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Hernández-Barrera L, Trejo-Valdivia B, Téllez-Rojo MM, Baccarelli A, Wright R, Cantoral A, Barquera S. Pre-Gestational Obesity and Gestational Weight Gain as Predictors of Childhood Obesity. Arch Med Res 2024; 55:103006. [PMID: 38763021 DOI: 10.1016/j.arcmed.2024.103006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/24/2024] [Accepted: 05/07/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE To evaluate the associations of pre-gestational body mass index (BMI) and gestational weight gain (GWG) with the risks of overweight, obesity, and adiposity in the first seven years of life in the offspring of a cohort of pregnant women. METHODS Analysis of 751 mothers and their children participating in the PROGRESS cohort. These women were recruited in Mexico City between 2007 and 2010. Pre-gestational BMI was classified as normal, overweight, and obesity according to the WHO. GWG was calculated as the difference between the last reported pre-pregnancy weight and the pre-gestational weight and categorized as inadequate, adequate, or excessive, according to US IOM recommendations. Children's anthropometry was evaluated at 4-5 and 6-7 years of age. Adiposity was classified into three groups: normal (BMI z-score and waist circumference), overweight (BMI z-score>1), and overweight plus abdominal obesity (OW+AO). A generalized structural equation model (GSEM) was constructed to account for the temporal relationship between variables and to assess direct and indirect effects. RESULTS A total of 49.3% of the women had excessive (13.8 ± 4.2 kg) and 19.8% inadequate (3.15 ± 3.4 kg) GWG. Women with pre-gestational overweight or obesity were more likely to have excessive GWG (OR 1.9 [95% CI: 1.32, 2.74] and 3.50 [95% CI: 1.83, 6.69], respectively). In the GSEM, excessive GWG was directly associated with OW+AO at 4-5 years. At 6-7 years, pre-gestational obesity was associated with OW+AO. CONCLUSION Pre-gestational obesity and excessive GWG were independent predictors of childhood obesity.
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Affiliation(s)
- Lucía Hernández-Barrera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Belem Trejo-Valdivia
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Martha María Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Andrea Baccarelli
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Gaillard R, Jaddoe VWV. Maternal cardiovascular disorders before and during pregnancy and offspring cardiovascular risk across the life course. Nat Rev Cardiol 2023; 20:617-630. [PMID: 37169830 DOI: 10.1038/s41569-023-00869-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 05/13/2023]
Abstract
Obesity, hypertension, type 2 diabetes mellitus and dyslipidaemia are highly prevalent among women of reproductive age and contribute to complications in >30% of pregnancies in Western countries. An accumulating body of evidence suggests that these cardiovascular disorders in women, occurring before and during their pregnancy, can affect the development of the structure, physiology and function of cardiovascular organ systems at different stages during embryonic and fetal development. These developmental adaptations might, in addition to genetics and sociodemographic and lifestyle factors, increase the susceptibility of the offspring to cardiovascular disease throughout the life course. In this Review, we discuss current knowledge of the influence of maternal cardiovascular disorders, occurring before and during pregnancy, on offspring cardiovascular development, dysfunction and disease from embryonic life until adulthood. We discuss findings from contemporary, large-scale, observational studies that provide insights into specific critical periods, evidence for causality and potential underlying mechanisms. Furthermore, we focus on priorities for future research, including defining optimal cardiovascular and reproductive health in women and men before their pregnancy and identifying specific embryonic, placental and fetal molecular developmental adaptations from early pregnancy onwards. Together, these approaches will help stop the intergenerational cycle of cardiovascular disease.
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Affiliation(s)
- Romy Gaillard
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands.
| | - Vincent W V Jaddoe
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Triantafyllidou P, Papadopoulou A, Thymara E, Papaevangelou V, Mastorakos G, Papadimitriou A, Kalantaridou S, Stratakis CA, Alexopoulou E. Aortic Intima-Media Thickness is Increased in Neonates of Mothers with Gestational Diabetes Mellitus: The Role of Thioredoxin-Interacting Protein as a Marker of Oxidative Stress. Curr Vasc Pharmacol 2023; 21:234-245. [PMID: 37518994 DOI: 10.2174/1570161121666230727150854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/07/2023] [Accepted: 07/04/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Offspring exposed in foetal life to gestational diabetes mellitus (GDM) are at increased risk for future metabolic diseases. OBJECTIVE To explore the prognostic role of abdominal aorta intima-media thickness (aIMT) in neonates exposed to GDM as a possible biomarker for later atherogenesis and its possible correlation with thioredoxin- interacting protein (TXNIP), a protein involved in oxidative stress. METHODS In this prospective, observational study, mother-infant pairs were studied in 2 groups (57 patients with GDM and 51 controls without GDM). TXNIP levels were measured in the placenta, as well as in the umbilical and neonatal blood. The data were correlated with aIMT in neonates. RESULTS aIMT was increased in GDM offspring (patients: median [range]=0.39 mm [0.31-0.46] vs controls: median=0.28 mm [0.23-0.33]; p=0.001) and remained significant after adjusting for possible confounders (e.g., triglycerides, blood pressure, vitamin D, birth weight and gender; β coefficient=0.131 p=0.049). TXNIP levels were increased in trophoblasts (p=0.001) and syncytiotrophoblasts (p=0.001) and were decreased in endothelial cells (p=0.022) in GDM offspring vs controls. Moreover, TXNIP levels in trophoblasts positively correlated with aIMT (r=0.369; p=0.001). TXNIP levels in umbilical/ neonatal blood were not associated with GDM. CONCLUSION Increased aIMT was demonstrated in the offspring of mothers with GDM. Non-invasive measurement of aIMT could be used as a biomarker to identify children at increased risk for atherogenesis later in life. This information may encourage early preventive measures. TXNIP may be associated with GDM and/or aIMT.
