Programming of infant neurodevelopment by maternal obesity: Potential role of maternal inflammation and insulin resistance

Background and Objectives: Recent studies show that maternal obesity is associated with impaired offspring neurodevelopmental outcomes. The mechanism underlying the association is unclear. However, there is evidence to suggest a role for intra-uterine exposure to inflammation and insulin resistance...

Full description

Saved in:
Bibliographic Details
Published inAsia Pacific journal of clinical nutrition Vol. 26; no. Suppl 1; pp. S36 - S39
Main Authors Dewi, Mira, Carlson, Susan E, Gustafson, Kathleen M, Sullivan, Debra K, Wick, Jo A, Hull, Holly R
Format Journal Article
LanguageEnglish
Published Clayton, Vic HEC Press 01.06.2017
Subjects
Online AccessGet full text
ISSN0964-7058
1440-6047
DOI10.6133/apjcn.062017.s11

Cover

Abstract Background and Objectives: Recent studies show that maternal obesity is associated with impaired offspring neurodevelopmental outcomes. The mechanism underlying the association is unclear. However, there is evidence to suggest a role for intra-uterine exposure to inflammation and insulin resistance (IR). We aimed to determine if maternal IR and inflammation were associated to fetal neurodevelopment as indicated by fetal heart rate variability (HRV), an index of fetal cardiac autonomic nervous system development. Method and Study Design: A total of 44 healthy maternal-fetal pairs (maternal pre-pregnancy BMI distribution: n=20 normal weight, 8 overweight, 16 obese) were analyzed. We assessed maternal inflammation (plasma IL-6 and TNF-a) and IR (HOMA index). Fetal HRV, a proxy for fetal neurodevelopment, was assessed using fetal magnetocardiogram at the 36th week of pregnancy. The relationships between maternal inflammation and IR with fetal HRV (SD1 and SD2) were estimated individually by Pearson bivariate correlations. Results: No correlations were observed between the fetal HRV components with maternal HOMA-IR and maternal plasma levels of IL-6 and TNF-a (all p<0.05). However, the negative association between maternal TNF-a level and fetal SD2 approached significance (correlation coefficient=-0.29, 95% confidence interval=-0.62,-0.03, p=0.07). Conclusion: Maternal IR and inflammation during pregnancy were not associated with fetal cardiac autonomic nervous system development. Further studies with a larger sample size and more maternal inflammatory indicators are needed to explore these relationships.
AbstractList Recent studies show that maternal obesity is associated with impaired offspring neurodevelopmental outcomes. The mechanism underlying the association is unclear. However, there is evidence to suggest a role for intra-uterine exposure to inflammation and insulin resistance (IR). We aimed to determine if maternal IR and inflammation were associated to fetal neurodevelopment as indicated by fetal heart rate variability (HRV), an index of fetal cardiac autonomic nervous system development. A total of 44 healthy maternal-fetal pairs (maternal pre-pregnancy BMI distribution: n=20 normal weight, 8 overweight, 16 obese) were analyzed. We assessed maternal inflammation (plasma IL-6 and TNF-α) and IR (HOMA index). Fetal HRV, a proxy for fetal neurodevelopment, was assessed using fetal magnetocardiogram at the 36th week of pregnancy. The relationships between maternal inflammation and IR with fetal HRV (SD1 and SD2) were estimated individually by Pearson bivariate correlations. No correlations were observed between the fetal HRV components with maternal HOMA-IR and maternal plasma levels of IL-6 and TNF-α (all p<0.05). However, the negative association between maternal TNF-α level and fetal SD2 approached significance (correlation coefficient=-0.29, 95% confidence interval=-0.62,-0.03, p=0.07). Maternal IR and inflammation during pregnancy were not associated with fetal cardiac autonomic nervous system development. Further studies with a larger sample size and more maternal inflammatory indicators are needed to explore these relationships.
