1
|
Österroos A, Lindström L, Wikman P, Forslund A, Wikström AK, Sundström Poromaa I, Ahlsson F. Maternal body mass index, gestational weight gain, and early childhood growth: A register-based cohort study. Acta Obstet Gynecol Scand 2024. [PMID: 39231783 DOI: 10.1111/aogs.14961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 07/22/2024] [Accepted: 08/19/2024] [Indexed: 09/06/2024]
Abstract
INTRODUCTION Childhood obesity is associated with maternal obesity, but the link to gestational weight gain (GWG) is not fully elucidated. We examined the relationship between early pregnancy maternal body mass index (BMI) and GWG on early childhood growth. MATERIAL AND METHODS Data from 30 197 mother-child pairs from Uppsala County Mother and Child Cohort were divided into 15 groups according to maternal BMI and GWG, based on World Health Organization classification and Institute of Medicine guidelines, respectively. Postnatal growth patterns were analyzed with linear mixed regression models within maternal BMI groups. Odds ratios of overweight and obesity at 4 years of age were assessed with logistic regression analyses. We treated children of mothers with normal weight and adequate GWG as the reference group, and all analyses were adjusted for potential confounders. RESULTS GWG was associated with infant BMI z-score at birth, independent of potential confounding factors. Independent of GWG, we observed an overall decrease in BMI z-score from 18 months to 5 years in children of mothers who were underweight, while an increase in BMI z-score was seen in children of mothers who were overweight or obese. In children of normal- and overweight mothers, the risk of childhood overweight and obesity was associated with excessive compared to adequate GWG (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] 1.01-1.36 for normal-weight mothers, and aOR 1.25, 95% CI 1.04-1.51 for overweight mothers, respectively). Children of mothers with obesity and excessive GWG had the highest risk of being overweight or obese at 4 years (aOR 2.88, 95% CI 2.40-3.44, and 4.38, 95% CI 3.37-5.67, respectively). Associations did not differ between children of mothers with obesity class 1 and 2-3 when comparing excessive and adequate GWG (aOR 1.33, 95% CI 0.96-1.85, and 1.12, 95% CI 0.74-1.70, respectively). CONCLUSIONS Maternal GWG affects infant birth size and growth until 18 months, although maternal BMI is more crucial for childhood growth beyond 18 months. Further, children of mothers who are normal- or overweight and experience excessive GWG have an increased risk of obesity at 4 years.
Collapse
Affiliation(s)
- Anna Österroos
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Linda Lindström
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Per Wikman
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Anders Forslund
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Anna-Karin Wikström
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Inger Sundström Poromaa
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Fredrik Ahlsson
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| |
Collapse
|
2
|
Shrestha D, K C Bhandari A, Ogawa K, Tanaka H, Miyayama C, Horikawa R, Urayama KY, Morisaki N. Effect of postpartum depression and role of infant feeding practices on relative weight of child at 1 and 3 years of age. BMC Pregnancy Childbirth 2024; 24:336. [PMID: 38698333 PMCID: PMC11067203 DOI: 10.1186/s12884-024-06483-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Childhood obesity has increased and is considered one of the most serious public health challenges of the 21st century globally, and may be exacerbated by postpartum depression (PPD). The purpose of this study was to examine the association between PPD at 1st and 6th month postpartum, infant feeding practices, and body mass index (BMI) z-score of the child at one and three years of age. METHODS This study used data from an ongoing prospective maternal-child birth cohort performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan with the period of recruitment from May 13, 2010 to November 28, 2013. Out of 2,309 total number of mothers, 1,279 mother-child dyads were assessed in the study. We performed multivariable linear regression analysis to examine the association between PPD and child's BMI z-score stratified by the child's age at 1 year and 3 years of age. RESULTS The prevalence of PPD at 1 month postpartum (17%) was found to be higher than at 6 months (12%). In multivariable linear regression analysis we observed that children at 3 years who had mothers with PPD at 6 months had, on average, a BMI z-score 0.25 higher than children of mothers who did not have PPD at 6 months (ß coefficient 0.25, 95% CI [0.04 to 0.46], p value 0.02), holding all other covariates constant. Also, initiation of weaning food when child is at six months of age was associated with higher BMI z-score of the child at 3 years after adjusting for all covariates (ß coefficient = 0.18, 95% CI [0.03 to 0.34], p-value < 0.05). CONCLUSION The significant association between PPD at 6 months and child's BMI z-score at 3 years of age, in conjunction with birth trends and high prevalence of PPD, can add to the body of evidence that there is need for multiple assessment across the first postpartum year to rule out PPD as early screening and early interventions may benefit both maternal health and child development outcomes. These findings can indicate the need for establishing support systems for care-giving activities for mothers with PPD.
Collapse
Affiliation(s)
- Drishti Shrestha
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.
| | - Aliza K C Bhandari
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kohei Ogawa
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Hisako Tanaka
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Chiharu Miyayama
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Kevin Y Urayama
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan.
| |
Collapse
|
3
|
Sneed NM, Heerman WJ, Shaw PA, Han K, Chen T, Bian A, Pugh S, Duda S, Lumley T, Shepherd BE. Associations Between Gestational Weight Gain, Gestational Diabetes, and Childhood Obesity Incidence. Matern Child Health J 2024; 28:372-381. [PMID: 37966561 PMCID: PMC10922599 DOI: 10.1007/s10995-023-03853-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
INTRODUCTION Excessive maternal gestational weight gain (GWG) is strongly correlated with childhood obesity, yet how excess maternal weight gain and gestational diabetes mellitus (GDM) interact to affect early childhood obesity is poorly understood. The purpose of this study was to investigate whether overall and trimester-specific maternal GWG and GDM were associated with obesity in offspring by age 6 years. METHODS A cohort of 10,335 maternal-child dyads was established from electronic health records. Maternal weights at conception and delivery were estimated from weight trajectory fits using functional principal components analysis. Kaplan-Meier curves and Cox regression, together with generalized raking, examined time-to-childhood-obesity. RESULTS Obesity diagnosed prior to age 6 years was estimated at 19.7% (95% CI: 18.3, 21.1). Maternal weight gain during pregnancy was a strong predictor of early childhood obesity (p < 0.0001). The occurrence of early childhood obesity was lower among mothers with GDM compared with those without diabetes (adjusted hazard ratio = 0.58, p = 0.014). There was no interaction between maternal weight gain and GDM (p = 0.55). Higher weight gain during the first trimester was associated with lower risk of early childhood obesity (p = 0.0002) whereas higher weight gain during the second and third trimesters was associated with higher risk (p < 0.0001). DISCUSSION Results indicated total and trimester-specific maternal weight gain was a strong predictor of early childhood obesity, though obesity risk by age 6 was lower for children of mothers with GDM. Additional research is needed to elucidate underlying mechanisms directly related to trimester-specific weight gain and GDM that impede or protect against obesity prevalence during early childhood.
Collapse
Affiliation(s)
- Nadia M Sneed
- Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave., Nashville, TN, 37212, USA.
- Center for Research Development and Scholarship, Vanderbilt University School of Nursing, 319E Godchaux Hall, Nashville, TN, 37240, USA.
| | - William J Heerman
- Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave., Nashville, TN, 37212, USA
| | - Pamela A Shaw
- Biostatistics Unit, Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave Suite 1600, Seattle, WA, 98101, USA
| | - Kyunghee Han
- Department of Mathematics, Statistics, and Computer Science, University of Illinois at Chicago, 851 S Morgan St, 503 Science and Engineering Offices, Chicago, IL, 60607, USA
| | - Tong Chen
- Department of Statistics, University of Auckland, 38 Princes St., Auckland, 1010, New Zealand
| | - Aihua Bian
- Department of Biostatistics, Vanderbilt University Medical Center, 2525 West End Ave., Room/Suite 11124, Nashville, TN, 37203, USA
| | - Shannon Pugh
- Department of Emergency Medicine, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
| | - Stephany Duda
- Department of Biomedical Informatics, Vanderbilt University Medical Center, 2525 West End Ave., Nashville, TN, 37203, USA
| | - Thomas Lumley
- Department of Statistics, University of Auckland, 38 Princes St., Auckland, 1010, New Zealand
| | - Bryan E Shepherd
- Department of Biostatistics, Vanderbilt University Medical Center, 2525 West End Ave., Room/Suite 11124, Nashville, TN, 37203, USA
| |
Collapse
|
4
|
Harmancıoğlu B, Kabaran S. Maternal high fat diets: impacts on offspring obesity and epigenetic hypothalamic programming. Front Genet 2023; 14:1158089. [PMID: 37252665 PMCID: PMC10211392 DOI: 10.3389/fgene.2023.1158089] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/04/2023] [Indexed: 05/31/2023] Open
Abstract
Maternal high-fat diet (HFD) during pregnancy is associated with rapid weight gain and fetal fat mass increase at an early stage. Also, HFD during pregnancy can cause the activation of proinflammatory cytokines. Maternal insulin resistance and inflammation lead to increased adipose tissue lipolysis, and also increased free fatty acid (FFA) intake during pregnancy (˃35% of energy from fat) cause a significant increase in FFA levels in the fetus. However, both maternal insulin resistance and HFD have detrimental effects on adiposity in early life. As a result of these metabolic alterations, excess fetal lipid exposure may affect fetal growth and development. On the other hand, increase in blood lipids and inflammation can adversely affect the development of the liver, adipose tissue, brain, skeletal muscle, and pancreas in the fetus, increasing the risk for metabolic disorders. In addition, maternal HFD is associated with changes in the hypothalamic regulation of body weight and energy homeostasis by altering the expression of the leptin receptor, POMC, and neuropeptide Y in the offspring, as well as altering methylation and gene expression of dopamine and opioid-related genes which cause changes in eating behavior. All these maternal metabolic and epigenetic changes may contribute to the childhood obesity epidemic through fetal metabolic programming. Dietary interventions, such as limiting dietary fat intake <35% with appropriate fatty acid intake during the gestation period are the most effective type of intervention to improve the maternal metabolic environment during pregnancy. Appropriate nutritional intake during pregnancy should be the principal goal in reducing the risks of obesity and metabolic disorders.
