Key words: Obesity, Gestational Diabetes, Infant body compositions

Background and Objective:

Maternal obesity and gestational diabetes (GDM) increase the risk for childhood obesity and associated complications. Body composition during periods of critical development may explain different mechanisms and pathophysiological features underlying dysregulated metabolism. In this study, we utilized free-breathing (FB) magnetic resonance imaging (MRI) to quantify body composition in infants born to lean mothers (CON group) and infants born to overweight mothers with GDM (AT RISK group).

Methods Used:

Subjects were recruited from the University of California Los Angeles (2021-2024) and were between 1-6 months of age with a gestational age > 35 weeks. Infants in the CON group were born to mothers with a pre-pregnancy body mass index (BMI) <25 kg/m2 without GDM. Infants in the AT RISK group were born to mothers with a BMI ³ 25 kg/m2 with GDM. FB-MRI scans were performed without sedation or contrast on a 3 T MRI scanner. Multi-echo gradient-echo FB-MRI scans were used to calculate maps of proton density fat fraction (PDFF), a parameter that measures fat content and is a validated marker for hepatic steatosis. Subcutaneous (SAT) and visceral adipose tissue (VAT) volume and PDFF, as well as hepatic PDFF (HPDFF), were measured on the PDFF maps.

Results:

20 subjects completed the study (n=12, CON; n=8, AT RISK). The mean age (SD) in the CON and AT RISK group were similar (p=0.13). As expected, mothers in the AT RISK group had a higher pre-pregnancy BMI compared to the CON group (p<0.0001) (Table 1). There was a trend indicating increased VAT-PDFF in the AT RISK group vs. CON group (p=0.2). HPDFF was higher in the AT RISK group vs. CON group (p=0.03). Maternal pre-pregnancy BMI was positively correlated with infant VAT-PDFF (p<0.02) (Fig 1).

Conclusions:

In this study, compared to infants born to lean mothers, infants born to overweight mothers with GDM had higher hepatic fat fraction, and a mother’s pre-pregnancy BMI positively correlated with infant VAT-PDFF. Maternal obesity and GDM may set the stage for future obesity and metabolic dysfunction-associated steatotic liver disease.