Background and Objectives: Recent studies show that maternal obesity is associated with impaired offspring neurodevelopmental outcomes. The mechanism underlying the association is unclear. However, there is evidence to suggest a role for intra-uterine exposure to inflammation and insulin resistance (IR). We aimed to determine if maternal IR and inflammation were associated to fetal neurodevelopment as indicated by fetal heart rate variability (HRV), an index of fetal cardiac autonomic nervous system development. Method and Study Design: A total of 44 healthy maternal-fetal pairs (maternal pre-pregnancy BMI distribution: n=20 normal weight, 8 overweight, 16 obese) were analyzed. We assessed maternal inflammation (plasma IL-6 and TNF-a) and IR (HOMA index). Fetal HRV, a proxy for fetal neurodevelopment, was assessed using fetal magnetocardiogram at the 36th week of pregnancy. The relationships between maternal inflammation and IR with fetal HRV (SD1 and SD2) were estimated individually by Pearson bivariate correlations. Results: No correlations were observed between the fetal HRV components with maternal HOMA-IR and maternal plasma levels of IL-6 and TNF-a (all p<0.05). However, the negative association between maternal TNF-a level and fetal SD2 approached significance (correlation coefficient=-0.29, 95% confidence interval=-0.62,-0.03, p=0.07). Conclusion: Maternal IR and inflammation during pregnancy were not associated with fetal cardiac autonomic nervous system development. Further studies with a larger sample size and more maternal inflammatory indicators are needed to explore these relationships.
Key Words: maternal obesity, inflammation, insulin resistance, fetal heart rate variability INTRODUCTION Maternal obesity is a strong risk factor for increased offspring adiposity and metabolic disorders such as diabetes and cardiovascular disease.1,2 More recently, studies have suggested that maternal obesity affects offspring neurodevelopmental outcomes during childhood.3-5 The mechanism underlying this association remains unclear; however, the role of intrauterine exposure to insulin resistance (IR) and inflammation has been reported. Inflammation and IR are greater in obese pregnant women when compared to normal weight pregnant women and fetuses exposed to obesity are more insulin resistant.6,7 Greater maternal inflammatory cytokine levels are associated with an increased offspring risk of schizophrenia in adulthood,8 and children born to diabetic mothers have a higher risk of impaired brain development and neurological deficits.4 In a rodent model, higher maternal blood inflammatory marker levels are associated with higher inflammatory cytokine levels in the offspring brain.9 Rodent offspring exposed to maternal obesity and high fat diet have increased brain inflammation and show neurobehavioral disturbances.10 Taken together, these studies suggest that the adverse effect of maternal obesity on offspring neurodevelopment may be mediated through IR and inflammation. To the best of our knowledge, the association of mater nal IR and inflammation with offspring neurodevelopment in utero has not been investigated in humans. [...]we investigated whether measures of maternal IR and levels of inflammation are associated with fetal heart rate variability (HRV). Fetal HRV is an index of fetal cardiac autonomic nervous system development, has been used as a proxy for...
Recent studies show that maternal obesity is associated with impaired offspring neurodevelopmental outcomes. The mechanism underlying the association is unclear. However, there is evidence to suggest a role for intra-uterine exposure to inflammation and insulin resistance (IR). We aimed to determine if maternal IR and inflammation were associated to fetal neurodevelopment as indicated by fetal heart rate variability (HRV), an index of fetal cardiac autonomic nervous system development.BACKGROUND AND OBJECTIVESRecent studies show that maternal obesity is associated with impaired offspring neurodevelopmental outcomes. The mechanism underlying the association is unclear. However, there is evidence to suggest a role for intra-uterine exposure to inflammation and insulin resistance (IR). We aimed to determine if maternal IR and inflammation were associated to fetal neurodevelopment as indicated by fetal heart rate variability (HRV), an index of fetal cardiac autonomic nervous system development.A total of 44 healthy maternal-fetal pairs (maternal pre-pregnancy BMI distribution: n=20 normal weight, 8 overweight, 16 obese) were analyzed. We assessed maternal inflammation (plasma IL-6 and TNF-α) and IR (HOMA index). Fetal HRV, a proxy for fetal neurodevelopment, was assessed using fetal