Collapse
|
5
|
Tanigawa K, Kawanishi Y, Ikehara S, Kimura T, Ueda K, Kimura T, Ozono K, Iso H. Association between gestational weight gain and risk of overweight at 3 years old: The Japan Environment and Children's Study. Pediatr Obes 2023; 18:e12978. [PMID: 36102849 DOI: 10.1111/ijpo.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 08/06/2022] [Accepted: 08/15/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND It is unclear if gestational weight gain (GWG) increases the risk of children with overweight. OBJECTIVES We examined the association between GWG and the risk of overweight in 3-year-old children in the Japanese nationwide birth cohort study. METHODS Among 64 336 singleton births, we calculated the risk ratios (RRs) and 95% confidence intervals (95% CIs) of the association between GWG categories and children with overweight, following an adjustment of the confounding variables. RESULTS GWG was positively associated with the risk of overweight among 3-year-old children. The multivariable RR (95% CI) was 1.21 (1.17-1.25) per 5 kg increase of the GWG. The multivariable RR (95% CI) for excessive GWG was 1.20 (1.12-1.28) and 1.27 (1.16-1.39) based on the modified Japanese and IOM criteria, respectively, compared to adequate GWG. The multivariable RR (95% CI) of overweight with children for inadequate versus adequate GWG was 0.83 (0.78-0.88) and 0.84 (0.79-0.89) based on the modified Japanese and IOM criteria, respectively. CONCLUSIONS GWG was positively associated with a high risk of overweight at 3 years of age. The risk of offspring overweight was 20%-27% higher and 16%-17% lower with excessive GWG and inadequate GWG, respectively, compared to adequate GWG, based on the aforementioned criteria.
Collapse
Affiliation(s)
- Kanami Tanigawa
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.,Osaka Maternal and Child Health Information Center, Osaka Women's and Children's Hospital, Osaka, Japan.,Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Osaka, Japan
| | - Yoko Kawanishi
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Osaka, Japan.,Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satoyo Ikehara
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.,Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Osaka, Japan
| | - Takashi Kimura
- Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kimiko Ueda
- Osaka Maternal and Child Health Information Center, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroyasu Iso
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Osaka, Japan.,Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | | |
Collapse
|
6
|
Łoniewska B, Michalczyk K, Podsiadło K, Adamek K, Michalczyk B, Tousty P, Kaczmarczyk M, Łoniewski I. Analysis of the Influence of Pre-Pregnancy BMI and Weight Gain during Pregnancy on the Weight of Healthy Children during the First 2 Years of Life: A Prospective Study. CHILDREN 2022; 9:children9101431. [PMID: 36291367 PMCID: PMC9600872 DOI: 10.3390/children9101431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022]
Abstract
Background: Increased pre-pregnancy maternal BMI (pBMI) and gestational weight gain (GWG) have been found to increase infants’ birthweight and result in the programming of child weight and impact its later weight gain. Aim: To assess the impact of pBMI and GWG on the weight of children from birth to 2 years of age and over the duration of breastfeeding. Methods: Single Centre observational prospective longitudinal cohort study. Data were collected from medical records, and medical history. The analysis of multiple linear and mixed models was involved. Findings: 20% of females were overweight, while 13% were obese before the pregnancy. An overall model, including gender and smoking, indicated a significant impact of pBMI category on a child’s birth mass (p = 0.01). The GWG category affected a child’s birth weight (p = 0.018, Effect size 0.41). pBMI did not affect the breastfeeding duration. Conclusion: pBMI and GWG correlate with birth weight and weight in neonatal period, however they become insignificant in later childhood. Weight assessment methods among children aged up to two years of age require standardization. Maternal weight before the pregnancy nor the weight gain during the pregnancy do not influence the length of breastfeeding. The biggest limitation was the small sample size and the failure to account for weight gain per trimester of pregnancy. Further research on a larger population should be continued.
Collapse
Affiliation(s)
- Beata Łoniewska
- Department of Neonatology and Intensive Neonatal Care, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Kaja Michalczyk
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
- Correspondence:
| | - Konrad Podsiadło
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Karolina Adamek
- Department of Neonatology and Intensive Neonatal Care, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Barbara Michalczyk
- Department of Neonatology and Intensive Neonatal Care, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Piotr Tousty
- Department of Obstetrics and Gynecology, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Mariusz Kaczmarczyk
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Igor Łoniewski
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland
- Department of Biochemical Sciences, Pomeranian Medical University in Szczecin, Broniewskiego 24, 71-460 Szczecin, Poland
| |
Collapse
|
7
|
Lorenz L, Krebs F, Nawabi F, Alayli A, Stock S. Preventive Counseling in Routine Prenatal Care-A Qualitative Study of Pregnant Women's Perspectives on a Lifestyle Intervention, Contrasted with the Experiences of Healthcare Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6122. [PMID: 35627659 PMCID: PMC9140722 DOI: 10.3390/ijerph19106122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 11/22/2022]
Abstract
Maternal lifestyle during pregnancy and excessive gestational weight gain can influence maternal and infant short and long-term health. As part of the GeMuKi intervention, gynecologists and midwives provide lifestyle counseling to pregnant women during routine check-up visits. This study aims to understand the needs and experiences of participating pregnant women and to what extent their perspectives correspond to the experiences of healthcare providers. Semi-structured interviews were conducted with 12 pregnant women and 13 multi-professional healthcare providers, and were analyzed using qualitative content analysis. All interviewees rated routine check-up visits as a good setting in which to focus on lifestyle topics. Women in their first pregnancies had a great need to talk about lifestyle topics. None of the participants were aware of the link between gestational weight gain and maternal and infant health. The healthcare providers interviewed attributed varying relevance regarding the issue of weight gain and, accordingly, provided inconsistent counseling. The pregnant women expressed dissatisfaction regarding the multi-professional collaboration. The results demonstrate a need for strategies to improve multi-professional collaboration. In addition, health care providers should be trained to use sensitive techniques to inform pregnant women about the link between gestational weight gain and maternal and infant health.
Collapse
Affiliation(s)
- Laura Lorenz
- Institute of Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Cologne, Germany; (F.K.); (F.N.); (A.A.); (S.S.)
| | | | | | | | | |
Collapse
|
8
|
Krebs F, Lorenz L, Nawabi F, Alayli A, Stock S. Effectiveness of a Brief Lifestyle Intervention in the Prenatal Care Setting to Prevent Excessive Gestational Weight Gain and Improve Maternal and Infant Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105863. [PMID: 35627403 PMCID: PMC9141141 DOI: 10.3390/ijerph19105863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 02/04/2023]
Abstract
Research on perinatal programming shows that excessive gestational weight gain (GWG) increases the risk of overweight and obesity later in a child’s life and contributes to maternal weight retention and elevated risks of obstetrical complications. This study examined the effectiveness of a brief lifestyle intervention in the prenatal care setting, compared to routine prenatal care, in preventing excessive GWG as well as adverse maternal and infant health outcomes. The GeMuKi study was designed as a cluster RCT using a hybrid effectiveness implementation design and was conducted in the prenatal care setting in Germany. A total of 1466 pregnant women were recruited. Pregnant women in intervention regions received up to six brief counseling sessions on lifestyle topics (e.g., physical activity, nutrition, drug use). Data on GWG and maternal and infant outcomes were entered into a digital data platform by the respective healthcare providers. The intervention resulted in a significant reduction in the proportion of women with excessive GWG (OR = 0.76, 95% CI (0.60 to 0.96), p = 0.024). Gestational weight gain in the intervention group was reduced by 1 kg (95% CI (−1.56 to −0.38), p < 0.001). No evidence of intervention effects on pregnancy, birth, or neonatal outcomes was found.
