Fetal growth trajectories and measures of insulin resistance in young adults

Document Type

Journal Article

Publication Title

The Journal of Clinical Endocrinology & Metabolism


Oxford University Press


School of Medical and Health Sciences / Nutrition and Health Innovation Research Institute




he 22-year follow-up of the Raine Study was funded by the NHMRC (project grants 1027449, 1044840, and 1021858). The 27-year follow-up was funded by an NHMRC project grant (1102106); the Royal Perth Hospital Research Foundation; Heart Foundation, Western Australia Branch; Lions Eye Institute; School of Population and Global Health, The University of Western Australia; Division of Obstetrics and Gynaecology, The University of Western Australia; and Prof John Olynyk. R.C.H. and T.A.M. are supported by NHMRC fellowships (1053384/1142858 and 1136046, respectively). A.Y.'s PhD is funded by an Australian Government Research Training Program scholarship and a Raine Study PhD Top-up scholarship.

Grant Number

NHMRC Numbers : 1027449, 1044840, 1021858, 1102106, 1053384, 1142858, 1136046

Grant Link

http://purl.org/au-research/grants/nhmrc/1027449 http://purl.org/au-research/grants/nhmrc/1102106 http://purl.org/au-research/grants/nhmrc/1053384 http://purl.org/au-research/grants/nhmrc/1142858 http://purl.org/au-research/grants/nhmrc/1136046


Yadav, A., Beilin, L. J., Huang, R. C., Newnham, J. P., White, S. W., & Mori, T. A. (2023). Fetal growth trajectories and measures of insulin resistance in young adults. The Journal of Clinical Endocrinology & Metabolism, 108(9), e861-e870. https://doi.org/10.1210/clinem/dgad292


Context: Events during gestation greatly influence the risk of cardiometabolic diseases including diabetes in offspring during later life. Objective: This study aimed to investigate relationships between serial ultrasound-derived fetal growth trajectories and markers of insulin resistance in young adults in the Raine Study, an Australian pregnancy cohort. Methods: Linear mixed modeling examined the relationship between fetal growth trajectory groups, constructed using serial ultrasound-based abdominal circumference (AC), femur length (FL), and head circumference (HC) from 1333 mother-fetal pairs, and offspring Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), as a marker of diabetes risk, at 20 (n = 414), 22 (n = 385), and 27 (n = 431) years. Analyses were adjusted for age, sex, ethnicity, socioeconomic status, adult lifestyle factors, and maternal factors during pregnancy. Results: The study identified 7 AC, 5 FL, and 5 HC growth trajectory groups. Compared to the average-stable (reference) group, a low-falling AC growth trajectory (26%; P = .005) and 2 low HC growth trajectories (20%; P = .006% and 8%; P = .021) were associated with higher adult HOMA-IR. Trajectories representing a high-stable FL and a rising HC were associated with 12% (P = .002) and 9% (P = .021) lower adult HOMA-IR, respectively, compared to the reference group. Conclusion: Restricted fetal HC and AC from early pregnancy are associated with higher relative insulin resistance in the offspring during adulthood. These data strengthen our understanding of the importance of the intrauterine environment and its effect on the risk of predisposition to adult diabetes and related metabolic disorders.



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