magnetocardiogram at the 36th week of pregnancy. The relationships between maternal inflammation and IR with fetal HRV (SD1 and SD2) were estimated individually by Pearson bivariate correlations.METHODS AND STUDY DESIGNA total of 44 healthy maternal-fetal pairs (maternal pre-pregnancy BMI distribution: n=20 normal weight, 8 overweight, 16 obese) were analyzed. We assessed maternal inflammation (plasma IL-6 and TNF-α) and IR (HOMA index). Fetal HRV, a proxy for fetal neurodevelopment, was assessed using fetal magnetocardiogram at the 36th week of pregnancy. The relationships between maternal inflammation and IR with fetal HRV (SD1 and SD2) were estimated individually by Pearson bivariate correlations.No correlations were observed between the fetal HRV components with maternal HOMA-IR and maternal plasma levels of IL-6 and TNF-α (all p<0.05). However, the negative association between maternal TNF-α level and fetal SD2 approached significance (correlation coefficient=-0.29, 95% confidence interval=-0.62,-0.03, p=0.07).RESULTSNo correlations were observed between the fetal HRV components with maternal HOMA-IR and maternal plasma levels of IL-6 and TNF-α (all p<0.05). However, the negative association between maternal TNF-α level and fetal SD2 approached significance (correlation coefficient=-0.29, 95% confidence interval=-0.62,-0.03, p=0.07).Maternal IR and inflammation during pregnancy were not associated with fetal cardiac autonomic nervous system development. Further studies with a larger sample size and more maternal inflammatory indicators are needed to explore these relationships.CONCLUSIONMaternal IR and inflammation during pregnancy were not associated with fetal cardiac autonomic nervous system development. Further studies with a larger sample size and more maternal inflammatory indicators are needed to explore these relationships.
Author Debra K Sullivan
Mira Dewi
Susan E Carlson
Holly R Hull
Kathleen M Gustafson
Jo A Wick
AuthorAffiliation 1 Department of Dietetics and Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
3 Department of Neurology, School of Medicine, Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
4 Department of Biostatistics, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
2 Department of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University, Bogor, Indonesia
AuthorAffiliation_xml – name: 2 Department of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University, Bogor, Indonesia
– name: 3 Department of Neurology, School of Medicine, Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
– name: 4 Department of Biostatistics, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
– name: 1 Department of Dietetics and Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
Author_xml – sequence: 1
  givenname: Mira
  surname: Dewi
  fullname: Dewi, Mira
  organization: Department of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University, Bogor, Indonesia
– sequence: 2
  givenname: Susan E
  surname: Carlson
  fullname: Carlson, Susan E
  organization: Department of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University, Bogor, Indonesia
– sequence: 3
  givenname: Kathleen M
  surname: Gustafson
  fullname: Gustafson, Kathleen M
  organization: Department of Neurology, School of Medicine, Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS, USAa
– sequence: 4
  givenname: Debra K
  surname: Sullivan
  fullname: Sullivan, Debra K
  organization: Department of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University, Bogor, Indonesia
– sequence: 5
  givenname: Jo A
  surname: Wick
  fullname: Wick, Jo A
  organization: Department of Biostatistics, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
– sequence: 6
  givenname: Holly R
  surname: Hull
  fullname: Hull, Holly R
  email: hhull@kumc.edu
  organization: Department of Dietetics and Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA. Email: hhull@kumc.edu
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28625035$$D View this record in MEDLINE/PubMed
BookMark eNpdkc1rVDEUxYNU7LS6dyUP3LiZ8eblW0SQUj-gYBe6Dnl5eWOGvGRM8grjX99MW4u6Cpz7u4dzT87QSUzRIfQSw4ZjQt6a_c7GDfAesNgUjJ-gFaYU1hyoOEErUJyuBTB5is5K2QEAocCeodNe8p4BYSv0-zqnbTbz7OO2S1Pn42Ri7aJbchrdjQtpP7smDIduNtXlaEKXBld8PbzrrlNtM9-knII7rj8yzSc0V1N9ip2JYxPKEnzsctst1UTrnqOnkwnFvXh4z9GPT5ffL76sr759_nrx8WptKO7resITjEIIbkerOAFqKBBMDFEwTHLsBQZg02BEu87JyfVSCYm5FFYwO4yCnKMP9777ZZjdaFvkbILeZz-bfNDJeP3vJPqfeptuNFdEEaGawZsHg5x-La5UPftiXQgmurQUjRXGWEnJWENf_4fu0nIs5I6ikikl-0a9-jvRY5Q_39KA9_dAnn3VNoXg7LHJsjO1OYEmBHPdOk53gMJMciolAKZ9a-cW-deolw
ContentType Journal Article
Copyright Copyright HEC Press Jun 2017
Copyright_xml – notice: Copyright HEC Press Jun 2017
DBID CGR
CUY
CVF
ECM
EIF
NPM
3V.
