Context: Offspring exposed in-utero to maternal obesity have an increased risk of later obesity; however, the underlying mechanisms remain unknown.

Objective: To assess the effect of an antenatal lifestyle intervention in obese women on the offspring's cord blood metabolic profile, and examine associations of cord blood metabolic profile with maternal clinical characteristics and offspring anthropometry at birth and age 6 months.

Design: Randomised controlled trial and cohort study.

Setting: The UK Pregnancies Better Eating and Activity randomised controlled trial (UPBEAT).

Participants: 344 mother-offspring pairs.

Intervention: Antenatal behavioural lifestyle (diet and physical activity) intervention.

Main outcome measures: Targeted cord blood metabolic profile, including candidate hormone and metabolomic analyses.

Results: The lifestyle intervention was not associated with change in the cord blood metabolic profile. Higher maternal glycaemia, specifically fasting glucose at 28 weeks' gestation had a linear association with higher cord blood concentrations of lysophosphatidylcholines 16.1 (β=0.65; 95%CI 0.03 to 0.10) and 18.1 (0.52; 0.02 to 0.80), independent of the lifestyle intervention. A principal component of cord blood phosphatidylcholines and lysophosphatidylcholines was associated with infant z-scores of birthweight (0.04; 0.02 to 0.07) and weight at age 6 months (0.05; 0.00 to 0.10). Cord blood IGF-1 and adiponectin concentrations were positively associated with infant weight z-scores at birth and at 6 months.

Conclusions: Concentrations of lysophosphatidylcholines and IGF-1 in cord blood are related to infant weight. These findings support the hypothesis that susceptibility to childhood obesity may be programmed in-utero, but further investigation is required to establish whether these associations are causally related.

Original languageEnglish
Pages (from-to)346–355
JournalThe Journal of clinical endocrinology and metabolism
Issue number1
Early online date13 Nov 2017
Publication statusPublished - 1 Jan 2018


  • Journal Article


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