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Affiliation(s)
- Pinelopi Triantafyllidou
- 3rd Department of Pediatrics, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Papadopoulou
- 3rd Department of Pediatrics, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eirini Thymara
- Department of Pathology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Vassiliki Papaevangelou
- 3rd Department of Pediatrics, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Mastorakos
- Endocrinology, Diabetes mellitus and Metabolism Unit, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Papadimitriou
- Department of Pediatrics-Endocrinology, National and Kapodistrian University of Athens, Athens, Greece
| | - Sophia Kalantaridou
- 3rd Department of Obstetrics and Gynecology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantine A Stratakis
- Human Genetics & Precision Medicine, Institute for Molecular Biology & Biotechnology (IMBB), Foundation for Research & Technology Hellas (FORTH), Heraklion, Crete, Greece
- Medical Genetics, ELPEN, Inc., ELPEN Research Institute & H. Dunant Hospital, Athens, Greece
- School of Medicine, European University of Cyprus, Nicosia, Cyprus
- National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Efthymia Alexopoulou
- 2nd Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Mogensen CS, Zingenberg H, Svare J, Astrup A, Magkos F, Geiker NRW. Gestational weight gain in women with pre-pregnancy overweight or obesity and anthropometry of infants at birth. Front Pediatr 2023; 11:1142920. [PMID: 37051436 PMCID: PMC10084734 DOI: 10.3389/fped.2023.1142920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/27/2023] [Indexed: 04/14/2023] Open
Abstract
Objective To examine the association of gestational weight gain (GWG) among women with pre-pregnancy overweight or obesity with infant weight and BMI z-score at birth. Methods This study is a secondary analysis of a randomized controlled trial including data from 208 infants at birth born by mothers with pre-pregnancy BMI between 28 and 45 kg/m2 who completed the APPROACH study (randomized to a high-protein low-glycemic index diet or a moderate-protein moderate-glycemic index diet). This analysis pooled the two diet treatment groups together and data were analyzed using a linear mixed model. Results Limiting GWG by 1 kg was associated with lower birthweight (-16 g, P = 0.003), BMI z-score (-0.03SD, P = 0.019), weight z-score (-0.03SD, P = 0.004), and infant abdominal circumference (-0.06 cm, P = 0.039). Infants born by mothers whose GWG was ≤9 kg weighed less (122 g, 95% CI: 6-249, P = 0.040), had similar BMI z-score (0.2SD, 95% CI: -0.06 to 0.55, P = 0.120), and lower incidence of emergency cesarean deliveries (11.5% vs. 23.1%, P = 0.044) compared to infants born by mothers whose GWG was >9 kg. When women were classified into GWG quartiles, women in Q1 (GWG range: -7.0 to 3.2 kg) gave birth to smaller infants (3,420 g, P = 0.015) with lower BMI z-score (-0.5SD, P = 0.041) than women in Q2 (3.3-7.1 kg), Q3 (7.2-10.9 kg) and Q4 (11.1-30.2 kg). Conclusions Limiting GWG among women with pre-pregnancy overweight or obesity was associated with lower infant weight, BMI z-score, weight z-score, and abdominal circumference at birth. Moreover, GWG below the Institute of Medicine guideline of a maximum of 9 kg was associated with lower birthweight and fewer emergency cesarean deliveries.
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Affiliation(s)
- Christina Sonne Mogensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
- Correspondence: Christina Sonne Mogensen
| | - Helle Zingenberg
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev-Gentofte, Herlev, Denmark
| | - Jens Svare
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev-Gentofte, Herlev, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Nina Rica Wium Geiker
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
- Dietetic and Clinical Nutrition Research Unit, Copenhagen University Hospital Herlev-Gentofte, Herlev, Denmark
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Lecorguillé M, Camier A, Kadawathagedara M. Weight Changes, Nutritional Intake, Food Contaminants, and Supplements in Women of Childbearing Age, including Pregnant Women: Guidelines for Interventions during the Perinatal Period from the French National College of Midwives. J Midwifery Womens Health 2022; 67 Suppl 1:S135-S148. [PMID: 36480662 DOI: 10.1111/jmwh.13423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/10/2022] [Indexed: 12/13/2022]
Abstract
Adequate maternal nutrition is crucial for a healthy pregnancy and optimal fetal growth. Many women in France of childbearing age start their pregnancy in an unfavorable nutritional status. Recent studies highlight the value of paying attention to weight issues from the preconceptional period. It is important to call attention to the need for folate supplementation and to promote a varied and balanced diet throughout pregnancy to cover essential nutritional needs.
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Affiliation(s)
| | - Aurore Camier
- Université de Paris, CRESS, INSERM, INRAE, Paris, F-75004, France
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de Lauzon-Guillain B, Marques C, Kadawathagedara M, Bernard JY, Tafflet M, Lioret S, Charles MA. Maternal diet during pregnancy and child neurodevelopment up to age 3.5 years: the nationwide Étude Longitudinale Française depuis l'Enfance (ELFE) birth cohort. Am J Clin Nutr 2022; 116:1101-1111. [PMID: 35918250 DOI: 10.1093/ajcn/nqac206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/26/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Dietary guidelines available to pregnant women are made to improve maternal health and fetal development. But their adequacy to sustain offspring neurodevelopment has remained understudied. OBJECTIVES We assessed the association between compliance with nutritional guidelines during pregnancy and neurodevelopment in preschool children. METHODS The analyses were based on data for 6780 to 11,278 children from the Étude Longitudinale Française depuis l'Enfance (ELFE) study, a nationwide birth cohort. Maternal diet during the last 3 mo of pregnancy was evaluated at delivery by using a validated 125-item FFQ. From this FFQ, food group consumption, a diet quality score (adapted National Health and Nutrition Program Guideline Score), and a nutrient intake score (Probability of Adequate Nutrient intake based Diet quality index) were calculated and dietary patterns were derived by principal component analysis. Child neurodevelopment was reported by parents at 1 and 3.5 y with the Child Development Inventory (CDI-1, CDI-3.5) and at 2 y with the MacArthur-Bates Communicative Development Inventories (MB-2), and assessed by a trained investigator at 3.5 y with the Picture Similarities test (British Ability Scales, PS-3.5). Associations between maternal diet and child neurodevelopment were assessed by multivariable linear regression models on standardized variables. RESULTS Higher nutrient intake score was associated with higher neurodevelopmental scores from 1 to 3.5 y (β = 0.04; 95% CI: 0.02, 0.06 for CDI-1; β = 0.03; 95% CI: 0.01, 0.05 for MB-2; and β = 0.03; 95% CI: 0.01, 0.05 for CDI-3.5). Higher fruit and vegetables or fish intake and lower pork-meat products intake were related to higher CDI-3.5 scores (β = 0.03; 95% CI: 0.01, 0.05 for fruit and vegetables; β = 0.03; 95% CI: 0.01, 0.05 for fish; and β = -0.02; 95% CI: -0.04, 0.00 for pork-meat products). A higher score on the processed food pattern was associated with poorer neurodevelopmental score at 1 y (β = -0.05; 95% CI: -0.06, -0.03). CONCLUSIONS Higher diet quality during pregnancy was associated with higher parent-reported neurodevelopmental scores in early childhood. The negative association of pork-meat products consumption with early neurodevelopmental scores needs to be further confirmed.
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Affiliation(s)
| | - Chloé Marques
- Université Paris Cité, CRESS, Inserm, INRAE, Paris, France
| | | | - Jonathan Y Bernard
- Université Paris Cité, CRESS, Inserm, INRAE, Paris, France.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Muriel Tafflet
- Université Paris Cité, CRESS, Inserm, INRAE, Paris, France
| | | | - Marie Aline Charles
- Université Paris Cité, CRESS, Inserm, INRAE, Paris, France.,Unité mixte Inserm-Ined-EFS ELFE, Ined, Aubervilliers, France
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Denizli M, Capitano ML, Kua KL. Maternal obesity and the impact of associated early-life inflammation on long-term health of offspring. Front Cell Infect Microbiol 2022; 12:940937. [PMID: 36189369 PMCID: PMC9523142 DOI: 10.3389/fcimb.2022.940937] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
The prevalence of obesity is increasingly common in the United States, with ~25% of women of reproductive age being overweight or obese. Metaflammation, a chronic low grade inflammatory state caused by altered metabolism, is often present in pregnancies complicated by obesity. As a result, the fetuses of mothers who are obese are exposed to an in-utero environment that has altered nutrients and cytokines. Notably, both human and preclinical studies have shown that children born to mothers with obesity have higher risks of developing chronic illnesses affecting various organ systems. In this review, the authors sought to present the role of cytokines and inflammation during healthy pregnancy and determine how maternal obesity changes the inflammatory landscape of the mother, leading to fetal reprogramming. Next, the negative long-term impact on offspring’s health in numerous disease contexts, including offspring’s risk of developing neuropsychiatric disorders (autism, attention deficit and hyperactive disorder), metabolic diseases (obesity, type 2 diabetes), atopy, and malignancies will be discussed along with the potential of altered immune/inflammatory status in offspring as a contributor of these diseases. Finally, the authors will list critical knowledge gaps in the field of developmental programming of health and diseases in the context of offspring of mothers with obesity, particularly the understudied role of hematopoietic stem and progenitor cells.
