(LB02-06-26) Newborn Triglycerides Are Associated With Growth Trajectories Within the First Year of Life

Objectives: Rapid early postnatal growth, higher birthweight (BW), and greater newborn (NB) adiposity are strong predictors of childhood and adult obesity. New evidence suggests that elevated maternal triglycerides (TG) are drivers of higher BW and NB adiposity, independent of glucose. However, the role of NB TG in shaping postnatal growth remains unknown. We aimed to test associations between maternal TG and NB TG, and if they predict infant growth rate during the first year of life.

Methods: Mother-infant dyads (mean±SD; BMI= 27±5 kg/m²; N=91) from two cohorts were included in the analysis (normal weight n=26; obesity n=19; diet-managed gestational diabetes n=46). Maternal fasting TG were measured at ~36 wks. NB pre-feed (~1-3 hrs fasting) TG were measured at 24 hrs of life. Infant anthropometrics were taken at birth, 2 wks, 5 mos, and 12 mos. Infant z-scores (weight for age, WAZ; weight for length, WLZ; length for age, LAZ) were calculated by WHO standards. Regression was used to assess associations between maternal and NB TG, adjusting for maternal BMI. Linear mixed-effects models (LMM) were used to evaluate the link between NB TG (mean-centered and scaled by ±1 SD to low, average, and high) and growth. LMM were adjusted for the interaction of feeding mode (breastfed n=36, formula n=7, combo n=6), and BW per gestational age.

Results: Maternal TG at 36 wks’ (226 ±68 mg/dL) did not associate with NB TG (94±31 mg/dL) or infant growth over 12 mos. NB TG did not predict z scores at birth, 2 wks, or 12 mos. However, NB TG showed a positive association with ponderal (but not linear) growth at 5 mos: WAZ (β =0.58, 95% CI: [0.06, 1.10], p=0.03, per +1 SD NB TG) and WLZ (β =1.21 [0.34, 2.08], p=0.007). Feeding mode modified this effect on WLZ at 5 mos (interaction p< 0.05) with the association attenuated in breastfed (β=0.24, [-0.12, 0.59]) and combo fed (β=0.15, [-0.54, 0.85]), but not formula fed infants (β=0.86 [0.09, 1.63]).

Conclusions: NB TG could be a biomarker to identify risk for rapid weight gain in infancy prior to the introduction of complementary foods (~5-6 mos). The weakened effect of high NB TG and growth at 5 mos underscores the need for lactation and breastfeeding support in mother-infant dyads with risk factors for rapid growth like high BMI and excess gestational weight gain.

Funding Sources: NIH T32DK007658-35

NIH 5R01DK78645-2

ADA 1-13-GSK-13

NIH R01DK101659

Janssen Research and Development