7X7
7XB
88E
8C1
8FI
8FJ
8FK
ABUWG
AFKRA
BENPR
BVBZV
CCPQU
FYUFA
GHDGH
K9.
M0S
M1P
PHGZM
PHGZT
PJZUB
PKEHL
PPXIY
PQEST
PQQKQ
PQUKI
PRINS
7X8
5PM
DOI 10.6133/apjcn.062017.s11
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
ProQuest Central (Corporate)
Health & Medical Collection
ProQuest Central (purchase pre-March 2016)
Medical Database (Alumni Edition)
Public Health Database
Hospital Premium Collection
Hospital Premium Collection (Alumni Edition)
ProQuest Central (Alumni) (purchase pre-March 2016)
ProQuest Central (Alumni)
ProQuest Central UK/Ireland
ProQuest Central
East & South Asia Database
ProQuest One Community College
Health Research Premium Collection
Health Research Premium Collection (Alumni)
ProQuest Health & Medical Complete (Alumni)
Health & Medical Collection (Alumni Edition)
PML(ProQuest Medical Library)
ProQuest Central Premium
ProQuest One Academic (New)
ProQuest Health & Medical Research Collection
ProQuest One Academic Middle East (New)
ProQuest One Health & Nursing
ProQuest One Academic Eastern Edition (DO NOT USE)
ProQuest One Academic
ProQuest One Academic UKI Edition
ProQuest Central China
MEDLINE - Academic
PubMed Central (Full Participant titles)
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
ProQuest Public Health
ProQuest One Academic Middle East (New)
ProQuest One Academic Eastern Edition
ProQuest Health & Medical Complete (Alumni)
ProQuest Central (Alumni Edition)
ProQuest One Community College
ProQuest One Health & Nursing
ProQuest Hospital Collection
Health Research Premium Collection (Alumni)
ProQuest Central China
ProQuest Hospital Collection (Alumni)
East & South Asia Database
ProQuest Central
ProQuest Health & Medical Complete
Health Research Premium Collection
ProQuest Medical Library
ProQuest One Academic UKI Edition
Health and Medicine Complete (Alumni Edition)
Health & Medical Research Collection
ProQuest Central (New)
ProQuest One Academic
ProQuest One Academic (New)
ProQuest Medical Library (Alumni)
ProQuest Central (Alumni)
MEDLINE - Academic
DatabaseTitleList MEDLINE

ProQuest Public Health
MEDLINE - Academic
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
– sequence: 3
  dbid: BENPR
  name: ProQuest Central
  url: http://www.proquest.com/pqcentral?accountid=15518
  sourceTypes: Aggregation Database
DeliveryMethod fulltext_linktorsrc
Discipline Anatomy & Physiology
Diet & Clinical Nutrition
EISSN 1440-6047
EndPage S39
ExternalDocumentID PMC6939379
28625035
10.3316/informit.915864880014240
Genre Original Articles
Journal Article
GrantInformation_xml – fundername: NCATS NIH HHS
  grantid: UL1 TR000001
– fundername: NICHD NIH HHS
  grantid: K12 HD052027
GroupedDBID ---
188
1OC
23N
2UF
31~
36B
53G
5GY
7X7
8-1
88E
8C1
8FI
8FJ
8R4
8R5
AAWTL
ABFSI
ABUWG
ACGFS
ACXQS
ADBBV
ADHUB
AENEX
AFKRA
AFZJQ
AH1
AHMBA
AJAOE
ALMA_UNASSIGNED_HOLDINGS
ATFKH
BAWUL
BENPR
BPHCQ
BVBZV
BVXVI
CAG
CCPQU
CEFSP
CNMHZ
COF
CS3
DIK
E.L
EBD
EBS
ECGQY
EJD
EMB
EMOBN
EX3
F5P
FRJ
FYUFA
HMCUK
IAEEK
IHE
J5H
KMS
KPA
KPS
LH4
LW6
M1P
OK1
P6G
PHGZM
PHGZT
PJZUB
PPXIY
PQQKQ
PROAC
PSQYO
PUEGO
Q2X
ROL
RPM
SJN
SV3
TR2
TUXDW
UKHRP
UZ5
WOQ
WOW
YFH
3V.