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Affiliation(s)
- Merve Denizli
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis IN, United States
| | - Maegan L. Capitano
- Department of Microbiology & Immunology, Indiana University School of Medicine, Indianapolis IN, United States
| | - Kok Lim Kua
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis IN, United States
- *Correspondence: Kok Lim Kua,
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Zeng J, Shen F, Zou ZY, Yang RX, Jin Q, Yang J, Chen GY, Fan JG. Association of maternal obesity and gestational diabetes mellitus with overweight/obesity and fatty liver risk in offspring. World J Gastroenterol 2022; 28:1681-1691. [PMID: 35581961 PMCID: PMC9048784 DOI: 10.3748/wjg.v28.i16.1681] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/30/2021] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Childhood obesity and fatty liver are associated with adverse outcomes such as diabetes, metabolic syndrome, and cardiovascular diseases in adulthood. It is very important to identify relevant risk factors and intervene as early as possible. At present, the relationship between maternal and offspring metabolic factors is conflicting.
AIM To estimate the association of maternal obesity and gestational diabetes mellitus (GDM) with overweight/obesity and fatty liver risk in offspring at 8 years of age.
METHODS The prospective study included mothers who all had a 75-g oral glucose tolerance test at 24-28 wk of gestation and whose offspring completed follow-up at 8 years of age. Offspring birth weight, sex, height, weight, and body mass index (BMI) were measured and calculated. FibroScan-502 examination with an M probe (Echosens, Paris, France) was prospectively conducted in offspring aged 8 years from the Shanghai Prenatal Cohort Study.
RESULTS A total of 430 mother-child pairs were included in the analysis. A total of 62 (14.2%) mothers were classified as obese, and 48 (11.1%) were classified as having GDM. The mean age of the offspring at follow-up was 8 years old. Thirty-seven (8.6%) offspring were overweight, 14 (3.3%) had obesity, and 60 (14.0%) had fatty liver. The prevalence of overweight, obesity and fatty liver in offspring increased significantly across maternal BMI quartiles (all P < 0.05). Among offspring of mothers with GDM, 12 (25.0%) were overweight, 4 (8.3%) were obese, and 12 (25.0%) had fatty liver vs. 25 (6.5%), 10 (2.6%) and 48 (12.6%), respectively, for offspring of mothers without GDM (all P < 0.05). In multiple logistic regression, after adjustment for variables, the OR for fatty liver in offspring was 8.26 (95%CI: 2.38-28.75) for maternal obesity and GDM.
CONCLUSION This study showed that maternal obesity can increase the odds of overweight/obesity and fatty liver in offspring, and GDM status also increases the odds of overweight/obesity in offspring. Weight management and glycemic control before and during pregnancy need to be highlighted in primary prevention of pediatric obesity and fatty liver.
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Affiliation(s)
- Jing Zeng
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Feng Shen
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Zi-Yuan Zou
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Rui-Xu Yang
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Qian Jin
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jing Yang
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Guang-Yu Chen
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jian-Gao Fan
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
- Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai 200092, China
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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.
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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
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Wu Y, Pei J, Dong L, Zhou Z, Zhou T, Zhao X, Che R, Han Z, Hua X. Association Between Maternal Weight Gain in Different Periods of Pregnancy and the Risk of Venous Thromboembolism: A Retrospective Case-Control Study. Front Endocrinol (Lausanne) 2022; 13:858868. [PMID: 35923618 PMCID: PMC9339610 DOI: 10.3389/fendo.2022.858868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Venous thromboembolism (VTE) remains an important cause of maternal deaths. Little is known about the associations of specific periods of gestational weight gain (GWG) with the category of VTE, pulmonary embolism (PE), or deep venous thrombosis (DVT) with or without PE. METHODS In a retrospective case-control study conducted in Shanghai First Maternity and Infant Hospital from January 1, 2017 to September 30, 2021, cases of VTE within pregnancy or the first 6 postnatal weeks were identified. Controls without VTE were randomly selected from women giving birth on the same day as the cases, with 10 controls matched to each case. Total GWG and rates of early, mid, and late GWG values were standardized into z-scores, stratified by pre-pregnant body mass index (BMI). The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated through multivariate logistic regression models. RESULTS There were 196 cases (14.4 per 10,000) of VTE within pregnancy or the first 6 postnatal weeks were identified. Higher total weight gain was associated with increased risks of PE (aOR, 13.22; 95% CI, 2.03-85.99) and VTE (OR, 10.49; 95% CI, 1.82-60.45) among women with underweight. In addition, higher total weight gain was associated with increased risk of PE (aOR, 2.06; 95% CI, 1.14-3.72) among women with healthy weight. Similarly, rate of higher early weight gain was associated with significantly increased risk for PE (aOR, 2.15; 95% CI, 1.05-4.42) among women with healthy BMI. The lower rate of late weight gain was associated with increased risks of PE (aOR, 7.30; 95% CI, 1.14-46.55) and VTE (OR, 7.54; 95% CI, 1.20-47.57) among women with underweight. No significant associations between maternal rate of mid GWG and increased risk for any category of VTE, PE, or DVT with or without PE were present, regardless of maternal pre-pregnant BMI. CONCLUSION The GWG associations with the category of VTE, PE, or DVT with or without PE differ at different periods of pregnancy. In order to effectively improve maternal and child outcomes, intensive weight management that continues through pregnancy may be indispensable.
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Affiliation(s)
- Yuelin Wu
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jindan Pei
- Obstetrics Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lingling Dong
- Obstetrics Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zheying Zhou
- Obstetrics Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tianfan Zhou
- Obstetrics Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaobo Zhao
- Obstetrics Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ronghua Che
- Obstetrics Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhimin Han
- Obstetrics Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaolin Hua
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- Obstetrics Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Xiaolin Hua,
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11
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Ventura AK, Phelan S, Silva Garcia K. Maternal Diet During Pregnancy and Lactation and Child Food Preferences, Dietary Patterns, and Weight Outcomes: a Review of Recent Research. Curr Nutr Rep 2021; 10:413-426. [PMID: 34383279 DOI: 10.1007/s13668-021-00366-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Efforts to promote children's preferences for healthy foods hold much potential for improving diet quality and preventing obesity. The purpose of this review was to summarize recent evidence for associations between maternal diet during pregnancy and lactation and child food preferences, dietary patterns, and weight outcomes. RECENT FINDINGS Recent research illustrates greater maternal vegetable intakes during pregnancy and lactation predict greater child preferences for and intakes of vegetables. Recent randomized clinical trials to improve maternal weight outcomes during the perinatal period via behavioral lifestyle interventions that included dietary components have yielded mixed findings for effects on child weight outcomes. There is strong evidence that maternal diet during pregnancy and lactation shapes flavor preferences during infancy; more research is needed to understand factors that facilitate versus hinder the translation of these preferences to later dietary patterns and weight outcomes.
