Higher maternal body mass index is associated with increased risk of cardiovascular disease in offspring
1. Higher maternal body mass index (BMI) was associated with an increased risk of cardiovascular disease in offspring, with stronger relationships seen with increasing BMI.
Evidence Rating Level: 2 (Good)
CVD, the leading cause of mortality worldwide, has had increasing prevalence in younger populations. Therefore, it is essential to understand the risk factors for early CVD. It is known that maternal obesity and excessive gestational weight gain (GWG) during pregnancy are associated with suboptimal intrauterine environments and adverse birth outcomes. However, few studies have studied the relationship between excessive GWG and long-term CVD risk in the offspring. This nationwide cohort study uses the Swedish Medical Birth Register, which contains antenatal, obstetric, and neonatal care for 98%-99% of births in Sweden. Excluding 51 526 offspring diagnosed with congenital heart disease, this study included 2 496 335 offspring from 1982-2014. 1 212 687 (48.6%) were female and 1 283 648 (51.4%) were male. CVD was defined as a composite measure of vascular disease (ischemic heart disease and cerebrovascular disease), heart failure, hypertensive disease, cardiomyopathy, and atrial fibrillation. At the end of follow-up, the mean (SD) age was 23.3 (9.8) years. 22 510 offspring (0.9%) were diagnosed with CVD; 17 605 (0.7%) died, and 55 068 (2.2%) emigrated before CVD. Compared with offspring of mothers with normal BMI, the HRs for major CVD were 1.29 (95% CI, 1.24-1.33) for maternal overweight, 1.66 (95% CI, 1.57-1.75) for maternal obesity class 1, 2.16 (95% CI, 1.96-2.39) for maternal obesity class 2, and 2.74 (95% CI, 2.29-3.28) for maternal obesity class 3. Furthermore, offspring of mothers with obesity were at significantly greater risk of heart failure, hypertensive disease, cardiomyopathy, and atrial fibrillation, with risk increasing with BMI. Further research should characterize the pathophysiological mechanism of how obesogenic environments increase the risk of CVD.
Click here to read this study in JAMA Network Open
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