P1.198: Association Between Maternal Prenatal and Fetal Cord Blood Metabolic Biomarker Profile in a High-Risk Pregnancy Cohort

Background: The fetal cord blood adipokines and glycemic biomarkers at birth may reflect the effects of adverse intrauterine exposures of maternal obesity and hyperglycemia and can serve as a reference point for the future metabolic health of the offspring. We examined the relationship between a wide range of established and novel metabolic biomarkers in maternal prenatal, and matched fetal cord blood samples from the Early Tracking of Childhood Health Determinants (ETCHED) pregnancy cohort between August 2022-November 2024, a longitudinal observational life-course study being conducted in the southwestern United States.

Methods: The current analysis includes data from seventy-one matched maternal-neonatal pairs from singleton pregnancies. Demographic, clinical, and 11-targeted adipokines and glycemic biomarkers (leptin, adiponectin, fructosamine, insulin, C-Peptide, hs-CRP, cortisol, ApoC3, RBPH, and FGF21) were analyzed from prenatal serum and fetal cord serum. Maternal HbA1c at baseline prenatal exam, was also included. Spearman’s partial correlation coefficient was used to investigate pairwise associations between maternal-fetal bio samples adjusted for covariates.

Results: Among 71 pregnant women, mean age was 30.1±6.8 years , majority 87.3% were Hispanic, 62.0% were high school educated, and 60.6% reported being unmarried. Over half (55%) of the women had a pregestational body mass index (BMI) in the obese category, with 10% reporting pre-existing type 2 diabetes, 15.5% had gestational diabetes, and 8.5% developed preeclampsia. Mean arterial BP was 79.3±7.8 mm Hg with no active smoking history in this cohort. Among 71 neonates, majority were female (63.5%), most (77.5%) were AGA, mean birth-weight being 3,333.7±501.5 gm, 5 (7%) were born with major congenital anomalies (2 neonates with congenital heart defects, 1 with tracheoesophageal fistula, 1 had Beckwith-Wiedemann syndrome and 1 was born with Trisomy-18). Table 1 shows the mean differences in metabolic biomarker levels between maternal prenatal and fetal cord serum, most biomarkers demonstrated significantly lower levels in the fetal cord blood correlations in Figure 1. depicts that maternal HbA1c, indicative of longer-term glycemia, was positively correlated with fetal leptin (r=0.3, p< 0.05), and fetal C-peptide (r= 0.31, p< 0.05) indicating that maternal hyperglycemia triggers fetal pancreatic β-cell activity. A statistically significant correlations were also observed between maternal-fetal C-peptide levels (r=0.26, p< 0.05) and maternal insulin and fetal C-peptide (r=0.37, p< 0.01). Maternal adiponectin had a significant negative correlation with fetal leptin (r= -0.32, p< 0.05).

Conclusion: In this high-risk inner-city pregnancy cohort with poor social determinants of health, we observed significant associations between maternal-fetal glycemic and metabolic biomarkers. By assaying a wide array of metabolic biomarkers in maternal-fetal circulation, our findings reinforce the importance of physiological alterations in the maternal intrauterine environment and its impact on the fetal metabolic health. Future studies should focus on the effect of these changes on offspring’s growth, development, and metabolic risk as they transition through childhood and adolescence.