Collapse
|
9
|
Zhang S, Li N, Li W, Wang L, Liu E, Zhang T, Dong W, Chen J, Leng J. Increased Gestational Weight Gain is Associated with a Higher Risk of Offspring Adiposity Before Five Years of Age: A Population-Based Cohort Study. Diabetes Metab Syndr Obes 2022; 15:2353-2363. [PMID: 35966828 PMCID: PMC9373997 DOI: 10.2147/dmso.s374427] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/21/2022] [Indexed: 04/20/2023] Open
Abstract
OBJECTIVE We aim to investigate the influence of weight gain during pregnancy on the risk of offspring adiposity before five years old. METHODS We retrospectively collected health information from the Tianjin mother-child cohort. Offspring outcome was BMI Z-score and prevalence of childhood adiposity from 0.5-5 years old. Gestational weight gain was analyzed using continuous and categorical variables evaluated by the IOM guidelines. Multivariate analysis adjusted maternal age, prepregnancy BMI, maternal height, smoking, cesarean section, gestational age at birth, birth weight, birth length, and mode of infant feeding during 0-6 months. RESULTS Gestational weight gain contributed to offspring's BMI Z-score from 1-5 years old, and the effect was most obvious in the first half of pregnancy (multivariate analysis, at 1, 2, 2.5, 3, 4, and 5 years of age: β 0.011, 95% CI 0.008-0.014; β 0.017, 95% CI 0.015-0.020; β 0.005, 95%CI 0.002-0.008; β 0.018, 95% CI 0.015-0.021; β 0.014, 95% CI 0.009-0.020; β 0.013, 95% CI 0.005-0.021). Excessive weight gain was associated with a higher prevalence of offspring adiposity before five years, even if prepregnancy BMI is normal. Multivariate regression analysis further confirmed that excessive weight gain during the first half of pregnancy significantly increased the risk of childhood obesity at aged one and three (AOR 1.083, 95% CI 1.003-1.169; AOR 1.158, 95% CI 1.036-1.293). CONCLUSION Offspring have a higher risk of preschool adiposity when gestational weight gain was excessive during the first half of pregnancy.
Collapse
Affiliation(s)
- Shuang Zhang
- Tianjin Women’s and Children’s Health Center, Tianjin, People’s Republic of China
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Nan Li
- Tianjin Women’s and Children’s Health Center, Tianjin, People’s Republic of China
| | - Weiqin Li
- Tianjin Women’s and Children’s Health Center, Tianjin, People’s Republic of China
| | - Leishen Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, People’s Republic of China
| | - Enqing Liu
- Tianjin Women’s and Children’s Health Center, Tianjin, People’s Republic of China
| | - Tao Zhang
- Tianjin Women’s and Children’s Health Center, Tianjin, People’s Republic of China
| | - Wei Dong
- Tianjin Women’s and Children’s Health Center, Tianjin, People’s Republic of China
| | - Jiujing Chen
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Junhong Leng
- Tianjin Women’s and Children’s Health Center, Tianjin, People’s Republic of China
- Correspondence: Junhong Leng, Email
| |
Collapse
|
10
|
Meyer DM, Stecher L, Brei C, Hauner H. Mid-pregnancy weight gain is associated with offspring adiposity outcomes in early childhood. Pediatr Res 2021; 90:390-396. [PMID: 33069163 DOI: 10.1038/s41390-020-01202-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Gestational weight gain (GWG) has been linked to childhood obesity. However, it is unclear if the timing of weight gain influences offspring body composition. A secondary analysis of a clinical trial examined the influence of total, early, and mid-pregnancy GWG on adiposity outcomes in 186 children at birth, 1, 3, and 5 years. METHODS Early (<15 weeks) and mid-pregnancy GWG (15-32 weeks) were assessed. Anthropometrics and abdominal ultrasound were measured annually in children from birth to 5 years. MRI was performed in a sub-group of 44 children at 5 years to estimate abdominal fat. RESULTS Almost half of the women (n = 86/186) gained excess weight in pregnancy, and women with a BMI ≥ 25 kg/m2 (n = 33) were more likely to gain in excess. Mid-pregnancy GWG predicted higher weight (g) and subcutaneous fat by ultrasound (mm2) and MRI (cm3) at 5 years [β: 139.34 g (95% CI: -0.22; 278.90), p = 0.050; β: 1.42 mm2 (95% CI: 0.06; 2.78), p = 0.041; and β: 18.56 cm3 (95% CI: 1.30; 35.82) p = 0.036, respectively]. CONCLUSIONS Mid-pregnancy weight gain was associated with greater fat depots at 5 years, which suggests that the timing of GWG has differential effects on offspring adiposity outcomes. IMPACT Gestational weight gained in mid-pregnancy is associated with growth and adipose tissue development at 5 years. We observed that maternal weight gain in early and mid-gestation has differential effects on offspring body composition. Mid-pregnancy weight gain (15-32 weeks gestation) appears to influence child growth and abdominal fat accretion which may have implications for long-term metabolic health. Interventions that prevent excessive gestational weight gain in mid-pregnancy may affect obesity risk in early childhood. Prenatal care should stress the importance of optimal weight gain throughout pregnancy.
Collapse
Affiliation(s)
- Dorothy Marie Meyer
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Lynne Stecher
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Christina Brei
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Hans Hauner
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany.
| |
Collapse
|
11
|
Zhao Q, Hu Z, Kocak M, Liu J, Fowke JH, Han JC, Kakhniashvili D, Lewinn KZ, Bush NR, Mason WA, Tylavsky FA. Associations of prenatal metabolomics profiles with early childhood growth trajectories and obesity risk in African Americans: the CANDLE study. Int J Obes (Lond) 2021; 45:1439-1447. [PMID: 33824402 PMCID: PMC8496965 DOI: 10.1038/s41366-021-00808-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 02/17/2021] [Accepted: 03/22/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Prenatal metabolomics profiles, providing measures of in utero nutritional and environmental exposures, may improve the prediction of childhood outcomes. We aimed to identify prenatal plasma metabolites associated with early childhood body mass index (BMI) trajectories and overweight/obesity risk in offspring. METHODS This study included 450 African American mother-child pairs from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood Study. An untargeted metabolomics analysis was performed on the mothers' plasma samples collected during the second trimester. The children's BMI-z-score trajectories from birth to age 4 [rising-high- (9.8%), moderate- (68.2%), and low-BMI (22.0%)] and overweight/obesity status at age 4 were the main outcomes. The least absolute shrinkage and selection operator (LASSO) was used to select the prenatal metabolites associated with childhood outcomes. RESULTS The mothers were 24.5 years old on average at recruitment, 76.4% having education less than 12 years and 80.0% with Medicaid or Medicare. In LASSO, seven and five prenatal metabolites were associated with the BMI-z-score trajectories and overweight/obese at age 4, respectively. These metabolites are mainly from/relevant to the pathways of steroid biosynthesis, amino acid metabolism, vitamin B complex, and xenobiotics metabolism (e.g., caffeine and nicotine). The odds ratios (95% CI) associated with a one SD increase in the prenatal metabolite risk scores (MRSs) constructed from the LASSO-selected metabolites were 2.97 (1.95-4.54) and 2.03 (1.54-2.67) for children being in the rising-high-BMI trajectory group and overweight/obesity at age 4, respectively. The MRSs significantly improved the risk prediction for childhood outcomes beyond traditional prenatal risk factors. The increase (95% CI) in the area under the receiver operating characteristic curves were 0.10 (0.03-0.18) and 0.07 (0.02-0.12) for the rising-high-BMI trajectory (P = 0.005) and overweight/obesity at age 4 (P = 0.007), respectively. CONCLUSIONS Prenatal metabolomics profiles advanced prediction of early childhood growth trajectories and obesity risk in offspring.
Collapse
Affiliation(s)
- Qi Zhao
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Zunsong Hu
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mehmet Kocak
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jiawang Liu
- Medicinal Chemistry Core, Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Pharmaceutical Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jay H Fowke
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Joan C Han
- Departments of Pediatrics and Physiology, University of Tennessee Health Science Center, and Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - David Kakhniashvili
- Proteomics and Metabolomics Core, Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kaja Z Lewinn
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Nicole R Bush
- Departments of Pediatrics and Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - W Alex Mason
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| |
Collapse
|
12
|
Rusek W, Baran J, Leszczak J, Adamczyk M, Baran R, Weres A, Inglot G, Czenczek-Lewandowska E, Pop T. Changes in Children's Body Composition and Posture during Puberty Growth. CHILDREN-BASEL 2021; 8:children8040288. [PMID: 33917775 PMCID: PMC8068155 DOI: 10.3390/children8040288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Abstract
The main goal of our study was to determine how the age of children, puberty and anthropometric parameters affect the formation of body composition and faulty body posture development in children. The secondary goal was to determine in which body segments abnormalities most often occur and how gender differentiates the occurrence of adverse changes in children's body posture and body composition during puberty. The study group consisted of 464 schoolchildren aged from 6-16. Body posture was assessed with the Zebris system. The composition of the body mass was tested with Tanita MC 780 MA body mass analyzer and the body height was measured using a portable stadiometer PORTSTAND 210. The participants were further divided due to the age of puberty. Tanner division was adopted. The cut-off age for girls is ≥10 years and for boys it is ≥12 years. The analyses applied descriptive statistics, the Pearson correlation, stepwise regression analysis and the t-test. The accepted level of significance was p < 0.05. The pelvic obliquity was lower in older children (beta = -0.15). We also see that age played a significant role in the difference in the height of the right pelvis (beta = -0.28), and the difference in the height of the right shoulder (beta = 0.23). Regression analysis showed that the content of adipose tissue (FAT%) increased with body mass index (BMI) and decreased with increasing weight, age, and height. Moreover, the FAT% was lower in boys than in girls (beta negative equal to -0.39). It turned out that older children (puberty), had greater asymmetry in the right shoulder blade (p < 0.001) and right shoulder (p = 0.003). On the other hand, younger children (who were still before puberty) had greater anomalies in the left trunk inclination (p = 0.048) as well as in the pelvic obliquity (p = 0.008). Girls in puberty were characterized by greater asymmetry on the right side, including the shoulders (p = 0.001), the scapula (p = 0.001) and the pelvis (p < 0.001). In boys, the problem related only to the asymmetry of the shoulder blades (p < 0.001). Girls were characterized by a greater increase in adipose tissue and boys by muscle tissue. Significant differences also appeared in the body posture of the examined children. Greater asymmetry within scapulas and shoulders were seen in children during puberty. Therefore, a growing child should be closely monitored to protect them from the adverse consequences of poor posture or excessive accumulation of adipose tissue in the body.
