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Liu W, Ren L, Fang F, Chen R. Maternal pre-pregnancy overweight or obesity and risk of birth defects in offspring: Population-based cohort study. Acta Obstet Gynecol Scand 2024; 103:862-872. [PMID: 38282287 PMCID: PMC11019515 DOI: 10.1111/aogs.14786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Maternal obesity, a health condition increasingly prevalent worldwide, has been suggested to be associated with a higher risk of birth defects in offspring, whereas evidence from population-based data from China was largely lacking. Additionally, the role of gestational diabetes in the association between maternal obesity and birth defects remains unclear. We aimed to investigate the association of maternal pre-pregnancy overweight or obesity with any and different types of birth defects in offspring and the interaction between pre-pregnancy overweight or obesity and gestational diabetes. MATERIAL AND METHODS We conducted a population-based cohort study including 257 107 singletons born between 2015 and 2021 in Longgang District, Shenzhen, China, using data from the Shenzhen Maternal and Child Health Management System. Poisson regression was conducted to estimate the associations of maternal pre-pregnancy overweight or obesity, as well as the interaction between pre-pregnancy overweight or obesity and gestational diabetes, with the risk of birth defects. Models were adjusted for maternal age at delivery, educational level, type of household registration, and gravidity. RESULTS Maternal pre-pregnancy overweight was associated with a higher risk of any birth defect (risk ratio [RR] 1.21, 95% confidence interval [CI] 1.12 to 1.31) as well as of congenital malformations of the circulatory system (RR 1.26, 95% CI 1.12 to 1.41), eye/ear/face/neck (RR 1.42, 95% CI 1.04 to 1.94), and musculoskeletal system (RR 1.21, 95% CI 1.01 to 1.44). Maternal pre-pregnancy obesity was associated with a higher risk of any birth defect (RR 1.38, 95% CI 1.18 to 1.63) and congenital malformations of the circulatory system (RR 1.61, 95% CI 1.30 to 1.98). Infants born to overweight or obese mothers with gestational diabetes had a higher risk of congenital malformations of the circulatory system than infants born to overweight or obese mothers without gestational diabetes. CONCLUSIONS Maternal pre-pregnancy overweight or obesity was associated with a higher risk of birth defects, particularly congenital malformations of the circulatory system, in offspring. Gestational diabetes interacts additively with pre-pregnancy overweight or obesity on modifying the risk of congenital malformations of the circulatory system. The importance of improving weight management and assessment of glucose and metabolic functions was emphasized among women planning for pregnancy who are overweight or obese.
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Affiliation(s)
- Weiying Liu
- Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College)ShenzhenChina
- Department of Epidemiology, School of Public Health (Shenzhen)Sun Yat‐sen UniversityShenzhenChina
| | - Luzhong Ren
- Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College)ShenzhenChina
| | - Fang Fang
- Institute of Environmental MedicineKarolinska InstituteStockholmSweden
| | - Ruoqing Chen
- Department of Epidemiology, School of Public Health (Shenzhen)Sun Yat‐sen UniversityShenzhenChina
- Institute of Environmental MedicineKarolinska InstituteStockholmSweden
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Matuszak O, Banach W, Pogorzały B, Muszyński J, Mengesha SH, Bogdański P, Skrypnik D. The Long-Term Effect of Maternal Obesity on the Cardiovascular Health of the Offspring-Systematic Review. Curr Probl Cardiol 2024; 49:102062. [PMID: 37652110 DOI: 10.1016/j.cpcardiol.2023.102062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 08/26/2023] [Indexed: 09/02/2023]
Abstract
Maternal obesity may affect offspring's cardiovascular health. Our literature search using PubMed, Web of Sciences included original English research and Google Scholar articles published over the past ten years, culminating in 96 articles in this topic. A mother's obesity during pregnancy has a negative impact on the cardiovascular risk for their offspring. Dependence was observed in relation to hypertension, coronary artery disease, stroke, and heart failure. The adverse impact of an abnormal diet in pregnant mice on heart hypertrophy was observed, and was also confirmed in human research. Pregnant women with obesity were at greater risk of having a child with innate heart disease than pregnant women with normal mass. To conclude: mother's obesity has a negative impact on the long-term cardiovascular consequences for their offspring, increasing their risk of high blood pressure, coronary heart disease, stroke and heart failure. It also increases the probability of heart hypertrophy and innate heart defects.
