Maternal Plasma Lipids during Pregnancy, Insulin-like Growth Factor-1, and Excess Fetal Growth

Kuan Yu Chen, Shin Yu Lin, Chien Nan Lee, Hung Tsung Wu, Ching Hua Kuo, Han Chun Kuo, Chia Chi Chuang, Chun Heng Kuo, Szu Chi Chen, Kang Chih Fan, Ming Wei Lin, Chi Tai Fang, Hung Yuan Li*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Context: Maternal lipids during pregnancy and placental growth factors are associated with excess fetal growth. However, how these factors interact to increase the risk of delivering large-for-gestational-age (LGA) neonates remains unclear. In this study, we investigated the relationship between maternal plasma triglycerides (TGs) and free fatty acids (FFAs) during pregnancy, cord blood insulin-like growth factors (IGF), and LGA. Objective: In a cell model, we studied the effect of different FAs on placental IGF-1 secretion. Methods: This cohort study included pregnant women with term pregnancy and without diabetes or hypertensive disorders in pregnancy. Maternal fasting plasma TGs and FFAs were measured in the second trimester. Cord blood IGF-1, IGF-2, and IGF binding protein-1 and protein-3 were measured at the time of delivery. A human trophoblast cell line, 3A-sub-E, was used to evaluate the effect of different FFAs on placental IGF-1 secretion. Results: We recruited 598 pregnant women-neonate pairs. Maternal plasma TG (180 mg/dL [152.5-185.5 mg/dL] vs 166 mg/dL [133-206 mg/dL], P=.04) and cord blood IGF-1 concentrations (72.7±23.0 vs 54.1±22.8 ng/mL, P<. 001) were higher in the LGA group and were significantly associated with birth weight z score. Maternal plasma free palmitic acid (PA) and stearic acid (SA), but not oleic acid (OA) or linoleic acid (LA), were significantly associated with cord blood IGF-1 concentrations. In 3A-sub-E cells, treatment with PA, SA, and LA, but not OA, induced IGF-1 expression and secretion. Conclusion: Certain FFAs can induce placental IGF-1 secretion, which suggests a potential pathophysiology linking maternal plasma lipids and LGA.

Original languageEnglish
Pages (from-to)E3461-E3472
JournalJournal of Clinical Endocrinology and Metabolism
Issue number9
StatePublished - 1 Sep 2021


  • birth weight
  • free fatty acid
  • insulin-like growth factor-1
  • large for gestational age
  • plasma triglyceride during pregnancy


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