Collapse
Affiliation(s)
- Wojciech Rusek
- Rehabilitation Centre Rehamed-Center Sp z o.o. Tajecina 66A, 36-002 Tajęcina, Poland; (W.R.); (M.A.)
| | - Joanna Baran
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland; (J.L.); (A.W.); (E.C.-L.); (T.P.)
- Natural and Medical Center for Innovative Research, ul. Litawora 2, 35-310 Rzeszów, Poland
- Correspondence:
| | - Justyna Leszczak
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland; (J.L.); (A.W.); (E.C.-L.); (T.P.)
- Natural and Medical Center for Innovative Research, ul. Litawora 2, 35-310 Rzeszów, Poland
| | - Marzena Adamczyk
- Rehabilitation Centre Rehamed-Center Sp z o.o. Tajecina 66A, 36-002 Tajęcina, Poland; (W.R.); (M.A.)
| | - Rafał Baran
- RehaKlinika Sp. z o.o., ul. Pogodne Wzgórze 12, 35-317 Rzeszów, Poland
| | - Aneta Weres
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland; (J.L.); (A.W.); (E.C.-L.); (T.P.)
- Natural and Medical Center for Innovative Research, ul. Litawora 2, 35-310 Rzeszów, Poland
| | - Grzegorz Inglot
- Solution-Statistical Analysis, ul. Stojałowskiego 4/73, 35-120 Rzeszów, Poland;
- Institute of Medical Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland;
| | - Ewelina Czenczek-Lewandowska
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland; (J.L.); (A.W.); (E.C.-L.); (T.P.)
- Natural and Medical Center for Innovative Research, ul. Litawora 2, 35-310 Rzeszów, Poland
| | - Teresa Pop
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland; (J.L.); (A.W.); (E.C.-L.); (T.P.)
- Natural and Medical Center for Innovative Research, ul. Litawora 2, 35-310 Rzeszów, Poland
| |
Collapse
|
13
|
Elwan D, Olveda R, Medrano R, Wojcicki JM. Excess pregnancy weight gain in latinas: Impact on infant's adiposity and growth hormones at birth. Prev Med Rep 2021; 22:101341. [PMID: 33898205 PMCID: PMC8053797 DOI: 10.1016/j.pmedr.2021.101341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 01/03/2023] Open
Abstract
Immigrant Latinas with overweight and obesity have excessive gestational gain. Excessive gestational weight gain is associated with high birthweight percentiles. Higher IGF-1 and lower PYY in cord blood in context of excessive gestational gain. Gestational weight counseling in pregnancy may help prevent childhood obesity.
Excess maternal weight gain during pregnancy has been associated with childhood overweight and obesity both in mothers with and without obesity. Latinx children are at higher risk for earlier obesity compared with other population groups. A cohort of 82 self-identified pregnant Latina women were recruited at the prenatal clinics of Zuckerberg San Francisco General Hospital (ZSFG) prior to delivery during the second and third trimesters of pregnancy in 2011 and 2012. Maternal pre-pregnancy weight and weight prior to delivery were collected by self-report to calculate maternal pre-pregnancy body mass index (BMI) and weight gain in pregnancy. At delivery, anthropometric measurements of infants were obtained and cord blood and maternal finger stick blood samples were collected for hormonal assays. Fifty-three point seven percent of women had excessive weight gain in pregnancy. A high percentage of the cohort was overweight and obese prior to pregnancy (67.1%) with mean pre-pregnancy BMI 27.4 ± 4.5 kg/m2 and greater pre-pregnancy weight was independently associated with weight gain during pregnancy (OR 1.05, 95%CI 1.002–1.09). Mean infant birthweight was 3377.2 ± 481.5 g and excessive weight gain in pregnancy was independently associated with birthweight percentile (OR 13.46, 95%CI 2.43–34.50). Excessive gestational gain was positively associated with cord blood insulin-like growth factor-1 (IGF-1) and negatively with Peptide YY (PYY) levels. Latina women with pre-pregnancy overweight and obesity have a high rate of excessive gestational gain in pregnancy and could benefit from early counseling about appropriate gain in pregnancy. Excessive gestational weight impacts the intrauterine environment in high-risk infants impacting fetal growth and development.
Collapse
Affiliation(s)
- Deena Elwan
- University of Hawai'i, Honolulu, Hawai'I, United States.,Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
| | - Rebecca Olveda
- Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
| | - Rosalinda Medrano
- Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
| | - Janet M Wojcicki
- Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
| |
Collapse
|
14
|
60 Minutes Per Day in Moderate to Vigorous Physical Activity as a Natural Health Protector in Young Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238918. [PMID: 33266258 PMCID: PMC7729608 DOI: 10.3390/ijerph17238918] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 12/11/2022]
Abstract
The aim of this study was to check whether following the recommendations of the World Health Organization (WHO) concerning physical activity protects children and adolescents against the occurrence of overweight and obesity. A total of 1002 children were included in the analysis. The average age of the studied children was 9.36 years ± 3.52 years. Measurement of height and body mass was performed for every child, followed by physical activity assessment over seven days. In each group analyzed, the overweight and obese children had a shorter time in moderate to vigorous physical activity (MVPA) than the children with normal body mass. Among the children spending < 60 min per day in MVPA, the risk of occurrence of overweight and obesity was greater than among children with physical activity > 60 min per day. It was also shown that the greatest risk of occurrence of body mass disorder was a situation in which the mother’s gestational weight gain (GWG) is over 18 kg and the child does not spend a minimum of 60 min/day in MVPA. Not meeting the recommendation is connected with an increased chance of the occurrence of overweight and obesity. The level of physical activity influences the incidence of overweight and obesity. The children with overweight and obesity spent less time per day in MVPA. An increased body mass in mothers during pregnancy associated with a child’s low level of physical activity increases the risk of the occurrence of overweight and obesity.
Collapse
|
15
|
Baran J, Weres A, Czenczek-Lewandowska E, Leszczak J, Kalandyk-Osinko K, Łuszczki E, Sobek G, Mazur A. Excessive Gestational Weight Gain: Long-Term Consequences for the Child. J Clin Med 2020; 9:jcm9123795. [PMID: 33255248 PMCID: PMC7761026 DOI: 10.3390/jcm9123795] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/11/2020] [Accepted: 11/21/2020] [Indexed: 02/07/2023] Open
Abstract
Background: The aim of the study was to analyse the impact of mothers’ gestational weight gain (GWG) and age at birth on the long-term risk of overweight and obesity in preschool and school-aged children. Methods: The study involved 749 mothers and children at ages between four and 15 years old. Each child was assessed for height and body weight, and then, the body mass category was determined based on the body mass index (BMI) percentile according to the sex and age of the subjects. Information on the perinatal risk factors for overweight and obesity came from the child’s health card or mother’s maternity card. They contained information about the mother’s age at the time of childbirth and the mother’s gestational weight gain during pregnancy. Results: In the group of 7–11-year-olds, the maternal weight gain during pregnancy was higher in obese children than in children with normal weight (18.8 kg vs. 14.3 kg; p = 0.002). This relationship was shown analogously in the group of 7–11-years-olds boys (20.6 kg vs. 15.1 kg; p = 0.005). Positive correlations were also shown between mother’s gestational weight gain and the BMI percentage of the whole group (p = 0.004). In the case of the mother’s age, no statistically significant relationship was found with the child’s weight category. Conclusions: Mothers’ weight gain during pregnancy is a factor that promotes overweightness and obesity in the child. Maternal age at birth does not appear to lead to any propensity toward overweightness and obesity in the later life of a child.
Collapse
Affiliation(s)
- Joanna Baran
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
- Correspondence:
| | - Aneta Weres
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Ewelina Czenczek-Lewandowska
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Justyna Leszczak
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Katarzyna Kalandyk-Osinko
- Institute of Medical Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (K.K.-O.); (A.M.)
