GWG are yet to be elucidated. This
study evaluated associations between a panel of inflammatory, angiogenic, and metabolic proteins measured in midpregnancy
and gestational weight gain.
Methods: Pregnant women were enrolled from Dar es Salaam, Tanzania, between 2001 and 2004. The participants
were enrolled at mid-pregnancy (12 to 27 weeks of gestation) and followed up until delivery. This analysis focused on
a cohort of 1002 women who were primigravid, had singleton live births, had longitudinal measures of gestational
weight, and whose mid-pregnancy plasma samples underwent analysis for 18 proteins.
Results: Higher plasma concentrations of leptin (mean difference in GWG percent adequacy comparing highest with
lowest quartiles: 10.24; 95% CI 3.31, 17.16; p-trend = 0.003) and chitinase-3-like protein-1 (CH3L1) (mean difference
in GWG percent adequacy comparing highest with lowest quartiles: 7.02; 95% CI 0.31, 13.72; p-trend = 0.007) were
associated with greater GWG in a dose-response pattern. Higher leptin concentrations were associated with a lower
risk of inadequate GWG (risk ratio comparing highest with lowest quartiles: 0.77; 95% CI 0.65, 0.91; p-trend = 0.001)
and a higher risk of excessive GWG (risk ratio comparing highest with lowest quartiles: 1.57; 95% CI 1.03, 2.39;
p-trend = 0.03). Higher CH3L1 concentrations were associated with a higher risk of excessive GWG (p-trend = 0.007).
The associations of leptin and CH3L1 with inadequate GWG were stronger during the second than the third trimester.
The other 16 proteins examined were not significantly associated with GWG.
Conclusions: Mid-pregnancy plasma leptin concentrations may be associated with GWG and have clinical predictive
utility in identifying women at a higher risk of inadequate or excessive gestational weight gain.