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Affiliation(s)
- Alison K Ventura
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, One Grand Ave, San Luis Obispo, CA, 93407, USA.
| | - Suzanne Phelan
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, One Grand Ave, San Luis Obispo, CA, 93407, USA
| | - Karina Silva Garcia
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, One Grand Ave, San Luis Obispo, CA, 93407, USA
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12
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Cornejo M, Fuentes G, Valero P, Vega S, Grismaldo A, Toledo F, Pardo F, Moore‐Carrasco R, Subiabre M, Casanello P, Faas MM, Goor H, Sobrevia L. Gestational diabesity and foetoplacental vascular dysfunction. Acta Physiol (Oxf) 2021; 232:e13671. [PMID: 33942517 DOI: 10.1111/apha.13671] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 12/15/2022]
Abstract
Gestational diabetes mellitus (GDM) shows a deficiency in the metabolism of D-glucose and other nutrients, thereby negatively affecting the foetoplacental vascular endothelium. Maternal hyperglycaemia and hyperinsulinemia play an important role in the aetiology of GDM. A combination of these and other factors predisposes women to developing GDM with pre-pregnancy normal weight, viz. classic GDM. However, women with GDM and prepregnancy obesity (gestational diabesity, GDty) or overweight (GDMow) show a different metabolic status than women with classic GDM. GDty and GDMow are associated with altered l-arginine/nitric oxide and insulin/adenosine axis signalling in the human foetoplacental microvascular and macrovascular endothelium. These alterations differ from those observed in classic GDM. Here, we have reviewed the consequences of GDty and GDMow in the modulation of foetoplacental endothelial cell function, highlighting studies describing the modulation of intracellular pH homeostasis and the potential implications of NO generation and adenosine signalling in GDty-associated foetal vascular insulin resistance. Moreover, with an increase in the rate of obesity in women of childbearing age worldwide, the prevalence of GDty is expected to increase in the next decades. Therefore, we emphasize that women with GDty and GDMow should be characterized with a different metabolic state from that of women with classic GDM to develop a more specific therapeutic approach for protecting the mother and foetus.
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Affiliation(s)
- Marcelo Cornejo
- Cellular and Molecular Physiology Laboratory Department of Obstetrics Division of Obstetrics and Gynaecology School of Medicine Faculty of Medicine Pontificia Universidad Católica de Chile Santiago Chile
- Faculty of Health Sciences Universidad de Talca Talca Chile
- Faculty of Health Sciences Universidad de Antofagasta Antofagasta Chile
| | - Gonzalo Fuentes
- Cellular and Molecular Physiology Laboratory Department of Obstetrics Division of Obstetrics and Gynaecology School of Medicine Faculty of Medicine Pontificia Universidad Católica de Chile Santiago Chile
- Faculty of Health Sciences Universidad de Talca Talca Chile
- Department of Pathology and Medical Biology University of GroningenUniversity Medical Center Groningen Groningen The Netherlands
| | - Paola Valero
- Cellular and Molecular Physiology Laboratory Department of Obstetrics Division of Obstetrics and Gynaecology School of Medicine Faculty of Medicine Pontificia Universidad Católica de Chile Santiago Chile
- Faculty of Health Sciences Universidad de Talca Talca Chile
| | - Sofía Vega
- Cellular and Molecular Physiology Laboratory Department of Obstetrics Division of Obstetrics and Gynaecology School of Medicine Faculty of Medicine Pontificia Universidad Católica de Chile Santiago Chile
- Medical School (Faculty of Medicine) Sao Paulo State University (UNESP) Sao Paulo Brazil
| | - Adriana Grismaldo
- Cellular and Molecular Physiology Laboratory Department of Obstetrics Division of Obstetrics and Gynaecology School of Medicine Faculty of Medicine Pontificia Universidad Católica de Chile Santiago Chile
- Department of Nutrition and Biochemistry Faculty of Sciences Pontificia Universidad Javeriana Bogotá D.C. Colombia
| | - Fernando Toledo
- Cellular and Molecular Physiology Laboratory Department of Obstetrics Division of Obstetrics and Gynaecology School of Medicine Faculty of Medicine Pontificia Universidad Católica de Chile Santiago Chile
- Department of Basic Sciences Faculty of Sciences Universidad del Bío‐Bío Chillán Chile
| | - Fabián Pardo
- Cellular and Molecular Physiology Laboratory Department of Obstetrics Division of Obstetrics and Gynaecology School of Medicine Faculty of Medicine Pontificia Universidad Católica de Chile Santiago Chile
- Metabolic Diseases Research Laboratory Interdisciplinary Centre of Territorial Health Research (CIISTe) Biomedical Research Center (CIB) School of Medicine Faculty of Medicine Universidad de Valparaíso San Felipe Chile
| | | | - Mario Subiabre
- Cellular and Molecular Physiology Laboratory Department of Obstetrics Division of Obstetrics and Gynaecology School of Medicine Faculty of Medicine Pontificia Universidad Católica de Chile Santiago Chile
| | - Paola Casanello
- Department of Pathology and Medical Biology University of GroningenUniversity Medical Center Groningen Groningen The Netherlands
- Department of Obstetrics Division of Obstetrics and Gynaecology, and Department of Neonatology Division of Pediatrics School of Medicine Faculty of Medicine Pontificia Universidad Católica de Chile Santiago Chile
| | - Marijke M Faas
- Department of Pathology and Medical Biology University of GroningenUniversity Medical Center Groningen Groningen The Netherlands
| | - Harry Goor
- Department of Pathology and Medical Biology University of GroningenUniversity Medical Center Groningen Groningen The Netherlands
| | - Luis Sobrevia
- Cellular and Molecular Physiology Laboratory Department of Obstetrics Division of Obstetrics and Gynaecology School of Medicine Faculty of Medicine Pontificia Universidad Católica de Chile Santiago Chile
- Department of Pathology and Medical Biology University of GroningenUniversity Medical Center Groningen Groningen The Netherlands
- Medical School (Faculty of Medicine) Sao Paulo State University (UNESP) Sao Paulo Brazil
- Department of Physiology Faculty of Pharmacy Universidad de Sevilla Seville Spain
- University of Queensland Centre for Clinical Research (UQCCR) Faculty of Medicine and Biomedical Sciences University of Queensland Herston QLD Australia
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13
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He Y, Tam CHT, Yuen LY, Catalano PM, Ma RCW, Tam WH. Optimal gestational weight gain for Chinese women - analysis from a longitudinal cohort with childhood follow-up. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 13:100190. [PMID: 34527983 PMCID: PMC8403904 DOI: 10.1016/j.lanwpc.2021.100190] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/07/2021] [Accepted: 05/27/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Maternal gestational weight gain (GWG) influences not only on pregnancy outcome but also impacts on mothers' and children's long-term health. However, there is no consensus on recommendations of optimal GWG in Asians or the Chinese population. METHODS We performed a secondary analysis of the birth outcome of Chinese women who had joined the "Hyperglycemia and Adverse Pregnancy Outcome" study in Hong Kong and their children's cardiometabolic risk at 7-year of age. Optimal ranges of GWG were derived from models based on the probabilities of small for gestational age and large for gestational age (model 1), lean and fat infants (model 2) and the integration of model 1 and 2 (model 3), and were compared with that recommended by the Institute of Medicine (IOM) on children's cardiometabolic risk. FINDINGS GWG range derived from model 2 is associated with 8 cardiometabolic risk factors, while that from models 1 and 3 are associated with 1 and 7 of them respectively. Mothers whose GWG lie within the recommended range increases from 40.8% according to the IOM recommendation to 50.2% according to that derived from model 2. INTERPRETATION Optimal GWG derived from model 2 (i.e. 14.0-18.5 kg, 9.0-16.5 kg and 5.0-11.0 kg for underweight, normal weight and overweight Chinese women, respectively) appeared to be associated with the lowest cardiometabolic risk in the offspring. FUNDING General Research Fund of the Research Grants Council of the Hong Kong SAR, China (grants CUHK 473408 and, in part, CUHK 471713).
