Evidence map›Paper›PMID 41819655›Full record

ArticlePlacenta2026

The inverse association between circulatory placental biomarkers in early pregnancy and maternal body mass index.

Nooria Atta, Cleo Pike, Tabitha Wishlade, Ulla Sovio, Clive J Petry, Sam Lockhart, Ken K Ong, Ieuan A Hughes, Sandra F Goodburn, Gordon Smith and 2 more

Abstract read
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In one paragraph

Article in Placenta, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Nooria AttaUniversity of Cambridge, Medical Research Council Metabolic Diseases Unit, Institute of Metabolic Science-Metabolic Research Laboratories, Cambridge, CB2 0QQ, UK; Department of Clinical Biochemistry, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
Cleo PikeDepartment of Obstetrics and Gynaecology, University of Cambridge, The Rosie Hospital NIHR Cambridge Biomedical Research Centre, Cambridge, CB2 0QQ, UK.
Tabitha WishladeDepartment of Obstetrics and Gynaecology, University of Cambridge, The Rosie Hospital NIHR Cambridge Biomedical Research Centre, Cambridge, CB2 0QQ, UK.
Ulla SovioDepartment of Obstetrics and Gynaecology, University of Cambridge, The Rosie Hospital NIHR Cambridge Biomedical Research Centre, Cambridge, CB2 0QQ, UK; The Loke Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, CB2 0QQ, UK.
Clive J PetryUniversity of Cambridge, Medical Research Council Metabolic Diseases Unit, Institute of Metabolic Science-Metabolic Research Laboratories, Cambridge, CB2 0QQ, UK.
Sam LockhartUniversity of Cambridge, Medical Research Council Metabolic Diseases Unit, Institute of Metabolic Science-Metabolic Research Laboratories, Cambridge, CB2 0QQ, UK; Queen's University Belfast, School of Medicine, Dentistry and Biomedical Sciences, Wellcome-Wolfson Institute for Experimental Medicine, Belfast, BT9 7BL, UK.
Ken K OngMRC Epidemiology Unit and NIHR Cambridge Biomedical Research Centre, Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, CB2 0QQ, UK; Department of Paediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, UK.
Ieuan A HughesDepartment of Paediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, UK.
Sandra F GoodburnDepartment of Paediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, UK.
Gordon SmithDepartment of Obstetrics and Gynaecology, University of Cambridge, The Rosie Hospital NIHR Cambridge Biomedical Research Centre, Cambridge, CB2 0QQ, UK; The Loke Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, CB2 0QQ, UK.
Catherine AikenDepartment of Obstetrics and Gynaecology, University of Cambridge, The Rosie Hospital NIHR Cambridge Biomedical Research Centre, Cambridge, CB2 0QQ, UK.
Stephen O'RahillyUniversity of Cambridge, Medical Research Council Metabolic Diseases Unit, Institute of Metabolic Science-Metabolic Research Laboratories, Cambridge, CB2 0QQ, UK; Department of Clinical Biochemistry, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK. Electronic address: so104@cam.ac.uk.

Funding

NIHR NIHR203312UK Medical Research Council and Wellcome MR/Z505924/1
6 · The paper itself

Abstract

High maternal body-mass-index (BMI) is linked to adverse pregnancy outcomes, partly through impaired placental development. An inverse association between BMI and placental biomarkers has been described, however it is unclear whether this relationship is restricted to obesity or occurs across the full-BMI range. We assessed the relationship between maternal BMI and placental biomarkers across multiple cohorts.

methodsWe analysed three UK cohorts: ALSPAC (n = 994), CBGS (n = 1202) and POPS (n = 3869). Concentrations of growth-differentiation-factor15 (GDF15), beta-human chorionic gonadotropin (βhCG), pregnancy-associated plasma protein-A (PAPP-A), and alpha-fetoprotein (AFP) were measured at 8-16 weeks of gestation in maternal serum and expressed as gestational age-adjusted z-scores. Cohort-specific regression and individual-participant-data-meta-analyses (IPD-MA) were used.

resultsAcross cohorts, each 1SD increase in maternal BMI was associated with significant reduction in: GDF15 (β: -0.16, 95%CI: -0.23 to -0.10; p<0.001), βhCG (β: -0.26, 95%CI: -0.28 to -0.23; p<0.001), PAPP-A (β: -0.38 95%CI: -0.41 to -0.36; p<0.001), and AFP (β: -0.21, 95%CI: -0.24 to -0.18; p<0.001). Associations were linear across the full BMI range, not driven solely by obesity. Biomarker levels correlated more strongly with early-pregnancy BMI than with estimated blood volume and associated directionally with the maternal polygenic-risk-scores (PRS) for BMI.

conclusionsMaternal BMI across its full range was inversely associated with biomarkers arising from, or transferred through, the placenta. We propose that the maternal caloric environment may regulate the development of the materno-fetal interface and its capacity for nutrient transfer, supporting similar rates of early fetal-growth in the face of substantial inter-individual variation in maternal body mass.

Indexed as

Body Mass IndexPlacentaAdultalpha-FetoproteinsBiomarkersChorionic Gonadotropin, beta Subunit, HumanCohort StudiesFemaleGrowth Differentiation Factor 15HumansObesityPlacentationPregnancyPregnancy-Associated Plasma Protein-Aalpha-FetoproteinsBiomarkersChorionic Gonadotropin, beta Subunit, HumanGDF15 protein, humanGrowth Differentiation Factor 15Pregnancy-Associated Plasma Protein-AALSPACBody mass indexMaternal nutritional statusPlacental biomarkersPlacentationPOPS

Identifiers

PMID41819655
PMCPMC7618890

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.