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Grzegorz Sobek
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Artur Mazur
- Institute of Medical Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (K.K.-O.); (A.M.)
| |
Collapse
|
16
|
Martínez-Hortelano JA, Cavero-Redondo I, Álvarez-Bueno C, Garrido-Miguel M, Soriano-Cano A, Martínez-Vizcaíno V. Monitoring gestational weight gain and prepregnancy BMI using the 2009 IOM guidelines in the global population: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:649. [PMID: 33109112 PMCID: PMC7590483 DOI: 10.1186/s12884-020-03335-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 10/14/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Previous studies have reported a high prevalence of excessive gestational weight gain (GWG) in women with prepregnancy BMI classified as overweight and obese. However, the joint evidence regarding GWG and prepregnancy BMI in the worldwide population has not been synthesized. Thus, this systematic review and meta-analysis aimed to estimate global and regional mean GWG and the prevalence of GWG above, within and below 2009 Institute of Medicine (IOM) guidelines. Second, we aimed to estimate global and regional prepregnancy BMI and the prevalence of BMI categories according to World Health Organization (WHO) classification. METHODS We searched Medline, Embase, the Cochrane Library and Web of Science to identify observational studies until 9 May 2018. We included studies published from 2009 that used 2009 IOM guidelines, reporting data from women in general population with singleton pregnancies. The 2009 IOM categories for GWG and the WHO categories for prepregnancy BMI were used. DerSimonian and Laird random effects methods were used to estimate the pooled and their respective 95% confidence intervals (95% CIs) of the mean and by category rates of GWG and prepregnancy BMI, calculated by global and regions. RESULTS Sixty-three published studies from 29 countries with a total sample size of 1,416,915 women were included. The global prevalence of GWG above and below the 2009 IOM guidelines, was 27.8% (95% CI; 26.5, 29.1) and 39.4% (95% CI; 37.1, 41.7), respectively. Furthermore, meta-regression analyses showed that the mean GWG and the prevalence of GWG above guidelines have increased. The global prevalence of overweight and obesity, was 23.0% (95% CI; 22.3, 23.7) and 16.3% (95% CI; 15.4, 17.4), respectively. The highest mean GWG and prepregnancy BMI were in North America and the lowest were in Asia. CONCLUSIONS Considering the high prevalence of GWG above the 2009 IOM guidelines and women with overweight/obesity and their continuously increasing trend in most regions, clinicians should recommend lifestyle interventions to improve women's weight during reproductive age. Due to regional variability, these interventions should be adapted to each cultural context. TRIAL REGISTRATION Prospectively registered with PROSPERO ( CRD42018093562 ).
Collapse
Affiliation(s)
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Santa Teresa Jornet s/n, 16071, Cuenca, Spain.
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay.
| | - Miriam Garrido-Miguel
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
| | - Alba Soriano-Cano
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
| |
Collapse
|
17
|
Liang Z, Liu H, Wang L, Chen Y, Zhou T, Heianza Y, Li W, Leng J, Wang J, Gao R, Hu G, Qi L. Maternal MTNR1B genotype, maternal gestational weight gain, and childhood obesity. Am J Clin Nutr 2020; 111:360-368. [PMID: 31826236 PMCID: PMC6997086 DOI: 10.1093/ajcn/nqz296] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 11/05/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Maternal metabolic abnormalities have been related to offspring obesity especially during childhood. OBJECTIVES We analyzed whether the gestational diabetes mellitus (GDM)-associated melatonin receptor 1B (MTNR1B) genotype of mothers modified the relation between maternal gestational weight gain and childhood obesity. METHODS A total of 1114 Chinese mother-child pairs (mothers with or without prior GDM) were included. Mothers' MTNR1B rs10830962 genotype and gestational weight gain were assessed. Indicators of childhood obesity included BMI-for-age z-score, weight-for-age z-score, waist circumference, and body fat. Childhood overweight and obesity were also analyzed. RESULTS We found that the maternal MTNR1B genotype significantly interacted with gestational weight gain on indicators of offspring's obesity (all P for interaction < 0.05). After multivariable adjustment, BMI-for-age z-scores associated with 1-kg gestational weight gain were 0.009 (SE 0.018), 0.026 (SE 0.010), and 0.061 (SE 0.010) in children with the maternal MTNR1B genotype CC, CG, and GG, respectively (P-interaction = 0.012). Similar interactions were observed for weight-for-age z-score, waist circumference, and body fat (P-interaction = 0.001, 0.003, and 0.012, respectively). The associations remained consistently significant in women with and without GDM. We also found significant interactions between the maternal MTNR1B genotype and gestational weight gain on the offspring's childhood overweight and obesity (P-interaction = 0.005 and 0.026, respectively). CONCLUSIONS The maternal MTNR1B genotype might interact with gestational weight gain on offspring's obesity risk during childhood.
Collapse
Affiliation(s)
- Zhaoxia Liang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, PR China
| | - Huikun Liu
- Tianjin Women's and Children's Health Center, Tianjin, PR China
| | - Leishen Wang
- Tianjin Women's and Children's Health Center, Tianjin, PR China
| | - Yuhang Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- Department of Public Health Laboratory Sciences, West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, PR China
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Weiqin Li
- Tianjin Women's and Children's Health Center, Tianjin, PR China
| | - Junhong Leng
- Tianjin Women's and Children's Health Center, Tianjin, PR China
| | - Jing Wang
- Tianjin Women's and Children's Health Center, Tianjin, PR China
| | - Ru Gao
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
18
|
Heslehurst N, Vieira R, Akhter Z, Bailey H, Slack E, Ngongalah L, Pemu A, Rankin J. The association between maternal body mass index and child obesity: A systematic review and meta-analysis. PLoS Med 2019; 16:e1002817. [PMID: 31185012 PMCID: PMC6559702 DOI: 10.1371/journal.pmed.1002817] [Citation(s) in RCA: 219] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/01/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND There is a global obesity crisis, particularly among women and disadvantaged populations. Early-life intervention to prevent childhood obesity is a priority for public health, global health, and clinical practice. Understanding the association between childhood obesity and maternal pre-pregnancy weight status would inform policy and practice by allowing one to estimate the potential for offspring health gain through channelling resources into intervention. This systematic review and meta-analysis aimed to examine the dose-response association between maternal body mass index (BMI) and childhood obesity in the offspring. METHODS AND FINDINGS Searches in MEDLINE, Child Development & Adolescent Studies, CINAHL, Embase, and PsycInfo were carried out in August 2017 and updated in March 2019. Supplementary searches included hand-searching reference lists, performing citation searching, and contacting authors. Two researchers carried out independent screening, data extraction, and quality assessment. Observational studies published in English and reporting associations between continuous and/or categorical maternal and child BMI or z-score were included. Categorical outcomes were child obesity (≥95th percentile, primary outcome), overweight/obesity (≥85th percentile), and overweight (85th to 95th percentile). Linear and nonlinear dose-response meta-analyses were conducted using random effects models. Studies that could not be included in meta-analyses were summarised narratively. Seventy-nine of 41,301 studies identified met the inclusion criteria (n = 59 cohorts). Meta-analyses of child obesity included 20 studies (n = 88,872); child overweight/obesity, 22 studies (n = 181,800); and overweight, 10 studies (n = 53,238). Associations were nonlinear and there were significantly increased odds of child obesity with maternal obesity (odds ratio [OR] 3.64, 95% CI 2.68-4.95) and maternal overweight (OR 1.89, 95% CI 1.62-2.19). Significantly increased odds were observed for child overweight/obesity (OR 2.69, 95% CI 2.10-3.46) and for child overweight (OR 1.80, 95% CI 1.25, 2.59) with maternal obesity. A limitation of this research is that the included studies did not always report the data in a format that enabled inclusion in this complex meta-analysis. CONCLUSIONS This research has identified a 264% increase in the odds of child obesity when mothers have obesity before conception. This study provides substantial evidence for the need to develop interventions that commence prior to conception, to support women of childbearing age with weight management in order to halt intergenerational obesity.
Collapse
Affiliation(s)
- Nicola Heslehurst
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
- * E-mail:
| | - Rute Vieira
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen,
United Kingdom
| | - Zainab Akhter
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Hayley Bailey
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Emma Slack
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Lem Ngongalah
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Augustina Pemu
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Judith Rankin
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| |
Collapse
|
19
|
Liu HK, Wu CY, Yang YN, Wu PL, He ZR, Yang SN, Tey SL. Association between maternal pre-delivery body mass index and offspring overweight/obesity at 1 and 2 years of age among residents of a suburb in Taiwan. PeerJ 2019; 7:e6473. [PMID: 30828490 PMCID: PMC6394342 DOI: 10.7717/peerj.6473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 01/18/2019] [Indexed: 12/27/2022] Open
Abstract
Background Overweight and obesity among children can cause metabolic syndrome in adulthood and are a significant public health issue. Some studies suggest that maternal pre-pregnancy body mass index (BMI) and excessive gestational weight gain during pregnancy are associated with overweight and obesity in offspring. However, it is difficult to collect information on accurate pre-pregnancy BMI and pregnancy weight gain for women living in areas where medical resources are scarce. Maternal pre-delivery BMI might be predictive of the risk of overweight and obesity among offspring of pregnant mothers living in suburban areas. Methods We retrospectively collected data on term neonates with appropriate weights for their gestational age born between April 2013 and October 2015. We excluded neonates with major congenital anomalies or diseases and incomplete data. Mothers with systemic diseases or drug abuse were also excluded. Offspring body weights and heights at 1- and 2-years-old were recorded. Maternal pre-delivery BMI was divided into following groups: <25, 25-29.9, and ≧30 kg/m2. Results We included 261 mother-child pairs in this study. The BMIs of the offspring differed significantly among the three maternal pre-delivery BMI groups at the age of 2 years (15.18 ± 1.04, 15.83 ± 1.28, and 16.29 ± 1.61 kg/m2, p < 0.001, respectively). After adjusting for potential cofounders possibly affecting weight using multivariate linear regression, the children's BMIs (adjusted 95% CI: 0.71 [0.31-1.11]; p = 0.001) and BMI percentiles (adjusted 95% CI 15.80 [7.32-24.28]; p < 0.001) at the age of 2 years were significantly higher in those born to mothers with pre-delivery BMIs of 25-29.9 kg/m2 compared to mothers with pre-delivery BMIs <25 kg/m2. Maternal pre-delivery BMI ≧30 kg/m2 was significantly associated with increased BMIs (adjusted 95% CI: 1.17 [0.72-1.63]; p < 0.001) and BMI percentiles (adjusted 95% CI: 23.48 [13.87-33.09]; p < 0.001) in their children. A maternal pre-delivery BMI of 27.16 kg/m2 was the optimal cut-off for predicting offspring overweight/obesity at the age of 2 years. Discussion Our results indicate that the maternal pre-delivery BMI was significantly associated with offspring BMI and weight gain at the age of 2 years. A maternal pre-delivery BMI of 27.16 kg/m2 might be a useful predictor for estimating the risk of overweight or obesity in offspring at the age of 2 years.