AINHJ
ALIPV
CGR
CUY
CVF
ECM
EIF
K97
NPM
7XB
8FK
K9.
PKEHL
PQEST
PQUKI
PRINS
7X8
5PM
ID FETCH-LOGICAL-a412t-f1f0d7776cdc96304a40313a390bf8d271005fba7003e8fe289781687c75cbd73
IEDL.DBID 7X7
ISSN 0964-7058
IngestDate Thu Aug 21 14:09:11 EDT 2025
Thu Sep 04 19:55:56 EDT 2025
Sun Sep 07 03:11:36 EDT 2025
Thu Jan 02 23:01:03 EST 2025
Tue Sep 23 20:24:23 EDT 2025
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue Suppl 1
Language English
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-a412t-f1f0d7776cdc96304a40313a390bf8d271005fba7003e8fe289781687c75cbd73
Notes Asia Pacific Journal of Clinical Nutrition, Vol. 26, 2017, S36-S39
Informit, Melbourne (Vic)
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
OpenAccessLink http://search.informit.org/doi/10.3316/informit.915864880014240
PMID 28625035
PQID 1914859982
PQPubID 45812
PageCount 36-S39
ParticipantIDs pubmedcentral_primary_oai_pubmedcentral_nih_gov_6939379
proquest_miscellaneous_1911198855
proquest_journals_1914859982
pubmed_primary_28625035
rmit_collectionsjats_10_3316_informit_915864880014240
PublicationCentury 2000
PublicationDate 20170601
PublicationDateYYYYMMDD 2017-06-01
PublicationDate_xml – month: 6
  year: 2017
  text: 20170601
  day: 1
PublicationDecade 2010
PublicationPlace Clayton, Vic
PublicationPlace_xml – name: Clayton, Vic
– name: Australia
– name: Southbank
PublicationTitle Asia Pacific journal of clinical nutrition
PublicationTitleAlternate Asia Pac J Clin Nutr
PublicationYear 2017
Publisher HEC Press
Publisher_xml – name: HEC Press
SSID ssj0003405
Score 2.1745522
Snippet Background and Objectives: Recent studies show that maternal obesity is associated with impaired offspring neurodevelopmental outcomes. The mechanism...
Recent studies show that maternal obesity is associated with impaired offspring neurodevelopmental outcomes. The mechanism underlying the association is...
Key Words: maternal obesity, inflammation, insulin resistance, fetal heart rate variability INTRODUCTION Maternal obesity is a strong risk factor for increased...
