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Ounjaijean S, Wongthanee A, Kulprachakarn K, Rerkasem A, Pruenglampoo S, Mangklabruks A, Rerkasem K, Derraik JGB. Higher maternal BMI early in pregnancy is associated with overweight and obesity in young adult offspring in Thailand. BMC Public Health 2021; 21:724. [PMID: 33853557 PMCID: PMC8048216 DOI: 10.1186/s12889-021-10678-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/22/2021] [Indexed: 01/10/2023] Open
Abstract
Background Rates of overweight and obesity among women of reproductive age have been steadily increasing worldwide and in Thailand. There is mounting evidence that maternal obesity during pregnancy is associated with an increased risk of obesity and other adverse health outcomes in the offspring, but such data are lacking for Thailand. We examined the associations between maternal body mass index (BMI) and anthropometry (particularly the likelihood of obesity) and cardiometabolic parameters in young adult offspring. Methods This was a prospective follow-up study of a birth cohort in Chiang Mai (Thailand). Pregnant women carrying singletons were recruited at their first antenatal visit (< 24 weeks of gestation) and followed until delivery in 1989–1990. Participants were their young adult offspring followed up in 2010. Maternal BMI was recorded at the first antenatal visit. The offspring underwent clinical assessments, including anthropometry, lipid profile, insulin sensitivity (HOMA-IR), blood pressure, and carotid intima-media thickness. The primary outcome of interest was the likelihood of obesity in the offspring. Results We assessed 628 young adults (54% were females) at 20.6 ± 0.5 years of age (range 19.1–22.1 years). The young adult offspring of mothers with overweight/obesity was 14.1 kg (95%CI 9.7, 18.5; p < 0.0001) and 9.4 kg (95% CI 6.1, 12.8; p < 0.0001) heavier than those born to mothers with underweight or normal weight, respectively, and had BMI 3.46 kg/m2 (95%CI 2.26, 4.67; p < 0.0001) and 5.27 kg/m2 (95%CI 3.67, 8.68; p < 0.0001) greater, respectively. For every 1-kg/m2 increase in maternal BMI, the adjusted odds ratio (aOR) of offspring obesity was 25% greater (95%CI 1.10, 1.42; p < 0.001). Thus, the aOR of obesity in offspring of mothers with overweight/obesity was 4.6 times greater (95%CI 1.86, 11.26; p < 0.001) and nearly 17-fold greater (95%CI 1.96, 146.4; p = 0.010) compared to young adults born to mothers with normal weight or underweight, respectively. There were no observed associations between maternal BMI status and offspring metabolism or blood pressure. Discussion Maternal overweight/obesity early in pregnancy was associated with increased BMI and greater odds of obesity in their young adult offspring in Thailand. These findings highlight the public health importance of fostering healthier lifestyle choices among women of reproductive age.
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Affiliation(s)
- Sakaewan Ounjaijean
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Antika Wongthanee
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kanokwan Kulprachakarn
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Amaraporn Rerkasem
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Sakda Pruenglampoo
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Ampica Mangklabruks
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand.,Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipan Rerkasem
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand. .,Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - José G B Derraik
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand. .,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. .,Liggins Institute, University of Auckland, Auckland, New Zealand. .,Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Associations of stunting at 2 years with body composition and blood pressure at 8 years of age: longitudinal cohort analysis from lowland Nepal. Eur J Clin Nutr 2018; 73:302-310. [PMID: 30154534 PMCID: PMC6368558 DOI: 10.1038/s41430-018-0291-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 08/03/2018] [Accepted: 08/03/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Stunting remains a very common form of child malnutrition worldwide, particularly in South Asian populations. There is poor understanding of how it develops and how it is associated with subsequent phenotype. SUBJECTS/METHODS We used data from a longitudinal cohort of children (n = 841) in lowland Nepal to investigate associations of stunting at 2 years with maternal traits and early growth patterns, and with body size and composition, kidney dimensions by ultrasound, lung function by spirometry and blood pressure (BP) at 8 years. RESULTS Compared to non-stunted children, children stunted at 2 years came from poorer families and had shorter, lighter mothers. They tended to have higher birth order, were born smaller, and remained shorter, lighter and thinner at 8 years. They had lower leg length, lean and fat masses, smaller kidneys, and reduced lung function (all p < 0.0001). These differences persisted with smaller magnitude after adjusting for current height, maternal height and education, family assets and birth order. Stunting was not associated with BP. DISCUSSION Stunting developed on an inter-generational timescale in this population and its risk increased with birth order. At 8 years, children stunted at 2 years had deficits in tissue masses and some aspects of physical function that were only partially attributable to their persisting short height and maternal phenotype. This suggests that the early stunting is associated with greater deficits in long-term outcomes than would be expected from the persistent short stature alone.