Collapse
Affiliation(s)
- Hsien-Kuan Liu
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chien-Yi Wu
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yung-Ning Yang
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Pei-Ling Wu
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Zong-Rong He
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - San-Nan Yang
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Shu-Leei Tey
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| |
Collapse
|
20
|
Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: An individual participant data meta-analysis. PLoS Med 2019; 16:e1002744. [PMID: 30742624 PMCID: PMC6370184 DOI: 10.1371/journal.pmed.1002744] [Citation(s) in RCA: 277] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/09/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact. METHODS AND FINDINGS We conducted an individual participant data meta-analysis of data from 162,129 mothers and their children from 37 pregnancy and birth cohort studies from Europe, North America, and Australia. We assessed the individual and combined associations of maternal pre-pregnancy BMI and gestational weight gain, both in clinical categories and across their full ranges, with the risks of overweight/obesity in early (2.0-5.0 years), mid (5.0-10.0 years) and late childhood (10.0-18.0 years), using multilevel binary logistic regression models with a random intercept at cohort level adjusted for maternal sociodemographic and lifestyle-related characteristics. We observed that higher maternal pre-pregnancy BMI and gestational weight gain both in clinical categories and across their full ranges were associated with higher risks of childhood overweight/obesity, with the strongest effects in late childhood (odds ratios [ORs] for overweight/obesity in early, mid, and late childhood, respectively: OR 1.66 [95% CI: 1.56, 1.78], OR 1.91 [95% CI: 1.85, 1.98], and OR 2.28 [95% CI: 2.08, 2.50] for maternal overweight; OR 2.43 [95% CI: 2.24, 2.64], OR 3.12 [95% CI: 2.98, 3.27], and OR 4.47 [95% CI: 3.99, 5.23] for maternal obesity; and OR 1.39 [95% CI: 1.30, 1.49], OR 1.55 [95% CI: 1.49, 1.60], and OR 1.72 [95% CI: 1.56, 1.91] for excessive gestational weight gain). The proportions of childhood overweight/obesity prevalence attributable to maternal overweight, maternal obesity, and excessive gestational weight gain ranged from 10.2% to 21.6%. Relative to the effect of maternal BMI, excessive gestational weight gain only slightly increased the risk of childhood overweight/obesity within each clinical BMI category (p-values for interactions of maternal BMI with gestational weight gain: p = 0.038, p < 0.001, and p = 0.637 in early, mid, and late childhood, respectively). Limitations of this study include the self-report of maternal BMI and gestational weight gain for some of the cohorts, and the potential of residual confounding. Also, as this study only included participants from Europe, North America, and Australia, results need to be interpreted with caution with respect to other populations. CONCLUSIONS In this study, higher maternal pre-pregnancy BMI and gestational weight gain were associated with an increased risk of childhood overweight/obesity, with the strongest effects at later ages. The additional effect of gestational weight gain in women who are overweight or obese before pregnancy is small. Given the large population impact, future intervention trials aiming to reduce the prevalence of childhood overweight and obesity should focus on maternal weight status before pregnancy, in addition to weight gain during pregnancy.
Collapse
|
21
|
Umbilical Cord SFRP5 Levels of Term Newborns in Relation to Normal and Excessive Gestational Weight Gain. Int J Mol Sci 2019; 20:ijms20030595. [PMID: 30704061 PMCID: PMC6387116 DOI: 10.3390/ijms20030595] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 01/27/2019] [Accepted: 01/28/2019] [Indexed: 02/07/2023] Open
Abstract
Among the new adipokines, secreted frizzled-related protein 5 (SFRP5) is considered to prevent obesity and insulin resistance. The umbilical cord SFRP5 levels have not yet been investigated. The main aim of the study was to investigate whether the umbilical cord SFRP5 concentrations are altered in term neonates born to mothers with excessive gestational weight gain (EGWG). Two groups of subjects were selected depending on their gestational weight gain, i.e. 28 controls and 38 patients with EGWG. Umbilical cord and maternal serum SFRP5 levels were lower in the EGWG group. Umbilical cord SFRP5 concentrations were directly associated with the maternal serum SFRP5, hemoglobin A1c and lean tissue index, umbilical cord leptin levels, as well as newborns’ anthropometric measurements in the EGWG subjects. In multiple linear regression models performed in all the study participants, umbilical cord SFRP5 concentrations depended positively on the maternal serum SFRP5, ghrelin, and leptin levels and negatively on the umbilical cord ghrelin levels, low-density lipoprotein cholesterol, pre-pregnancy body mass index, and gestational weight gain. EGWG is associated with disturbances in SFRP5 concentrations. Obstetricians and midwives should pay attention to nutrition and weight management during pregnancy.
Collapse
|
22
|
Pattison KL, Kraschnewski JL, Lehman E, Savage JS, Downs DS, Leonard KS, Adams EL, Paul IM, Kjerulff KH. Breastfeeding initiation and duration and child health outcomes in the first baby study. Prev Med 2019; 118:1-6. [PMID: 30287329 PMCID: PMC6322935 DOI: 10.1016/j.ypmed.2018.09.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 09/24/2018] [Accepted: 09/30/2018] [Indexed: 11/18/2022]
Abstract
Despite the known benefits of breastmilk, associations between breastfeeding and child overall health outcomes remain unclear. We aimed to understand associations between breastfeeding and health outcomes, including child weight, through age 3. Analysis included women (N = 3006) in the longitudinal, prospective First Baby Study from 2009 to 2014. For this analysis, breastfeeding initiation and duration were measured using self-reported data from the 1-, 6- and 12-month surveys; child illnesses were analyzed from the 6-, 12-, and 24-month interviews; height and weight at age 3 were used to determine overweight/obese (≥85th percentile) and obese (≥95th percentile). Adjusted logistic regressions were utilized to determine significance. Greater duration of breastfeeding was associated with fewer reported acute illnesses at 6 months (p < 0.001) and fewer diarrheal illness/constipation episodes at 6, 12, and 24 months (p = 0.05) in adjusted analyses. Fewer breastfed children, compared to non-breastfed children, were overweight/obese (23.5% vs. 37.8%; p = 0.032) or obese (9.1% vs. 21.6%; p = 0.012) at age 3. Breastfeeding duration was negatively associated with overweight/obese (never breastfed: 37.8%, 0-6 months: 26.9%, >6 months: 20.2%; p = 0.020) and obesity (never breastfed: 21.6%, 0-6 months: 11.0%, >6 months: 7.3%; p = 0.012). Overall, our findings support the hypothesis that duration of breastfeeding is associated with fewer reported acute illnesses at 6 months of age and diarrheal illness and/or constipation episodes at 6, 12, and 24 months. Additionally, results from our study suggest a protective effect of breastfeeding from childhood overweight/obesity, as children who received breastmilk for 6 months or longer had lower odds of overweight/obesity at age 3 years.