SourceID pubmedcentral
proquest
pubmed
rmit
SourceType Open Access Repository
Aggregation Database
Index Database
Publisher
StartPage S36
SubjectTerms Adult
Autism
Body Mass Index
Brain research
Central Nervous System - growth & development
Chronic illnesses
Complications
Cytokines
Cytokines - genetics
Cytokines - metabolism
Diabetes
Fasting
Female
Fetal heart rate monitoring
Gene Expression Regulation
Heart Rate
Homeostasis
Humans
Infant, Newborn
Inflammation
Inflammation - complications
Insulin resistance
Insulin Resistance - physiology
Metabolism
Nervous system
Neurodevelopmental treatment for infants
Obesity
Obesity - complications
Obesity in women
Plasma
Pregnancy
Pregnancy Complications
Prenatal Exposure Delayed Effects - pathology
Risk factors
Studies
Systems development
Womens health
Title Programming of infant neurodevelopment by maternal obesity: Potential role of maternal inflammation and insulin resistance
URI http://search.informit.org/doi/10.3316/informit.915864880014240
https://www.ncbi.nlm.nih.gov/pubmed/28625035
https://www.proquest.com/docview/1914859982
https://www.proquest.com/docview/1911198855
https://pubmed.ncbi.nlm.nih.gov/PMC6939379
Volume 26
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
journalDatabaseRights – providerCode: PRVBFR
  databaseName: Free Medical Journals
  customDbUrl:
  eissn: 1440-6047
  dateEnd: 99991231
  omitProxy: true
  ssIdentifier: ssj0003405
  issn: 0964-7058
  databaseCode: DIK
  dateStart: 19920101
  isFulltext: true
  titleUrlDefault: http://www.freemedicaljournals.com
  providerName: Flying Publisher
– providerCode: PRVPQU
  databaseName: East & South Asia Database
  customDbUrl:
  eissn: 1440-6047
  dateEnd: 99991231
  omitProxy: false
  ssIdentifier: ssj0003405
  issn: 0964-7058
  databaseCode: BVBZV
  dateStart: 20050101
  isFulltext: true
  titleUrlDefault: https://search.proquest.com/eastsouthasia
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: Health & Medical Collection
  customDbUrl:
  eissn: 1440-6047
  dateEnd: 99991231
  omitProxy: true
  ssIdentifier: ssj0003405
  issn: 0964-7058
  databaseCode: 7X7
  dateStart: 20050101
  isFulltext: true
  titleUrlDefault: https://search.proquest.com/healthcomplete
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: ProQuest Central
  customDbUrl: http://www.proquest.com/pqcentral?accountid=15518
  eissn: 1440-6047
  dateEnd: 99991231
  omitProxy: true
  ssIdentifier: ssj0003405
  issn: 0964-7058
  databaseCode: BENPR
  dateStart: 20050101
  isFulltext: true
  titleUrlDefault: https://www.proquest.com/central
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: Public Health Database
  customDbUrl:
  eissn: 1440-6047
  dateEnd: 99991231
  omitProxy: true
  ssIdentifier: ssj0003405
  issn: 0964-7058
  databaseCode: 8C1
  dateStart: 20050101
  isFulltext: true
  titleUrlDefault: https://search.proquest.com/publichealth
  providerName: ProQuest