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Affiliation(s)
- Yuanying He
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Claudia Ha-Ting Tam
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Lai Yuk Yuen
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Patrick M. Catalano
- Maternal Infant Research Institute, Tufts University School of Medicine, Tufts Medical Center, Boston, MA, USA
| | - Ronald Ching-Wan Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - Wing Hung Tam
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
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14
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Loh HH, Taipin H, Said A. The effect of obesity in pregnancy and gestational weight gain on neonatal outcome in glucose-tolerant mothers. Obes Sci Pract 2021; 7:425-431. [PMID: 34401200 PMCID: PMC8346371 DOI: 10.1002/osp4.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most studies showing association between mothers with obesity in pregnancy or excessive gestational weight gain (GWG) and adverse neonatal outcome were cross-sectional or retrospective. Many included patients are with gestational diabetes mellitus (GDM), which is a strong risk factor for this adverse outcome. There are no prospective studies on this topic in Malaysia. This study aimed to examine prospectively the effects of obesity in pregnancy and GWG, independent of GDM, on neonatal outcome. METHODS Pregnant mothers in the first trimester, who presented to health clinics in Kuching, were screened. Mothers with existing diabetes mellitus or GDM were excluded using 75-g oral glucose tolerance test during the first and second trimesters. Participants with the first trimester BMI ≥ 23 kg/m2 were recruited as overweight/obese group, whereas those with BMI 18.5-22.9 kg/m2 were taken as the comparison group. At every trimester visit, mothers' weights were recorded. Babies' birth weight and occurrence of adverse neonatal outcome were documented. RESULTS There were 123 mothers recruited as overweight/obese group (mean BMI 29.0 kg/m2 ± 4.45) and 102 mothers as comparison group (mean BMI 20.4 kg/m2 ± 1.48). The number of low birth weight was similar between groups: 9.8% in overweight/obese group, 6.9% in the comparison group (p = 0.416). More than half of these babies were born to mothers with inadequate GWG (58.3% in obese group vs. 57.1% in control group, p = 0.077). There was no significant difference in the mean birth weight (3000 g ± 454.5 vs. 3038 g ± 340.8, p = 0.471), preterm delivery (8.13% vs. 3.92%, p = 0.193), and admission rate to neonatal intensive care unit (8.13% vs. 7.85%, p = 0.937) between groups. There was a positive correlation between the total GWG in overweight/obese group on baby's weight (r = 0.222, p = 0.013). Inadequate GWG was not correlated with lower birth weight (p = 0.052). CONCLUSIONS Obesity in pregnancy was not associated with poor neonatal outcome in this small sample of women in Malaysia. Total GWG showed a weak correlation with baby's birth weight in overweight/obese group.
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Affiliation(s)
- Huai Heng Loh
- Faculty of Medicine and Health SciencesUniversiti Malaysia SarawakMalaysia
| | - Haslinda Taipin
- Malaysia Ministry of Health Training InstituteKota KinabaluSabahMalaysia
| | - Asri Said
- Faculty of Medicine and Health SciencesUniversiti Malaysia SarawakMalaysia
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15
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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.
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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.
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16
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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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17
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Wu Y, Wan S, Gu S, Mou Z, Dong L, Luo Z, Zhang J, Hua X. Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study. BMJ Open 2020; 10:e038187. [PMID: 32878761 PMCID: PMC7470642 DOI: 10.1136/bmjopen-2020-038187] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To assess the associations of gestational weight gain (GWG) in early and late pregnancy with subsequent risks of adverse pregnancy outcomes in Chinese women. DESIGN Prospective cohort study. SETTING Shanghai, China. PARTICIPANTS We studied 2630 nulliparous singleton pregnant women with complete data on weight gain in early (≤17 weeks of gestation) and late (>17 weeks) pregnancy in the Shanghai Birth Cohort. METHODS GWG was standardised into z-scores by gestational age and categorised as low (z-score <-1), normal (-1 to +1) and high (>1). The adjusted relative risks (aRRs) and 95%CIs were estimated through log-binomial regression models. Interaction effects between GWG and some other adjustment factors were tested, further stratified analyses were performed separately where interaction terms were significant. OUTCOME MEASURES Adverse maternal and neonatal outcomes. RESULTS Independent from GWG in late pregnancy, higher GWG in early pregnancy was associated with higher risks of gestational diabetes mellitus (aRR: 1.66; 95% CI: 1.11 to 2.48), caesarean section (aRR: 1.21; 95% CI: 1.05 to 1.39) and prolonged hospitalisation (aRR: 1.56; 95% CI: 1.03 to 2.38). Higher GWG in late pregnancy was independently associated with higher risks of caesarean section (aRR: 1.24; 95% CI: 1.09 to 1.41), large for gestational age (aRR: 2.01; 95% CI: 1.50 to 2.7) and macrosomia (aRR: 1.90; 95% CI: 1.30 to 2.78). In addition, the risk of gestational hypertension increased significantly with increased total GWG (aRR: 1.78; 95% CI: 1.14 to 2.76). The effects of GWG in late pregnancy on maternal and neonatal outcomes were significantly different between the women bearing a female and the women bearing male fetus. CONCLUSION The GWG associations with adverse pregnancy outcomes differ at early and late pregnancy, and there may be effect modification by fetal sex in the association of GWG in late pregnancy with some pregnancy outcomes.