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Affiliation(s)
- Oskar Matuszak
- Faculty of Medicine, Poznań University of Medical Sciences, Poznań, Poland; Student Scientific Association of Lifestyle Medicine, Poznań University of Medical Sciences, Poznań, Poland
| | - Weronika Banach
- Faculty of Medicine, Poznań University of Medical Sciences, Poznań, Poland; Student Scientific Association of Lifestyle Medicine, Poznań University of Medical Sciences, Poznań, Poland
| | - Bartosz Pogorzały
- Department of Internal Medicine and Cardiology, District Hospital, Juraszów St. 7-19, Poznań, Poland
| | - Józef Muszyński
- Faculty of Medicine, Poznań University of Medical Sciences, Poznań, Poland; Student Scientific Association of Lifestyle Medicine, Poznań University of Medical Sciences, Poznań, Poland
| | - Solyana Hailemelekot Mengesha
- Faculty of Medicine, Poznań University of Medical Sciences, Poznań, Poland; Student Scientific Association of Lifestyle Medicine, Poznań University of Medical Sciences, Poznań, Poland
| | - Paweł Bogdański
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences; Poznań, Poland
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences; Poznań, Poland.
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Portilla R E, Harizanov V, Sarmiento K, Holguín J, Gracia G, Hurtado-Villa P, Zarante I. Risk factors characterisation for CHD: a case-control study in Bogota and Cali, Colombia, 2002-2020. Cardiol Young 2024; 34:178-182. [PMID: 37318127 DOI: 10.1017/s1047951123001324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE CHDs correspond to 28% of all congenital anomalies, being the leading cause of infant mortality in the first year of life. Thus, it is essential to explore risk factors for CHDs presentation, allowing the detection of probable cases within a population. METHODS We identified newborns with CHDs within a cohort from the Program for the Prevention and Monitoring of Congenital Defects in Bogota and Cali, 2002-2020. Cases were classified as isolated, complex isolated, polymalformed, and syndromic. Variables were analysed by comparing case and control averages with Student's t test using a 95% confidence level. RESULTS Prevalence obtained was 19.36 per 10 000 live births; non-specified CHD, ventricular septal defect, and atrial septal defect were the most prevalent. As risk factors were found: paternal and maternal age above 45 years, pregestational diabetes, mother's body mass index above 25, low educational level, and socio-economic status. As protective factors: folic acid consumption within the first trimester and pregestational period. CONCLUSION Different risk and protective factors associated with the presentation of CHDs have been described. We consider that public health strategies should be aimed to reduce risk factors exposure. Also, improving diagnosis and prognosis by having a close monitoring on high-risk patients.
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Affiliation(s)
| | - Vyara Harizanov
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Karen Sarmiento
- Department of Physiological Sciences, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | | | - Paula Hurtado-Villa
- Department of Basic Sciences, Faculty of Health, Pontificia Universidad Javeriana, Cali, Colombia
| | - Ignacio Zarante
- Institute of Human Genetics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
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Wu XX, Ge RX, Huang L, Tian FY, Chen YX, Wu LL, Niu JM. Pregestational diabetes mediates the association between maternal obesity and the risk of congenital heart defects. J Diabetes Investig 2021; 13:367-374. [PMID: 34510805 PMCID: PMC8847144 DOI: 10.1111/jdi.13666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022] Open
Abstract
AIMS/INTRODUCTION We aimed to explore whether the association between obesity and congenital heart defects (CHDs) can be mediated by maternal pregestational diabetes (PGDM). MATERIALS AND METHODS We included 53,708 mother-infant pairs with deliveries between 2017 and 2019 from the Birth Cohort in Shenzhen. Mothers were categorized into four groups: the underweight group (body mass index [BMI] <18.5), normal weight group (18.5 ≤ BMI < 24), overweight group (24 ≤ BMI < 28) and obesity group (BMI ≥28). Multivariable logistic regression models were used to evaluate the association between BMI and CHDs. Mediation analysis was used to confirm the effect of PGDM on the association between maternal obesity and CHDs. RESULTS The proportion of obese individuals in the Birth Cohort in Shenzhen was 2.11%. Overall, 372 (0.69%) infants were diagnosed with CHDs. Maternal obesity was associated with an increased risk of CHDs (odds ratio 1.97, 95% confidence interval 1.14-3.41). The mediation effect of PGDM on the association between maternal obesity and CHDs was significant (odds ratio 1.18, 95% confidence interval 1.06-1.32). The estimated mediation proportion was 24.83%. CONCLUSIONS Maternal obesity was associated with increased risk for CHDs, and PGDM partially mediated the association between maternal obesity and CHDs.
