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Background  To determine the association between maternal cardiometabolic and inflammatory markers with measures of fetal biometry and adiposity.    Methods  Women included in this exploratory analysis were randomised to the ‘Standard Care’ group ( N  = 911) from the LIMIT randomised trial involving a total of 2212 pregnant women who were overweight or obese (ACTRN12607000161426, Date of registration 9/03/2007, prospectively registered). Fetal biometry including abdominal circumference (AC), estimated fetal weight (EFW), and adiposity measurements (mid-thigh fat mass, subscapular fat mass, abdominal fat mass) were obtained from ultrasound assessments at 28 and 36 weeks’ gestation. Maternal markers included C reactive protein (CRP), leptin and adiponectin concentrations, measured at 28 and 36 weeks’ gestation and fasting triglycerides and glucose concentrations measured at 28 weeks’ gestation.    Results  There were negative associations identified between maternal serum adiponectin and fetal ultrasound markers of biometry and adiposity. After adjusting for confounders, a 1-unit increase in log Adiponectin was associated with a reduction in the mean AC z score [− 0.21 (− 0.35, − 0.07),  P  = 0.004] and EFW [− 0.23 (− 0.37, − 0.10),  P  < 0.001] at 28 weeks gestation. Similarly, a 1-unit increase in log Adiponectin was association with a reduction in the mean AC z score [− 0.30 (− 0.46, − 0.13),  P  < 0.001] and EFW [− 0.24 (− 0.38, − 0.10),  P  < 0.001] at 36 weeks gestation. There were no consistent associations between maternal cardiometabolic and inflammatory markers with measurements of fetal adiposity.    Conclusion  Adiponectin concentrations are associated with measures of fetal growth. Our findings contribute to further understanding of fetal growth in the setting of women who are overweight or obesity.

Maternal cardiometabolic markers are associated with fetal growth: a secondary exploratory analysis of the LIMIT randomised trial