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Unexpected relationship between fat mass and basal metabolic rate in pregnant women

We investigated the relationships between BMR, fat-free mass (FFM) and fat mass in pregnancy. BMR was measured by indirect calorimetry and body composition was assessed by densitometry in seventeen non-pregnant women (79·9 (SD 26·3, range 505−151·4) kg) and sixteen pregnant women (75·7 (SD 20·6, range 545−115·9) kg). The pregnant women were evaluated during weeks 31−35 of gestation. Multiple regression analysis of BMR with FFM and fat mass in the non-pregnant women showed that FFM was a highly significant predictor of BMR (P < 0·0001), but fat mass was not (P = 0·09). In contrast, in the pregnant women, multiple regression analysis revealed that fat mass was a highly significant predictor (P < 0·001), while FFM was not (P = 0·69). Evaluation of the interaction terms in the combined data set confirmed that the relationships of BMR with FFM and fat mass differ significantly in non-pregnant and pregnant women. It is proposed that pregnancy represents a unique condition during which BMR is regulated by maternal adipose reserves. An augmented BMR in overweight pregnant women may be protective, given that excessive weight gain may be detrimental to neonatal and maternal health.