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Affiliation(s)
- Yuelin Wu
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Shanghai, China
| | - Sheng Wan
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Shanghai, China
| | - Shengyi Gu
- Department of Obstetrics and Gynaecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengqian Mou
- Department of Obstetrics and Gynaecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lingling Dong
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Shanghai, China
| | - Zhongcheng Luo
- Obstetrics and Gynaecology, Mount Sinai Hospital, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
| | - Jun Zhang
- Department of Obstetrics and Gynaecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaolin Hua
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Shanghai, China
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Liang Z, Liu H, Wang L, Song Q, Sun D, Li W, Leng J, Gao R, Hu G, Qi L. Maternal Gestational Diabetes Mellitus Modifies the Relationship Between Genetically Determined Body Mass Index During Pregnancy and Childhood Obesity. Mayo Clin Proc 2020; 95:1877-1887. [PMID: 32861332 PMCID: PMC7672776 DOI: 10.1016/j.mayocp.2020.04.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/29/2020] [Accepted: 04/10/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To analyze the interactions between maternal gestational diabetes mellitus (GDM) and genetically determined maternal body mass index (BMI) during pregnancy on offspring childhood obesity. RESEARCH DESIGN AND METHODS A total of 1114 Chinese mother-child pairs (560 GDM and 554 non-GDM) were included between August 2009 and July 2011. Maternal genetic risk score (GRS) of BMI during pregnancy was derived on the basis of 12 single nucleotide polymorphisms identified from a genome-wide association study. Offspring's BMI, BMI-for-age z score, weight, weight-for-age z score, waist circumference, sum of skinfolds, and body fat percentage during childhood were measured or calculated. RESULTS Maternal GRS of BMI during pregnancy significantly interacted with maternal GDM status on childhood risks of overweight and obesity (all P for interaction <.05). After multivariable adjustment, per unit of GRS was associated with a 24% (P<.001) and a 28% (P<.001) increased risk of overweight and obesity among children of GDM mothers, whereas no significant associations were observed among children of mothers without GDM. In addition, per unit GRS of BMI during pregnancy was significantly associated with 0.16 kg/m2 higher BMI (P=.002), 0.09 higher BMI-for-age z score (P=.002), 0.24 kg higher weight (P=.04), 0.06 higher weight-for-age z score (P=.02), 0.28 cm higher waist circumference (P=.03), 0.94 mm higher sum of skinfolds (P=.004), and 0.37% higher body fat percentage (P=.03) among children of GDM mothers. There were no significant associations between maternal GRS of BMI during pregnancy and offspring's obesity-related outcomes among children of mothers without GDM. CONCLUSION Our findings for the first time indicate that maternal GDM status may modify the relation between genetically determined maternal BMI during pregnancy and offspring's obesity risk during childhood.
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Affiliation(s)
- Zhaoxia Liang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; Department of Obstetrical, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Huikun Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Leishen Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Qiying Song
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Dianjianyi Sun
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Weiqin Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Junhong Leng
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Ru Gao
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
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19
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Kislal S, Shook LL, Edlow AG. Perinatal exposure to maternal obesity: Lasting cardiometabolic impact on offspring. Prenat Diagn 2020; 40:1109-1125. [PMID: 32643194 DOI: 10.1002/pd.5784] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 06/25/2020] [Accepted: 07/05/2020] [Indexed: 12/11/2022]
Abstract
Evidence from epidemiological, clinical, and animal model studies clearly demonstrates that prenatal and lactational maternal obesity and high-fat diet consumption are associated with cardiometabolic morbidity in offspring. Fetal and offspring sex may be an important effect modifier. Adverse offspring cardiometabolic outcomes observed in the setting of maternal obesity include an increased risk for obesity, features of metabolic syndrome (hypertension, hyperglycemia and insulin resistance, hyperlipidemia, increased adiposity), and non-alcoholic fatty liver disease. This review article synthesizes human and animal data linking maternal obesity and high-fat diet consumption in pregnancy and lactation to adverse cardiometabolic outcomes in offspring. We review key mechanisms underlying skeletal muscle, adipose tissue, pancreatic, liver, and central brain reward programming in obesity-exposed offspring, and how such malprogramming contributes to offspring cardiometabolic morbidity.
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Affiliation(s)
- Sezen Kislal
- Vincent Center for Reproductive Biology, Massachusetts General Hospital Research Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lydia L Shook
- Division of Maternal-Fetal Medicine, Department of Ob/Gyn, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrea G Edlow
- Vincent Center for Reproductive Biology, Massachusetts General Hospital Research Institute, Massachusetts General Hospital, Boston, Massachusetts, USA.,Division of Maternal-Fetal Medicine, Department of Ob/Gyn, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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20
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Razaz N, Villamor E, Muraca GM, Bonamy AKE, Cnattingius S. Maternal obesity and risk of cardiovascular diseases in offspring: a population-based cohort and sibling-controlled study. Lancet Diabetes Endocrinol 2020; 8:572-581. [PMID: 32559473 DOI: 10.1016/s2213-8587(20)30151-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/09/2020] [Accepted: 04/12/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Maternal overweight and obesity might increase risks of adiposity and cardiovascular and metabolic diseases in offspring. We examined associations between maternal overweight and obesity severity and risk of cardiovascular diseases in young offspring. METHODS In this population-based cohort study, we used data from live singleton births recorded in the Swedish Medical Birth Register. We calculated maternal BMI in early pregnancy from self-reported height and weight measurements at the first prenatal visit. We used multivariable Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% CIs. We calculated the proportion of the associations mediated through known consequences of obesity that also predicted cardiovascular diseases and did family case-control analyses. FINDINGS We identified 2 230 115 live singleton infants (without congenital malformations) in Sweden registered between Jan 1, 1992, and Dec 31, 2016. Overall, 1741 (0·08%) offspring were diagnosed with a cardiovascular disease between ages 1 and 25 years. Cardiovascular disease rates by maternal BMI categories were 0·57 per 10 000 child-years (BMI 18·5-24·9 kg/m2; normal weight), 0·61 per 10 000 child-years (25·0-29·9 kg/m2; overweight), 0·67 per 10 000 child-years (30·0-34·9 kg/m2; obesity grade I), 1·02 per 10 000 child-years (35·0-39·9 kg/m2; obesity grade II), and 1·38 per 10 000 child-years (≥40·0 kg/m2; obesity grade III). Compared with offspring of mothers with normal BMI, HRs of cardiovascular diseases were 1·10 (95% CI 0·97-1·25) for overweight, 1·16 (0·95-1·43) for obesity grade I, 1·84 (1·36-2·49) for obesity grade II, and 2·51 (1·60-3·92) for obesity grade III. Risks of cerebrovascular diseases increased with maternal obesity severity and were partly mediated through asphyxia-related neonatal complications. The sibling-cohort analysis also indicated a positive trend between maternal BMI and cardiovascular disease rates. INTERPRETATIONS Our findings indicate that maternal obesity might be a risk factor for cardiovascular diseases in childhood and early adulthood. These results need to be replicated and possible underlying mechanisms identified. FUNDING Swedish Research Council for Health, Working Life and Welfare.