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1Lb9QwELagvXBB0PIILZWRELe0TvxKuKBSWlVIrCpEpb1FdmyLVtRZuumh_Hpm7OyWCsRlD7aTVTwznhn78zeEvG0rJ4PE6mVBmVJYo0rLpSsVE9BitRHpoP3LTJ2ei89zOZ823JYTrHK1JqaF2g097pEfIA9ZIyE5qD8sfpZYNQpPV6cSGg_JZgWhCmq1nq8TLsZFhjC2SpSaySYfU4ID4wdmcdnHfabA_-n9ZVX9K8D8Gyf5xyX75H9OnpDHU-BID7Okn5IHPm6R7cMISfPVLX1HE5Qz7ZFvkeLThR-hbSL9_EFnK879bfLrLCOyrsBn0SFQ0DCYXJp4Ld0dgojaWwrBbGKIpkOuHvCeLoYR0UXQhKhEfHw9Bt4DypUvQlITHZ1Q7hTyeYxRQbmekfOT429Hp-VUgKE0oqrHMlSBOa216l0PhsqEEUj1aHjLbGhcjcxAMlijYap9EzwkbxrreOhey946zZ-TjThE_5LQUPteCiHQ6oXmtfFCW9ciubM32oSC7K7mv5usaNndybwgb9bdoP94qGGiH27SGBB900hZkBdZXN0iE3V0NaRrknHo0fcEuR6A3Nr3e-LF98SxrVpkCmwLIlHkHRplgsbF5aUZ4V9Zx3mlusxuCwPaSjYKF0OGVwfZq_9_zg55hIqXIWe7ZGO8vvGvIbgZ7V7SYPhtjqo9svnxeHb29TdCPv70
linkProvider ProQuest
linkToHtml http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV1Nb9QwEB2VcoALghZooICRgFtaJ_FHgoRQRam2tF1xaKW9BSexRSuaLN1UaPlR_EZm7OyWCsStV39ktZnn8Uz8_AbgVZE00kmqXuaUiUVlVFxlsokVF9hSaSP8QfvRWI1OxKeJnKzAr8VdGKJVLnyid9RNV9M38m3SIcslJgfp--n3mKpG0enqooRGgMWBnf_AlG32bn8X7fs6Tfc-Hn8YxUNVgdiIJO1jlzjeaK1V3dSIPi6MIP1Cg8l_5fImJbkb6SqjEe82dxYzEk3FKXStZV01OsPn3oLbAmeSVr-eLBM8nolAmSyUiDWXeTgWxQ0z2zbTs7rd4gr3W701S5J_BbR_8zL_uNTv97u9-3BvCFTZTkDWA1ix7Rqs77SYpJ_P2RvmqaP-m_waRLuntse2QWT0GxsvNP7X4efnwAA7xz2SdY4hotGYzOtoNleMJVbNGQbPXpGadaFawVs27XpiM2ETsSBp-nIMPgfBHC5eMtM2bGDVswucSyFvbR_CyY2Y5hGstl1rN4C51NZSCEFeRugsNVboqilITNoabVwEm4v3Xw6rdlZeYSyCl8tuXG90iGJa2136MUlS5LmUETwO5iqnQRikTDE9lDzDHn3NkMsBpOV9vac9_eo1vVVByoRFBJJMXpIT8FS8dnZmevxVXmZZosqgposDikTmipwvp6uK_Mn__84LuDM6PjosD_fHB0_hLoEw0N02YbW_uLTPMLDqq-cezQy-3PTy-Q2LYzga
linkToPdf http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1Lb9NAEB6VVkJceLQ8AgUWCbg58WMfNhJCLSFqKUQ90KrqxaztXdFC7dA4QulP46_wZ5jx2ikFxK0HrrtrR9md13q--QbgaRIUwgrqXmal9nimpZdFovCkz3EkU5o3ifb3Y7m1x98eiIMl-N7VwhCssrOJjaEuqpy-kQ-IhywWeDkIB7aFRewOR68mXz3qIEWZ1q6dhhORHTP_hte36cvtIZ71szAcvfnwestrOwx4mgdh7dnA-oVSSuZFjpLoc82Jy1BHiZ_ZuAiJ-kbYTCuUfRNbg7cTRY0qVK5EnhUqwvdegZVYKo4atbK5v3m4v_ADEXcAykRyT_kidklSdJ_RQE-O87LvS_S-qj8Ngr-Ft3-iNH8p8W-83-gG_Oj2zYFePvdnddbPz36jlPw_N_YmXG-DcrbhtOgWLJlyFdY2Sl1XJ3P2nDUw2Sb_sAq94ZGpcawlVP3Cxl0_gzU423VotxOMB1hlGWovCi5rOEOLc3QWy-YMLwoN-zarXGeGF2xS1YTcwiFCfNLjizX4HlRcV2TKdFmwtoKAneKzFN7n5jbsXcoO3YHlsirNPWA2NLngnJNF5SoKteEqKxIizjZaaduD9e7k09ZCTdPzY-_Bk8U02hZKGOnSVLNmTRAkcSxED-46YUwnjgQlDfEqLPwIZ9QFMV0sIN7yizPl0aeGv1wmxMKY9ECQQKdk8BrYYTk91jX-qp9GUSBTxxyMC5JAxJIcjU9lmf79f_-dx3AV5Td9tz3eeQDXSMMcsm8dluvTmXmIMWSdPWqVlcHHyxbjnys5hMk
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Programming+of+infant+neurodevelopment+by+maternal+obesity%3A+potential+role+of+maternal+inflammation+and+insulin+resistance&rft.jtitle=Asia+Pacific+journal+of+clinical+nutrition&rft.au=Dewi%2C+Mira&rft.au=Carlson%2C+Susan+E&rft.au=Gustafson%2C+Kathleen+M&rft.au=Sullivan%2C+Debra+K&rft.date=2017-06-01&rft.issn=0964-7058&rft.eissn=1440-6047&rft.volume=26&rft.issue=Suppl+1&rft.spage=S36&rft.epage=S39&rft_id=info:doi/10.6133%2Fapjcn.062017.s11&rft_id=info%3Apmid%2F28625035&rft.externalDocID=PMC6939379
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0964-7058&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0964-7058&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0964-7058&client=summon