Abstract:
Background: Obese children are at a higher risk of becoming obese and developing metabolic
syndrome in adulthood. Previous research revealed that foetal growth depends on genetic,
intrauterine and maternal metabolic factors. Therefore, finding the impact of modifiable
maternal metabolic factors on the foetal growth and controlling them in advance would be
useful in the management of childhood obesity. Although limited studies are reported from
other Asian countries, none have been carried out in Sri Lanka.
Objective: To determine the effects of maternal factors, umbilical cord lipids and C-reactive
proteins (CRP) on foetal growth in a tertiary care hospital in Southern Sri Lanka.
Methods: A prospective cohort study was conducted at the professorial obstetrics and
gynaecology unit of the Teaching Hospital Mahamodara (THM) using convenient sampling
among all the mothers who were admitted for their confinement and their newborn babies.
Fasting blood samples from mothers before their delivery and umbilical cord blood samples
were collected to measure fasting blood sugar (FBS), lipid profile and CRP. Birth weight (BW),
birth length (BL), head circumference (HC), occipital frontal circumference (OFC), abdominal
circumference (AC) and hip circumference (HpC) as anthropometric measurements and
Capillary blood sugar (CBS) level of their newborns were obtained. Ultrasound scan (USS)
reports and bed head ticket (BHT) were used to collect socio demographic details and other
information. Data were analysed using SPSS version 23.0.
Results: Among the 50 newborns, 28 (56%) were females and 42 (84%) were appropriate for
their gestational age. Among the maternal population, five (10%) had CRP above normal level
(26 mg/dL). Maternal factors such as maternal age, pre pregnancy body mass index, gestational
weight gain, haemoglobin (Hb), FBS concentration, high density lipoprotein and low-density
lipoprotein had a significant association with the foetal growth. However, the highest positive
correlation was observed between the maternal haemoglobin concentrations with BW (r=0.281,
p=0.048), BL (r=0.319, p=0.024), HC (r=0.355, p=0.011), OFC (r=0.322, p=0.023) and AC
(r=0.351, p=0.012).
Conclusions: Since maternal Hb concentration showed the highest positive correlation with
foetal anthropometric parameters, it is worth exploring further.