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Affiliation(s)
- Neda Razaz
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
| | - Eduardo Villamor
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Giulia M Muraca
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Anna-Karin Edstedt Bonamy
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Sachs' Children's and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Sven Cnattingius
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
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21
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Boone-Heinonen J, Biel FM, Marshall NE, Snowden JM. Maternal prepregnancy BMI and size at birth: race/ethnicity-stratified, within-family associations in over 500,000 siblings. Ann Epidemiol 2020; 46:49-56.e5. [PMID: 32448735 PMCID: PMC7315911 DOI: 10.1016/j.annepidem.2020.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 11/19/2019] [Accepted: 04/27/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To estimate racial/ethnic-stratified effects of maternal prepregnancy BMI on size for gestational age at birth, by comparing siblings within families. METHODS This study examined linked vital statistics and patient discharge data from 580,960 infants born to 278,770 women in the State of California (2007-2012). To control for family-level confounding, we used fixed effects multinomial regression, modeling size for gestational age (small [SGA], appropriate, large [LGA]) as a function of maternal BMI (underweight, normal weight, overweight, obesity class I, II, III) and time-varying covariates. We conducted overall and race/ethnicity-stratified (non-Hispanic white, black, Asian; Hispanic) analyses. For comparison, we fit analogous random effects models, which do not control for family-level confounding. RESULTS In fixed effects models, maternal BMI was most strongly associated with LGA in non-Hispanic white women, reaching 6.7 times greater for class III obesity (OR [95% CI]: 6.7 [5.1, 8.7]); and weakest in black women (OR [95% CI]: 3.0 [1.5, 5.7]). Associations with SGA were similar across race/ethnicity. Compared with random effects estimates, fixed effects were most attenuated for LGA associations among racial/ethnic minority women. CONCLUSIONS Maternal prepregnancy BMI was differentially associated with size for gestational age across racial/ethnic groups, with the strongest family-level confounding in racial/ethnic minority women.
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Affiliation(s)
| | - Frances M Biel
- Oregon Health & Science University, School of Public Health, Portland, OR
| | - Nicole E Marshall
- Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR
| | - Jonathan M Snowden
- Oregon Health & Science University, School of Public Health, Portland, OR; Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR
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22
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Nyasordzi J, Penczynski K, Remer T, Buyken AE. Early life factors and their relevance to intima-media thickness of the common carotid artery in early adulthood. PLoS One 2020; 15:e0233227. [PMID: 32428029 PMCID: PMC7237005 DOI: 10.1371/journal.pone.0233227] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/30/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Early life factors may predispose an offspring to cardiovascular disease in later life; relevance of these associations may extend to ‟healthy" people in Western populations. We examined the prospective associations between early life factors and adult carotid intima-media thickness (IMT), a surrogate marker of atherosclerosis, in a healthy German population. METHODS We studied term participants (n = 265) of the DONALD Study, with bilateral sonographic measurements of IMT (4-8 measurements on both left and right carotid artery) at age 18-40 years and prospectively collected data on early life factors (maternal and paternal age at child birth, birth weight, gestational weight gain and full breastfeeding (>17weeks). Mean IMT values were averaged from mean values of both sides. Associations between early life factors and adult IMT were analyzed using multivariable linear regression models with adjustment for potential confounders. RESULTS Adult mean IMT was 0.56mm, SD 0.03, (range: 0.41 mm-0.78 mm). Maternal age at child birth was of relevance for adult IMT, which was sex specific: Advanced maternal age at child birth was associated with an increased adult IMT among female offspring only (β 0.03, SE 0.009 mm/decade, P = 0.003), this was not affected by adult waist circumference, BMI or blood pressure. Other early life factors were not relevant for IMT levels in males and females. CONCLUSION This study suggests that advanced maternal age at child birth is of prospective relevance for adult IMT levels in a healthy German population and this association may be of adverse relevance for females only.
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Affiliation(s)
- Juliana Nyasordzi
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Paderborn, Germany
- University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Katharina Penczynski
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Paderborn, Germany
| | - Thomas Remer
- DONALD Study Dortmund, Department of Nutrition and Food Sciences (IEL), Nutritional Epidemiology, University of Bonn, Dortmund, Germany
| | - Anette E. Buyken
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Paderborn, Germany
- * E-mail:
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23
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Salazar-Gutiérrez L, González-Stager MA, Pastén-Dué G, Rodríguez-Fernández A, Parra-Flores J, Maury-Sintjago E. Association between high pre-pregnancy body mass index, excess gestational weight gain, and poor breastfeeding with overweight in 3-4-year-old Chilean children. Nutrition 2020; 77:110786. [PMID: 32283342 DOI: 10.1016/j.nut.2020.110786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/30/2019] [Accepted: 02/03/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this study was to determine the association between prepregnancy body mass, gestational weight gain, and inadequate breastfeeding (BF) with overweight in Chilean children ages 3 to 4 y. METHODS This was an analytical and cross-sectional study with 560 participants. Age, residence, BF, and weight gain information were collected from child care records. The children's nutritional status (NS) was determined according to the weight-for-height z-score for sex. Bivariate relationships were evaluated by the χ2 test, and a multivariate logistic regression model was applied with the Stata version 15 software at α < 0.05. RESULTS Prepregnancy NS values were 37% normal and 63% overweight. Excess weight gain occurred in 75% of the mothers. The children's NS was related to the duration of BF (P = 0.002), prepregnancy NS (P = 0.002), and weight gain (P = 0.004). When adjusting the logistic regression model for sex and maternal age, the overweight prepregnancy NS increased up to twice the risk for OW in children (odds ratio [OR], 2; 95% confidence interval [CI], 1.3-4.1), as well as excess weight gain (OR, 2.3; 95% CI, 1.5-5.9), and non-exclusive BF (OR, 2.4; 95% CI, 1.3-4.4). CONCLUSION Children showing risk factors such as non-exclusive BF, prepregnancy NS with overweight, and excess gestational weight gain faced between 2 and 2.4 times more risk for overweight than children without these factors.
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Affiliation(s)
| | | | - Gustavo Pastén-Dué
- Departamento de Nutrición y Salud Pública, Universidad del Bío-Bío, Chillán, Ñuble, Chile
| | | | - Julio Parra-Flores
- Departamento de Nutrición y Salud Pública, Universidad del Bío-Bío, Chillán, Ñuble, Chile
| | - Eduard Maury-Sintjago
- Departamento de Nutrición y Salud Pública, Universidad del Bío-Bío, Chillán, Ñuble, Chile.
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24
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Molecular and Lifestyle Factors Modulating Obesity Disease. Biomedicines 2020; 8:biomedicines8030046. [PMID: 32121611 PMCID: PMC7148479 DOI: 10.3390/biomedicines8030046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/25/2020] [Accepted: 02/28/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity adversely affects bone health by means of multiple mechanisms, e.g., alterations in bone-regulating hormones, inflammation, and oxidative stress. Substantial evidence supports the relationship between adiposity and bone disorders in overweight/obese individuals. It is well known that the balance between mutually exclusive differentiation of progenitor cells into osteoblasts or adipocytes is controlled by different agents, including growth factors, hormones, genetic and epigenetic factors. Furthermore, an association between vitamin D deficiency and obesity has been reported. On the other hand, regular physical activity plays a key role in weight control, in the reduction of obesity-associated risks and promotes osteogenesis. The aim of this review is to highlight relevant cellular and molecular aspects for over-weight containment. In this context, the modulation of progenitor cells during differentiation as well as the role of epigenetics and microbiota in obesity disease will be discussed. Furthermore, lifestyle changes including an optimized diet as well as targeted physical activity will be suggested as strategies for the treatment of obesity disease.
