{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T07:05:05Z","timestamp":1788851105445,"version":"build-2803163510"},"reference-count":53,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000855","name":"University of Birmingham","doi-asserted-by":"publisher","award":["201508060007"],"award-info":[{"award-number":["201508060007"]}],"id":[{"id":"10.13039\/501100000855","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","award":["201508060007"],"award-info":[{"award-number":["201508060007"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81673181"],"award-info":[{"award-number":["81673181"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81703244"],"award-info":[{"award-number":["81703244"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81803251"],"award-info":[{"award-number":["81803251"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,11,21]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the independent association of maternal lipid levels with birth weight and cord blood insulin (CBI) level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The Born in Guangzhou Cohort Study, Guangzhou, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Women who delivered between January 2015 and June 2016 and with umbilical cord blood retained were eligible for this study. Those with prepregnancy health conditions, without an available fasting blood sample in the second trimester, or without demographic and glycaemic information were excluded. After random selection, data from 1522 mother\u2013child pairs were used in this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposures and outcome measures<\/jats:title>\n                    <jats:p>Additive Bayesian network analysis was used to investigate the interdependency of lipid profiles with other metabolic risk factors (prepregnancy body mass index (BMI), fasting glucose and early gestational weight gain) in association with birth weight and CBI, along with multivariable linear regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In multivariable linear regressions, maternal triglyceride was associated with increased birth weight (adjusted \u03b2=67.46, 95%\u2009CI 41.85 to 93.06\u2009g per mmol\/L) and CBI (adjusted \u03b2=0.89, 95%\u2009CI 0.06 to 1.72 \u03bcU\/mL per mmol\/L increase), while high-density lipoprotein cholesterol was associated with decreased birth weight (adjusted \u03b2=\u221245.29, 95%\u2009CI \u221285.49 to \u22125.09\u2009g per mmol\/L). After considering the interdependency of maternal metabolic risk factors in the Network analysis, none of the maternal lipid profiles was independently associated with birth weight and CBI. Instead, prepregnancy BMI was the global strongest factor for birth weight and CBI directly and indirectly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gestational dyslipidaemia appears to be secondary to metabolic dysfunction with no clear association with metabolic adverse outcomes in neonates. Maternal prepregnancy overweight\/obesity appears the most influential upstream metabolic risk factor for both maternal and neonatal metabolic health; these data imply weight management may need to be addressed from the preconception period and during early pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-064122","type":"journal-article","created":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T13:01:56Z","timestamp":1672318916000},"page":"e064122","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Association of maternal lipid levels with birth weight and cord blood insulin: a Bayesian network analysis"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1498-2693","authenticated-orcid":false,"given":"Jingya","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yashu","family":"Kuang","sequence":"additional","affiliation":[{"name":"Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Guangdong Provincial Key Laboratory of Research in Structure Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songying","family":"Shen","sequence":"additional","affiliation":[{"name":"Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Guangdong Provincial Key Laboratory of Research in Structure Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm James","family":"Price","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhua","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Guangdong Provincial Key Laboratory of Research in Structure Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1604-2593","authenticated-orcid":false,"given":"Naveed","family":"Sattar","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianrong","family":"He","sequence":"additional","affiliation":[{"name":"Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Guangdong Provincial Key Laboratory of Research in Structure Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Pittavino","sequence":"additional","affiliation":[{"name":"University of Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimin","family":"Xia","sequence":"additional","affiliation":[{"name":"Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.Neil","family":"Thomas","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu","family":"Qiu","sequence":"additional","affiliation":[{"name":"Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"},{"name":"Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kar Keung","family":"Cheng","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6816-1279","authenticated-orcid":false,"given":"Krishnarajah","family":"Nirantharakumar","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"2025121514233484000_12.12.e064122.1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00310.2010"},{"key":"2025121514233484000_12.12.e064122.2","doi-asserted-by":"publisher","DOI":"10.2337\/db15-1748"},{"key":"2025121514233484000_12.12.e064122.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707943"},{"key":"2025121514233484000_12.12.e064122.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69473-7"},{"key":"2025121514233484000_12.12.e064122.5","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1001\/jama.2019.3820","article-title":"Association of gestational weight gain with adverse maternal and infant outcomes","volume":"321","author":"Voerman","year":"2019","journal-title":"JAMA"},{"key":"2025121514233484000_12.12.e064122.6","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-1934"},{"key":"2025121514233484000_12.12.e064122.7","doi-asserted-by":"publisher","DOI":"10.2337\/dci18-0048"},{"key":"2025121514233484000_12.12.e064122.8","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.atherosclerosis.2018.06.884","article-title":"Blood lipids during pregnancy: a progressively appreciated subject in basic and clinical research","volume":"276","author":"Busso","year":"2018","journal-title":"Atherosclerosis"},{"key":"2025121514233484000_12.12.e064122.9","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1111\/obr.12693","article-title":"Gestational dyslipidaemia and adverse birthweight outcomes: a systematic review and meta-analysis","volume":"19","author":"Wang","year":"2018","journal-title":"Obes Rev"},{"key":"2025121514233484000_12.12.e064122.10","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-2445"},{"key":"2025121514233484000_12.12.e064122.11","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-0039"},{"key":"2025121514233484000_12.12.e064122.12","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1007\/s00125-016-4182-2","article-title":"Associations of maternal BMI and insulin resistance with the maternal metabolome and newborn outcomes","volume":"60","author":"Sandler","year":"2017","journal-title":"Diabetologia"},{"key":"2025121514233484000_12.12.e064122.13","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-017-0239-x"},{"key":"2025121514233484000_12.12.e064122.14","first-page":"1","article-title":"The guidelines for prevention and control of overweight and obesity in Chinese adults","volume":"17 Suppl","author":"Chen","year":"2004","journal-title":"Biomed Environ Sci"},{"key":"2025121514233484000_12.12.e064122.15","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0719"},{"key":"2025121514233484000_12.12.e064122.16","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwk071"},{"key":"2025121514233484000_12.12.e064122.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199904223401603"},{"key":"2025121514233484000_12.12.e064122.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2011.00867.x"},{"key":"2025121514233484000_12.12.e064122.19","doi-asserted-by":"publisher","DOI":"10.1159\/000455904"},{"key":"2025121514233484000_12.12.e064122.20","doi-asserted-by":"publisher","DOI":"10.1016\/0378-3782(92)90135-4"},{"key":"2025121514233484000_12.12.e064122.21","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/S2213-8587(14)70121-4","article-title":"The likeness of fetal growth and newborn size across non-isolated populations in the INTERGROWTH-21st project: the fetal growth longitudinal study and newborn cross-sectional study","volume":"2","author":"Villar","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025121514233484000_12.12.e064122.22","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-1939"},{"key":"2025121514233484000_12.12.e064122.23","doi-asserted-by":"crossref","DOI":"10.3389\/fncom.2014.00131","article-title":"Bayesian networks in neuroscience: a survey","volume":"8","author":"Bielza","year":"2014","journal-title":"Front Comput Neurosci"},{"key":"2025121514233484000_12.12.e064122.24","unstructured":"Pittavino M , Lewis F , Furrer R . Abn: an R package for modelling multivariate data using additive Bayesian networks. The Comprehensive R Archive Network 2016:1\u201337."