Collapse
Affiliation(s)
- Krista L Pattison
- Penn State PRO Wellness, Department of Pediatrics, Penn State College of Medicine, United States of America.
| | - Jennifer L Kraschnewski
- Penn State PRO Wellness, Department of Pediatrics, Penn State College of Medicine, United States of America; Department of Public Health Sciences, Penn State College of Medicine, United States of America; Department of Medicine, Penn State College of Medicine, United States of America
| | - Erik Lehman
- Department of Public Health Sciences, Penn State College of Medicine, United States of America
| | - Jennifer S Savage
- Center of Childhood Obesity Research, Department of Nutritional Sciences, The Pennsylvania State University, United States of America
| | - Danielle Symons Downs
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, United States of America; Department of Obstetrics and Gynecology, Penn State College of Medicine, United States of America
| | - Krista S Leonard
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, United States of America
| | - Elizabeth L Adams
- Center of Childhood Obesity Research, Department of Nutritional Sciences, The Pennsylvania State University, United States of America
| | - Ian M Paul
- Department of Public Health Sciences, Penn State College of Medicine, United States of America; Department of Pediatrics, Penn State College of Medicine, United States of America
| | - Kristen H Kjerulff
- Department of Public Health Sciences, Penn State College of Medicine, United States of America; Department of Obstetrics and Gynecology, Penn State College of Medicine, United States of America
| |
Collapse
|
23
|
Wan N, Cai L, Tan W, Zhang T, Yang J, Chen Y. Associations of gestational weight gain with offspring thinness and obesity: by prepregnancy body mass index. Reprod Health 2018; 15:149. [PMID: 30180902 PMCID: PMC6123984 DOI: 10.1186/s12978-018-0585-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/14/2018] [Indexed: 12/11/2022] Open
Abstract
Background Previous studies indicated that excessive gestational weight gain (GWG) was positively associated with offspring obesity. Nevertheless, little is known about the effect of GWG on offspring thinness. This study aimed to assess the association of GWG with childhood weight status across the full range of weight status by prepregnancy body mass index (BMI). Methods We used data from a retrospective study of 33,828 Chinese children aged 6–18 years and their mothers. Children’s weight and height were objectively measured. Maternal GWG and other information were collected by using self-reported questionnaires. Multivariate linear regressions and logistic regressions were applied. Results Overall, the prevalence of thinness and overweight/obesity in children were 12.9 and 17.3% respectively (p < 0.05). Children’s BMI z-score was on average 0.021 higher for every 1-kg greater GWG. For mothers who were underweight or normal weight before pregnancy, excessive GWG was positively associated with offspring overweight/obesity [OR (95% CI): 1.51 (1.21, 1.90) and 1.30 (1.17, 1.45)], whereas inadequate GWG was associated with increased risk of offspring thinness [OR (95% CI): 1.24 (1.05, 1.46) and 1.17 (1.04, 1.32)]. Similar but non-significant associations were found in prepregnancy overweight mothers. Notably, there was a very high prevalence of child overweight/obesity (30.2%) in prepregnancy overweight subgroup regardless of GWG status. Conclusions Inadequate GWG was associated with an increased risk of offspring thinness, whereas excessive GWG was associated with an increased risk of offspring overweight and obesity among prepregnancy underweight and normal weight mothers only.
Collapse
Affiliation(s)
- Nianqing Wan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China
| | - Weiqing Tan
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510000, China
| | - Ting Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China
| | - Jiewen Yang
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510000, China.
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China.
| |
Collapse
|
24
|
Lamminpää R, Vehviläinen-Julkunen K, Schwab U. A systematic review of dietary interventions for gestational weight gain and gestational diabetes in overweight and obese pregnant women. Eur J Nutr 2018; 57:1721-1736. [PMID: 29128995 PMCID: PMC6060815 DOI: 10.1007/s00394-017-1567-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 10/13/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE The number of overweight and obese women is increasing in the obstetric population. The aim of this study was to review studies that reported results related to the efficacy of dietary interventions on gestational weight gain (GWG) or the prevention of gestational diabetes (GDM) in overweight and obese women. METHODS The search was performed using the CINAHL, PubMed, Scopus and Medic electronic databases and limited to the years between 2000 and March 2016. This systematic review includes 15 research articles of which 12 were randomized controlled trials, and three were controlled trials. Three main categories emerged as follows: (1) the types of interventions, (2) the contents of the interventions and (3) the efficacy of the intervention on GWG and the prevention of GDM. The quality of the selected studies was evaluated using the AHRQ Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews. RESULTS Of the selected 15 studies, eight included a specified diet with limited amounts of nutrients or energy, and the others included a dietary component along with other components. Ten studies reported significant differences in the measured outcomes regarding GWG or the prevention of GDM between the intervention and the control groups. CONCLUSIONS This review confirms the variability in the strategies used to deliver dietary interventions in studies aiming to limit GWG and prevent GDM in overweight and obese women. Inconsistency in the provider as well as the content of the dietary interventions leaves the difficulty of summarizing the components of effective dietary interventions.
Collapse
Affiliation(s)
- Reeta Lamminpää
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, P.O. BOX 1627, 70211, Kuopio, Finland.
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland and Kuopio University Hospital, 70029, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, 70211, Kuopio, Finland
- Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, 70029, Kuopio, Finland
| |
Collapse
|
25
|
Fujita Y, Kouda K, Nakamura H, Iki M. Relationship Between Maternal Pre-pregnancy Weight and Offspring Weight Strengthens as Children Develop: A Population-Based Retrospective Cohort Study. J Epidemiol 2018; 28:498-502. [PMID: 29806638 PMCID: PMC6242787 DOI: 10.2188/jea.je20170137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Maternal pre-pregnancy weight has been reported to be positively associated with offspring weight. The association between maternal weight and offspring weight might be explained by maternal lifestyle. We investigated the strength of the relationship between maternal body mass index (BMI) at the beginning of pregnancy and offspring BMI at several growth stages. Methods The source population was all eighth graders registered in all public schools in the city of Fukuroi, Japan, in 2012. Records of maternal anthropometry at the beginning of pregnancy were obtained from the Maternal and Child Health (MCH) Handbook. The height and body weight of each student were measured. A regression model was used to assess the association between maternal BMI z-score at the beginning of pregnancy and offspring BMI z-score at various ages. Results Of the source population, data from the MCH Handbook were obtained for 480 students. Among males, maternal BMI z-score was not associated with offspring BMI z-score at birth and at age 3 years but was associated with offspring BMI z-score at age 13 years (standardized regression coefficient (β) = 0.19; P < 0.01). Among females, maternal BMI z-score was associated with offspring BMI z-score at birth (β = 0.11; P < 0.05), at age 3 years (β = 0.22; P < 0.01) and at age 13 years (β = 0.51; P < 0.01). Conclusions Our results suggest that the positive association between maternal weight at the beginning of pregnancy and offspring weight around puberty is stronger than that between maternal weight and offspring weight at birth. Maternal lifestyle may influence offspring weight in adolescence.
Collapse
Affiliation(s)
- Yuki Fujita
- Department of Public Health, Kindai University Faculty of Medicine
| | - Katsuyasu Kouda
- Department of Public Health, Kindai University Faculty of Medicine
| | - Harunobu Nakamura
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University
| | - Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine
| |
Collapse
|
26
|
Kasper P, Vohlen C, Dinger K, Mohr J, Hucklenbruch-Rother E, Janoschek R, Köth J, Matthes J, Appel S, Dötsch J, Alejandre Alcazar MA. Renal Metabolic Programming Is Linked to the Dynamic Regulation of a Leptin-Klf15 Axis and Akt/AMPKα Signaling in Male Offspring of Obese Dams. Endocrinology 2017; 158:3399-3415. [PMID: 28938412 DOI: 10.1210/en.2017-00489] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 07/24/2017] [Indexed: 12/27/2022]
Abstract
Childhood obesity is associated with renal diseases. Maternal obesity is a risk factor linked to increased adipocytokines and metabolic disorders in the offspring. Therefore, we studied the impact of maternal obesity on renal-intrinsic insulin and adipocytokine signaling and on renal function and structure. To induce maternal obesity, female mice were fed a high-fat diet (HFD) or a standard diet (SD; control group) prior to mating, during gestation, and throughout lactation. A third group of dams was fed HFD only during lactation (HFD-Lac). After weaning at postnatal day (P)21, offspring of all groups received SD. Clinically, HFD offspring were overweight and insulin resistant at P21. Although no metabolic changes were detected at P70, renal sodium excretion was reduced by 40%, and renal matrix deposition increased in the HFD group. Mechanistically, two stages were differentiated. In the early stage (P21), compared with the control group, HFD showed threefold increased white adipose tissue, impaired glucose tolerance, hyperleptinemia, and hyperinsulinemia. Renal leptin/Stat3-signaling was activated. In contrast, the Akt/ AMPKα cascade and Krüppel-like factor 15 expression were decreased. In the late stage (P70), although no metabolic differences were detected in HFD when compared with the control group, leptin/Stat3-signaling was reduced, and Akt/AMPKα was activated in the kidneys. This effect was linked to an increase of proliferative (cyclinD1/D2) and profibrotic (ctgf/collagen IIIα1) markers, similar to leptin-deficient mice. HFD-Lac mice exhibited metabolic changes at P21 similar to HFD, but no other persistent changes. This study shows a link between maternal obesity and metabolic programming of renal structure and function and intrinsic-renal Stat3/Akt/AMPKα signaling in the offspring.
