1. Higher pre-pregnancy body mass index (BMI) was associated with offspring adverse adolescent cardio-metabolic profile.
2. Higher early pregnancy weight gain was associated with offspring adverse adolescent cardio-metabolic profile.
Evidence Rating Level: 1 (Excellent)
Study Rundown: In the U.S. approximately 64 percent of women of reproductive age are overweight and 35 percent are obese. Obesity during pregnancy has been linked with an increased risk of adverse maternal health outcomes like pre-eclampsia and gestational diabete and adverse neonatal outcomes like fetal distress, stillbirth, and large-for-gestational-age infants. Additionally, a growing base of evidence suggests that maternal obesity in pregnancy may have long-term health impacts for her offspring. Previous studies have examined the relationship between maternal pre-pregnancy BMI, gestational weight gain, and risk of childhood obesity, but very few have assessed adolescent obesity. In this study, researchers assessed how maternal pre-pregnancy BMI and weight gain in pregnancy were related to the BMI and cardio-metabolic risk factors of their adolescent offspring.
Higher pre-pregnancy BMI and early pregnancy weight gain were associated with offspring with an adverse adolescent cardio-metabolic profile. Strengths included a large, prospective, population-based cohort and a median follow-up period of 17 years. Limitations included self-reported pre-pregnancy weight, which has been demonstrated to represent an underestimation of a person’s true weight such that results may be biased away from the null. Replication of these results in a prospective investigation accounting for socioeconomic status and indicators of exercise and diet would reduce risks of confounding and confirm the findings presented herein.
In-Depth [prospective cohort study]: Researchers analyzed data from 1392 mothers and their children from the Raine Cohort, a population-based prospective cohort in Perth, Australia. Maternal pre-pregnancy weight was self-reported and maternal weight in the second and third trimesters were obtained from medical records. The primary outcome was the offspring’s cardio-metabolic profile at a median age of 17, which included BMI, waist circumference, waist-to-hip ratio, blood pressure, total and HDL-cholesterol, triglycerides, insulin, glucose and HOMA-IR, a measure of insulin resistance.
Every standard deviation increase in maternal pre-pregnancy BMI from the median was associated with an offspring having a 0.32 standard of deviation higher BMI, 0.28 standard deviation higher waist circumference, and a 0.16 standard deviation higher waist-to-hip ratio (all p < 0.05). Higher maternal pre-pregnancy BMI was also linked to higher adolescent systolic blood pressure, insulin, glucose and HOMA-IR (p<0.05). Greater weight gain in early pregnancy was associated with a higher adolescent BMI, waist circumference, and waist-to-hip ratio (p < 0.05). These associations lost significance when controlling for current adolescent BMI.
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