},{"key":"2025121514233484000_12.12.e064122.25","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1975"},{"key":"2025121514233484000_12.12.e064122.26","doi-asserted-by":"publisher","DOI":"10.3390\/nu5041218"},{"key":"2025121514233484000_12.12.e064122.27","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0432"},{"key":"2025121514233484000_12.12.e064122.28","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13261"},{"key":"2025121514233484000_12.12.e064122.29","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00063.2017"},{"key":"2025121514233484000_12.12.e064122.30","doi-asserted-by":"publisher","DOI":"10.3390\/ijms150916153"},{"key":"2025121514233484000_12.12.e064122.31","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00330.2010"},{"key":"2025121514233484000_12.12.e064122.32","doi-asserted-by":"publisher","DOI":"10.1038\/414799a"},{"key":"2025121514233484000_12.12.e064122.33","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-013-2869-1"},{"key":"2025121514233484000_12.12.e064122.34","doi-asserted-by":"crossref","first-page":"2492","DOI":"10.1007\/s00125-014-3386-6","article-title":"Pregnancy glycaemia and cord-blood levels of insulin and leptin in Pakistani and white British mother\u2013offspring pairs: findings from a prospective pregnancy cohort","volume":"57","author":"Lawlor","year":"2014","journal-title":"Diabetologia"},{"key":"2025121514233484000_12.12.e064122.35","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2020-002022"},{"key":"2025121514233484000_12.12.e064122.36","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jpeds.2020.01.013","article-title":"Glucose, insulin, and lipids in cord blood of neonates and their association with birthweight: differential metabolic risk of large for gestational age and small for gestational age babies","volume":"220","author":"Wang","year":"2020","journal-title":"J Pediatr"},{"key":"2025121514233484000_12.12.e064122.37","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00063.2017"},{"key":"2025121514233484000_12.12.e064122.38","doi-asserted-by":"crossref","first-page":"2492","DOI":"10.1007\/s00125-014-3386-6","article-title":"Pregnancy glycaemia and cord-blood levels of insulin and leptin in Pakistani and white British mother-offspring pairs: findings from a prospective pregnancy cohort","volume":"57","author":"Lawlor","year":"2014","journal-title":"Diabetologia"},{"key":"2025121514233484000_12.12.e064122.39","first-page":"66","article-title":"Diabetes mellitus and pregnancy: present status of the hyperglycaemia--hyperinsulinism theory and the weight of the newborn baby","author":"Pedersen","year":"1971","journal-title":"Postgrad Med J"},{"key":"2025121514233484000_12.12.e064122.40","unstructured":"Rasmussen KM , Yaktine AL . Weight gain during pregnancy: reexamining the guidelines, 2009."},{"key":"2025121514233484000_12.12.e064122.41","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0049217"},{"key":"2025121514233484000_12.12.e064122.42","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0010074"},{"key":"2025121514233484000_12.12.e064122.43","doi-asserted-by":"publisher","DOI":"10.1210\/en.2007-1570"},{"key":"2025121514233484000_12.12.e064122.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2014.11.005"},{"key":"2025121514233484000_12.12.e064122.45","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00310.2010"},{"key":"2025121514233484000_12.12.e064122.46","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2007.00464.x"},{"key":"2025121514233484000_12.12.e064122.47","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2008.00541.x"},{"key":"2025121514233484000_12.12.e064122.48","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.M600098-JLR200"},{"key":"2025121514233484000_12.12.e064122.49","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2007.12.010"},{"key":"2025121514233484000_12.12.e064122.50","doi-asserted-by":"crossref","unstructured":"Ellis BJ , Del Giudice M . Developmental adaptation to stress: an evolutionary perspective, 2019.","DOI":"10.1146\/annurev-psych-122216-011732"},{"key":"2025121514233484000_12.12.e064122.51","unstructured":"Weight management before, during and after pregnancy. Available: https:\/\/www.nice.org.uk\/Guidance\/PH27"},{"key":"2025121514233484000_12.12.e064122.52","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1007\/s10995-017-2266-3","article-title":"Comparison of self-reported and measured Pre-pregnancy weight: implications for gestational weight gain counseling","volume":"21","author":"Bannon","year":"2017","journal-title":"Matern Child Health J"},{"key":"2025121514233484000_12.12.e064122.53","unstructured":"Care of women with obesity in pregnancy (Green-top guideline No. 72). Available: https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/gtg72\/"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-064122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T22:23:45Z","timestamp":1765837425000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-064122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":53,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,29]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/bmjopen-2022-064122"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-064122","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]}}}