Collapse
Affiliation(s)
- Philipp Kasper
- Translational Experimental Pediatrics, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Christina Vohlen
- Translational Experimental Pediatrics, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
- Metabolism and Perinatal Programming, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Katharina Dinger
- Translational Experimental Pediatrics, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Jasmine Mohr
- Translational Experimental Pediatrics, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Eva Hucklenbruch-Rother
- Metabolism and Perinatal Programming, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Ruth Janoschek
- Metabolism and Perinatal Programming, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Jessica Köth
- Department of Pharmacology, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Jan Matthes
- Department of Pharmacology, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Sarah Appel
- University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Jörg Dötsch
- University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Miguel A Alejandre Alcazar
- Translational Experimental Pediatrics, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
- University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| |
Collapse
|
27
|
Increased birth weight is associated with altered gene expression in neonatal foreskin. J Dev Orig Health Dis 2017; 8:575-583. [PMID: 28482944 DOI: 10.1017/s2040174417000290] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Elevated birth weight is linked to glucose intolerance and obesity health-related complications later in life. No studies have examined if infant birth weight is associated with gene expression markers of obesity and inflammation in a tissue that comes directly from the infant following birth. We evaluated the association between birth weight and gene expression on fetal programming of obesity. Foreskin samples were collected following circumcision, and gene expression analyzed comparing the 15% greatest birth weight infants (n=7) v. the remainder of the cohort (n=40). Multivariate linear regression models were fit to relate expression levels on differentially expressed genes to birth weight group with adjustment for variables selected from a list of maternal and infant characteristics. Glucose transporter type 4 (GLUT4), insulin receptor substrate 2 (IRS2), leptin receptor (LEPR), lipoprotein lipase (LPL), low-density lipoprotein receptor-related protein 1 (LRP1), matrix metalloproteinase 2 (MMP2), plasminogen activator inhibitor-1 (PAI-1) and transcription factor 7-like 2 (TCF7L2) were significantly upregulated and histone deacetylase 1 (HDAC1) and thioredoxin (TXN) downregulated in the larger birth weight neonates v. CONTROLS Multivariate modeling revealed that the estimated adjusted birth weight group difference exceeded one standard deviation of the expression level for eight of the 10 genes. Between 25 and 50% of variation in expression level was explained by multivariate modeling for eight of the 10 genes. Gene expression related to glycemic control, appetite/energy balance, obesity and inflammation were altered in tissue from babies with elevated birth weight, and these genes may provide important information regarding fetal programming in macrosomic babies.
Collapse
|
28
|
Impact of Pregestational Weight and Weight Gain during Pregnancy on Long-Term Risk for Diseases. PLoS One 2017; 12:e0168543. [PMID: 28045917 PMCID: PMC5207749 DOI: 10.1371/journal.pone.0168543] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 12/02/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to analyse the impact of maternal BMI at start of pregnancy and maternal weight gain during pregnancy on the risk of various diseases later in life. METHODS In a population-based cohort from southern Sweden, women with at least one delivery registered in the Swedish Medical Birth Register ten or more years before answering a health questionnaire were identified (n = 13,608). Complete data were found in 3,539 women. RESULTS Women with BMI >25 at start of pregnancy had increased risk of developing obesity (OR 21.9), diabetes (OR 6.4), cardiac disease (OR 2.7), endocrine diseases (OR 2.3), and other morbidity (OR 1.4), compared with women of normal weight. A high weight gain (>15 kg) during pregnancy was associated to later risk of overweight (OR 2.0) and obesity (OR 2.2), but not diabetes, cardiac disease, or endocrine diseases. A positive association was found between low weight gain and the risk of developing psychiatric disorders (OR 1.6). CONCLUSIONS A high BMI at start of pregnancy significantly increased the risk of several diseases later in life. However, a high weight gain during pregnancy was only significant for future overweight and obesity. These findings have implications for both pregestational intervention and post gestational follow up of obese and overweight women.
Collapse
|
29
|
Abdolaliyan N, Shahnazi H, Kzemi A, Hasanzadeh A. Determinants of the self-efficacy of physical activity for maintaining weight during pregnancy: The application of the health belief model. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2017; 6:93. [PMID: 29114560 PMCID: PMC5651666 DOI: 10.4103/jehp.jehp_175_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 05/23/2017] [Indexed: 05/11/2023]
Abstract
INTRODUCTION Pregnancy is one of the high-risk periods for women's health that the lack of attention to healthy behaviors such as weight control behaviors can lead to adverse consequences on the health of women and also the fetus. Therefore, the aim of this paper was to explore the determinants of weight control self-efficacy among pregnant women using Health Belief Model (HBM). MATERIALS AND METHODS In this cross-sectional study were enrolled 202 pregnant women referring to Health Care Center in Isfahan city, Iran. Sampling method was multistage random. A researcher-made instrument based on HBM structures was used after confirming the valid and reliable. Data were analyzed by software SPSS 21 and descriptive statistics were represented with (frequency, mean and standard deviation) and analytical (Pearson correlation, independent t and liner regression) at the significant level of <0.05. RESULTS The average age of participants was 27.80 ± 5.08. HBM structures were able explained 31% of variance of weight control self-efficacy. Also, of the studied structures, perceived benefits, perceived barriers were statistically significant predictors of weight control self-efficacy, within which perceived barriers (β = 0.391) was the most significant predictor. CONCLUSION The findings of current study showed that the HBM model could be as a suitable framework to identify effective factors for designing educational intervention to improve weight control behaviors among pregnant women.
Collapse
Affiliation(s)
- Nafise Abdolaliyan
- Department of Health Education, School of Public Health, Isfahan University of Medical Science, Isfahan, Iran
| | - Hossein Shahnazi
- Department of Health Education, School of Public Health, Isfahan University of Medical Science, Isfahan, Iran
- Address for correspondence: Dr. Hossein Shahnazi, School of Public Health, Isfahan University of Medical Science, Isfahan, Iran. E-mail:
| | - Ashraf Kzemi
- Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
| | - Akbar Hasanzadeh
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Science, Isfahan, Iran
| |
Collapse
|
30
|
Barisic T, Mandic V, Barac I. Associations of Body Mass Index and Gestational Weight Gain with Term Pregnancy Outcomes. Mater Sociomed 2017; 29:52-57. [PMID: 28484356 PMCID: PMC5402376 DOI: 10.5455/msm.2017.29.52-57] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Obesity is one of the greatest health problems in the world. The World Health Organization (WHO) defined obesity as a disease in which the excess of adipose tissue accumulates in such a degree that is endangers health. Obesity is a very complex multifactor disease that is developed under the influence of genetic and metabolic factors, environment, social and cultural environment as well as bad habits. The causes of obesity can be numerous. The most common source of obesity is the development of energetic imbalance. Material and methods: A retrospective study of medical records in the Department of Obstetrics and Gynecology, University Clinical Hospital in Mostar was conducted. It included 1300 pregnant women and their children that were delivered in the time period from January 1st 2015 to December 31st 2015. It was conducted a retrospective study which involved 1300 pregnant women who gave births in the Department of Obstetrics and Gynecology of University Clinical Hospital in Mostar in the period from January 1st 2015 to December 31st 2015 and their newborns. Results: The difference in age of pregnant women with different body mass index was not statistically relevant. The average age of pregnant women with normal body mass was 29.52 ± 5.48, overweight pregnant women 30.30 ± 5.138, and obese pregnant women 30.00 ± 5.103 (F = 2.730; p = 0.066). The youngest was 24, and the oldest was 49 years old. The average gestational age at delivery was 39.23 ± 1.556 (min 28; max. 42 weeks of gestation). The majority of pregnant women; 660 of them (50.8 %), were overweight in the early stages of their pregnancy, there were 322 (24.8 %) obese women, and there were 318 (24.5 %) normal weight women. At the end of the pregnancy, the highest number was that of obese pregnant women 925 (71.2 %), while 328 (25.2 %) pregnant women were overweight, and only 47 (3.6 %) pregnant women had normal weight. Conclusion: Nutritive status and weight gain of a mother during pregnancy are an important indication of her health and of the foetus growth. Overweightness and obesity of a mother before pregnancy and during pregnancy has a negative influence on the health of the mother and infant. Moreover, it is linked with risk and a negative pregnancy outcome. BMI was associated with an increased risk of adverse perinatal outcome.
Collapse
Affiliation(s)
- Tatjana Barisic
- Department of Obstetrics and Gynecology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | | | - Ivana Barac
- Ministry of health of FBiH, Sarajevo, Bosnia and Herzegovina
| |
Collapse
|
31
|
Total and Trimester-Specific Gestational Weight Gain and Offspring Birth and Early Childhood Weight: A Prospective Cohort Study on Monozygotic Twin Mothers and Their Offspring. Twin Res Hum Genet 2016; 19:367-76. [PMID: 27161254 DOI: 10.1017/thg.2016.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Gestational weight gain (GWG) has in numerous studies been associated with offspring birth weight (BW) and childhood weight. However, these associations might be explained by genetic confounding as offspring inherit their mother's genetic potential to gain weight. Furthermore, little is known about whether particular periods of pregnancy could influence offspring body weight differently. We therefore aimed to explore total and trimester-specific effects of GWG in monozygotic (MZ) twin mother-pairs on their offspring's BW, weight at 1 year and body mass index (BMI) at 5 and 10 years. MZ twin mothers born 1962-1975 were identified in national Swedish registers, and data on exposure and outcome variables was collected from medical records. We analyzed associations within and between twin pairs. We had complete data on the mothers' GWG and offspring BW for 82 pairs. The results indicated that total, and possibly also second and third trimester GWG were associated with offspring BW within the twin pairs in the fully adjusted model (β = 0.08 z-score units, 95% CI: 0.001, 0.17; β = 1.32 z-score units, 95% CI: -0.29, 2.95; and β = 1.02 z-score units, 95% CI: -0.50, 2.54, respectively). Our findings, although statistically weak, suggested no associations between GWG and offspring weight or BMI during infancy or childhood. Our study suggests that total, and possibly also second and third trimester, GWG are associated with offspring BW when taking shared genetic and environmental factors within twin pairs into account. Larger family-based studies with long follow-up are needed to confirm our findings.
Collapse
|