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Second, to identify an early-pregnancy metabolite profile associated with birthweight in women with a higher prepregnancy BMI that improved prediction of birthweight compared to glucose and lipid concentrations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>Prepregnancy BMI was obtained in a subgroup of 682 Dutch pregnant women from the Generation R prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Maternal nonfasting targeted amino acids, nonesterified fatty acid, phospholipid, and carnitine concentrations measured in blood serum at mean gestational age of 12.8 weeks. Birthweight was obtained from medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A higher prepregnancy BMI was associated with 72 altered amino acids, nonesterified fatty acid, phospholipid and carnitine concentrations, and 6 metabolite ratios reflecting Krebs cycle, inflammatory, oxidative stress, and lipid metabolic processes (P-values\u2005&amp;lt;\u20050.05). Using penalized regression models, a metabolite profile was selected including 15 metabolites and 4 metabolite ratios based on its association with birthweight in addition to prepregnancy BMI. The adjusted R2 of birthweight was 6.1% for prepregnancy BMI alone, 6.2% after addition of glucose and lipid concentrations, and 12.9% after addition of the metabolite profile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A higher maternal prepregnancy BMI was associated with altered maternal early-pregnancy amino acids, nonesterified fatty acids, phospholipids, and carnitines. Using these metabolites, we identified a maternal metabolite profile that improved prediction of birthweight in women with a higher prepregnancy BMI compared to glucose and lipid concentrations.<\/jats:p><\/jats:sec>","DOI":"10.1210\/clinem\/dgab596","type":"journal-article","created":{"date-parts":[[2021,8,14]],"date-time":"2021-08-14T13:11:08Z","timestamp":1628946668000},"page":"e315-e327","source":"Crossref","is-referenced-by-count":31,"title":["Maternal Body Mass Index, Early-Pregnancy Metabolite Profile, and Birthweight"],"prefix":"10.1210","volume":"107","author":[{"given":"Rama J","family":"Wahab","sequence":"first","affiliation":[{"name":"The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam,the Netherlands"},{"name":"Department of Pediatrics, Sophia\u2019s Children\u2019s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent W V","family":"Jaddoe","sequence":"additional","affiliation":[{"name":"The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam,the Netherlands"},{"name":"Department of Pediatrics, Sophia\u2019s Children\u2019s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellis","family":"Voerman","sequence":"additional","affiliation":[{"name":"The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam,the Netherlands"},{"name":"Department of Pediatrics, Sophia\u2019s Children\u2019s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George J G","family":"Ruijter","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics, Center for Lysosomal and Metabolic Disease, Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine F","family":"Felix","sequence":"additional","affiliation":[{"name":"The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam,the Netherlands"},{"name":"Department of Pediatrics, Sophia\u2019s Children\u2019s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Marchioro","sequence":"additional","affiliation":[{"name":"Division of Metabolic and Nutritional Medicine, Dept. 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