Conclusion

In conclusion, in this cohort study, high maternal pre-pregnancy BMI appeared to be the most influential upstream risk factor for gestational hyperglycaemia/hypertriglyceridemia in mothers and increased birthweight/insulin secretion in neonates. Our findings based on robust novel statistical methods highlights the impact of maternal pre-pregnancy BMI on maternal and neonatal metabolic outcomes. We also found that maternal hyperglycaemia was positively associated with elevated neonatal insulin secretion, suggesting this may be a key reason for foetal fat deposition. By contrast, maternal lipid levels do not appear to have meaningful independent associations with neonatal birthweight or CBI.