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Derraik JGB, Ahlsson F, Lundgren M, Jonsson B, Cutfield WS. First-borns have greater BMI and are more likely to be overweight or obese: a study of sibling pairs among 26,812 Swedish women. J Epidemiol Community Health 2015; 70:78-81. [PMID: 26311896 DOI: 10.1136/jech-2014-205368] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 07/27/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND A number of large studies have shown phenotypic differences between first-borns and later-borns among adult men. In this study, we aimed to assess whether birth order was associated with height and BMI in a large cohort of Swedish women. METHODS Information was obtained from antenatal clinic records from the Swedish National Birth Register over 20 years (1991-2009). Maternal anthropometric data early in pregnancy (at approximately 10-12 weeks of gestation) were analysed on 13,406 pairs of sisters who were either first-born or second-born (n=26,812). RESULTS Early in pregnancy, first-born women were of BMI that was 0.57 kg/m(2) (2.4%) greater than their second-born sisters (p<0.0001). In addition, first-borns had greater odds of being overweight (OR 1.29; p<0.0001) or obese (OR 1.40; p<0.0001) than second-borns. First-borns were also negligibly taller (+1.2 mm) than their second-born sisters. Of note, there was a considerable increase in BMI over the 18-year period covered by this study, with an increment of 0.11 kg/m(2) per year (p<0.0001). CONCLUSIONS Our study corroborates other large studies on men, and the steady reduction in family size may contribute to the observed increase in adult BMI worldwide.
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Affiliation(s)
- José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fredrik Ahlsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Maria Lundgren
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Björn Jonsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
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The association of birth order with later body mass index and blood pressure: a comparison between prospective cohort studies from the United Kingdom and Brazil. Int J Obes (Lond) 2013; 38:973-9. [PMID: 24097298 PMCID: PMC4024316 DOI: 10.1038/ijo.2013.189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 08/29/2013] [Accepted: 09/24/2013] [Indexed: 01/15/2023]
Abstract
Background: Previous studies have found greater adiposity and cardiovascular risk in first born children. The causality of this association is not clear. Examining the association in diverse populations may lead to improved insight. Methods: We examine the association between birth order and body mass index (BMI), systolic and diastolic blood pressure (SBP/DBP) in the 2004 Pelotas cohort from southern Brazil and the Avon Longitudinal Study of Parents and Children (ALSPAC) from Bristol, south-west England, restricting analysis to families with two children in order to remove confounding by family size. Results: No consistent differences in BMI, SBP or DBP were observed comparing first and second born children. Within the Pelotas 2004 cohort, first born females were thinner, with lower SBP and DBP; for example, mean difference in SBP comparing first with second born was −0.979 (95% confidence interval −2.901 to 0.943). In ALSPAC, first born females had higher BMI, SBP and DBP. In both cohorts, associations tended to be in the opposite direction in males, although no statistical evidence for gender interactions was found. Conclusions: The findings do not support an association between birth order and BMI or blood pressure. Differences to previous studies may be explained by differences in populations and/or confounding by family size in previous studies.
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Ayyavoo A, Derraik JGB, Hofman PL, Cutfield WS. Is being first-born another risk factor for metabolic and cardiovascular diseases? Future Cardiol 2013; 9:447-50. [DOI: 10.2217/fca.13.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ahila Ayyavoo
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
- Gravida: National Centre for Growth & Development, Auckland, New Zealand
| | - José GB Derraik
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
- Gravida: National Centre for Growth & Development, Auckland, New Zealand
| | - Wayne S Cutfield
- Gravida: National Centre for Growth & Development, Auckland, New Zealand
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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Rios-Castillo I, Cerezo S, Corvalán C, Martínez M, Kain J. Risk factors during the prenatal period and the first year of life associated with overweight in 7-year-old low-income Chilean children. MATERNAL AND CHILD NUTRITION 2012; 11:595-605. [PMID: 23241511 DOI: 10.1111/mcn.12024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The objective of this study was to identify in low-income Chilean children with normal birthweight which factors occurring during the prenatal period and the first year are associated with overweight (OW)/obesity at 7 years. The sample included 652 7-year-olds from a larger cohort study. We collected anthropometric data at 0, 12 and 84 months, maternal pre-pregnancy and pregnancy characteristics, early feeding practices, number of siblings, birth order, breastfeeding, and timing of solid introduction information. We determined the residuals for z-scores for body mass index (BMI) (BAZ), weight/age and height/age0-12 months , run univariate analysis (X(2) or t-test) and multivariate logistic analyses (stepwise approach); P < 0.05 was considered significant. We evaluated the goodness of fit of the model using the Hosmer-Lemeshow test and checked for overdispersion using the Pearson's X(2) . The odds of children being OW at 7 years increased if their mothers were OW before pregnancy, if born with a higher BAZ (increase of 18-74% per each additional unit of BAZ) and if their BAZ growth during the first year was higher (62-239% per each unit over the predicted BAZ increase). Higher birth order was protective (6-68% less risk for 2nd birth compared with 1st and 10-73% less for ≥3rd child). All other variables, including gender, were non-significant (P > 0.1). In low-income Chilean children with normal birth, four factors during the prenatal period and the first year were associated with OW at 7 years: pre-pregnancy BMI, BMI at birth, BMI gain between 0 and 12 months, and birth order.
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Affiliation(s)
- Israel Rios-Castillo
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Sheila Cerezo
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Mario Martínez
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Juliana Kain
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
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