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Affiliation(s)
- Xiao-Xia Wu
- Department of Obstetrics, Cheeloo College of Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shandong University, Shenzhen, Guangdong, China
| | - Ru-Xiu Ge
- Department of Obstetrics, Cheeloo College of Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shandong University, Shenzhen, Guangdong, China
| | - Le Huang
- Department of Obstetrics, Cheeloo College of Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shandong University, Shenzhen, Guangdong, China
| | - Fu-Ying Tian
- Department of Obstetrics, Cheeloo College of Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shandong University, Shenzhen, Guangdong, China
| | - Yi-Xuan Chen
- Department of Obstetrics, Cheeloo College of Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shandong University, Shenzhen, Guangdong, China
| | - Lin-Lin Wu
- Department of Obstetrics, Cheeloo College of Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shandong University, Shenzhen, Guangdong, China
| | - Jian-Min Niu
- Department of Obstetrics, Cheeloo College of Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shandong University, Shenzhen, Guangdong, China
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Hedermann G, Hedley PL, Thagaard IN, Krebs L, Ekelund CK, Sørensen TIA, Christiansen M. Maternal obesity and metabolic disorders associate with congenital heart defects in the offspring: A systematic review. PLoS One 2021; 16:e0252343. [PMID: 34043700 PMCID: PMC8158948 DOI: 10.1371/journal.pone.0252343] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/12/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Congenital heart defects (CHDs) are the most common congenital malformations. The aetiology of CHDs is complex. Large cohort studies and systematic reviews and meta-analyses based on these have reported an association between higher risk of CHDs in the offspring and individual maternal metabolic disorders such as obesity, diabetes, hypertension, and preeclampsia, all conditions that can be related to insulin resistance or hyperglycaemia. However, the clinical reality is that these conditions often occur simultaneously. The aim of this review is, in consequence, both to evaluate the existing evidence on the association between maternal metabolic disorders, defined as obesity, diabetes, hypertension, preeclampsia, dyslipidaemia and CHDs in the offspring, as well as the significance of combinations, such as metabolic syndrome, as risk factors. METHODS A systematic literature search of papers published between January 1, 1990 and January 14, 2021 was conducted using PubMed and Embase. Studies were eligible if they were published in English and were case-control or cohort studies. The exposures of interest were maternal overweight or obesity, hypertension, preeclampsia, diabetes, dyslipidaemia, and/or metabolic syndrome, and the outcome of interest was CHDs in the offspring. Furthermore, the studies were included according to a quality assessment score. RESULTS Of the 2,250 identified studies, 32 qualified for inclusion. All but one study investigated only the individual metabolic disorders. Some disorders (obesity, gestational diabetes, and hypertension) increased risk of CHDs marginally whereas pre-gestational diabetes and early-onset preeclampsia were strongly associated with CHDs, without consistent differences between CHD subtypes. A single study suggested a possible additive effect of maternal obesity and gestational diabetes. CONCLUSIONS Future studies of the role of aberrations of the glucose-insulin homeostasis in the common aetiology and mechanisms of metabolic disorders, present during pregnancy, and their association, both as single conditions and-particularly-in combination, with CHDs are needed.
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Affiliation(s)
- Gitte Hedermann
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
- * E-mail:
| | - Paula L. Hedley
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
| | - Ida N. Thagaard
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Slagelse Hospital, Slagelse, Denmark
| | - Lone Krebs
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Amager and Hvidovre Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Kvist Ekelund
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thorkild I. A. Sørensen
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Christiansen
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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