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25
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Dodd JM, Deussen AR, Louise J. A Randomised Trial to Optimise Gestational Weight Gain and Improve Maternal and Infant Health Outcomes through Antenatal Dietary, Lifestyle and Exercise Advice: The OPTIMISE Randomised Trial. Nutrients 2019; 11:nu11122911. [PMID: 31810217 PMCID: PMC6949931 DOI: 10.3390/nu11122911] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 01/06/2023] Open
Abstract
There are well-recognised associations between excessive gestational weight gain (GWG) and adverse pregnancy outcomes, including an increased risk of pre-eclampsia, gestational diabetes and caesarean birth. The aim of the OPTIMISE randomised trial was to evaluate the effect of dietary and exercise advice among pregnant women of normal body mass index (BMI), on pregnancy and birth outcomes. The trial was conducted in Adelaide, South Australia. Pregnant women with a body mass index in the healthy weight range (18.5–24.9 kg/m2) were enrolled in a randomised controlled trial of a dietary and lifestyle intervention versus standard antenatal care. The dietitian-led dietary and lifestyle intervention over the course of pregnancy was based on the Australian Guide to Healthy Eating. Baseline characteristics of women in the two treatment groups were similar. There was no statistically significant difference in the proportion of infants with birth weight above 4.0 kg between the Lifestyle Advice and Standard Care groups (24/316 (7.59%) Lifestyle Advice versus 26/313 (8.31%) Standard Care; adjusted risk ratio (aRR) 0.91; 95% confidence interval (CI) 0.54 to 1.55; p = 0.732). Despite improvements in maternal diet quality, no significant differences between the treatment groups were observed for total GWG, or other pregnancy and birth outcomes.
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Affiliation(s)
- Jodie M. Dodd
- Discipline of Obstetrics & Gynaecology, and Robinson Research Institute, The University of Adelaide, Adelaide, SA 5006, Australia; (A.R.D.); (J.L.)
- Department of Perinatal Medicine Women’s and Children’s Hospital, North Adelaide, Adelaide, SA 5006, Australia
- Correspondence:
| | - Andrea R. Deussen
- Discipline of Obstetrics & Gynaecology, and Robinson Research Institute, The University of Adelaide, Adelaide, SA 5006, Australia; (A.R.D.); (J.L.)
| | - Jennie Louise
- Discipline of Obstetrics & Gynaecology, and Robinson Research Institute, The University of Adelaide, Adelaide, SA 5006, Australia; (A.R.D.); (J.L.)
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Larqué E, Labayen I, Flodmark CE, Lissau I, Czernin S, Moreno LA, Pietrobelli A, Widhalm K. From conception to infancy - early risk factors for childhood obesity. Nat Rev Endocrinol 2019; 15:456-478. [PMID: 31270440 DOI: 10.1038/s41574-019-0219-1] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2019] [Indexed: 12/25/2022]
Abstract
Maternal lifestyle during pregnancy, as well as early nutrition and the environment infants are raised in, are considered relevant factors for the prevention of childhood obesity. Several models are available for the prediction of childhood overweight and obesity, yet most have not been externally validated. Moreover, the factors considered in the models differ among studies as the outcomes manifest after birth and depend on maturation processes that vary between individuals. The current Review examines and interprets data on the early determinants of childhood obesity to provide relevant strategies for daily clinical work. We evaluate a selection of prenatal and postnatal factors associated with child adiposity. Actions to be considered for preventing childhood obesity include the promotion of healthy maternal nutrition and weight status at reproductive age and during pregnancy, as well as careful monitoring of infant growth to detect early excessive weight gain. Paediatricians and other health-care professionals should provide scientifically validated, individual nutritional advice to families to counteract excessive adiposity in children. Based on systematic reviews, original papers and scientific reports, we provide information to help with setting up public health strategies to prevent overweight and obesity in childhood.
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Affiliation(s)
- Elvira Larqué
- Department of Physiology, University of Murcia, Murcia, Spain
| | - Idoia Labayen
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD) and Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Carl-Erik Flodmark
- Childhood Obesity Unit, Department of Pediatrics, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences, Faculty of Medicine, University of Lund, Lund, Sweden
| | - Inge Lissau
- Childhood Obesity Unit, Department of Pediatrics, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences, Faculty of Medicine, University of Lund, Lund, Sweden
- Clinical Research Centre, University Hospital Copenhagen, Hvidovre, Denmark
| | - Sarah Czernin
- Deptartment of Pediatrics, Division of Nutrition and Metabolism and Austrian Academic institute for Clinical Nutrition, Vienna, Austria
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, Universidad de Zaragoza, Zaragoza, Spain.
- Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
| | - Angelo Pietrobelli
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Kurt Widhalm
- Deptartment of Pediatrics, Division of Nutrition and Metabolism and Austrian Academic institute for Clinical Nutrition, Vienna, Austria
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Mărginean C, Mărginean CO, Bănescu C, Meliţ LE, Tripon F, Iancu M. The relationship among GNB3 rs5443, PNPLA3 rs738409, GCKR rs780094 gene polymorphisms, type of maternal gestational weight gain and neonatal outcomes (STROBE-compliant article). Medicine (Baltimore) 2019; 98:e16414. [PMID: 31305457 PMCID: PMC6641780 DOI: 10.1097/md.0000000000016414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The gestational weight gain is determined by food habits, environmental and genetic factors.The aims of this paper were to establish relationships between maternal gene polymorphisms (patatin-like phospholipase domain-containing protein 3 rs738409 [PNPLA3 rs738409], glucokinase regulatory protein rs780094 [GCKR rs780094], and guanine nucleotide-binding protein rs5443 [GNB3 rs5443]) and mothers' gestational weight gain, but also neonatal outcomes (birth weight, length, and ponderal index [PI]).We performed a cross-sectional study in a sample of 158 mothers and their product of conception' in an Obstetrics-Gynecology Clinic from Romania. We divided the pregnant women according to the Institute of Medicine recommendations into 3 subgroups: (1) insufficient gestational weight gain; (2) normal gestational weight gain; and (3) excessive gestational weight gain.The gestational weight gain among pregnant women included in this study was classified as insufficient (10.1%), normal (31%), and excessive (58.9%). We found a tendency towards statistical significance for mothers that were overweight or obese before pregnancy to present an excessive gestational weight gain as compared to the normal weight ones. Similarly, we identified a tendency for statistical significance regarding the association between the variant genotype of GNB3 rs5443 and excessive gestational weight gain. We noticed differences that tended to be statistical significant concerning aspartate aminotransferase values between the 3 subgroups, mothers with excessive gestational weight gain having higher values than mothers with normal gestational weight gain (median, IQR: 22.89[17.53; 31.59] for mothers with excessive gestational weight gain versus 22.71[18.58; 27.37] for mothers with normal gestational weight gain). In mothers with excessive gestational weight gain, we found a significant association between the variant genotype of PNPLA3 rs738409 polymorphism and neonatal PI noticing a decrease of this index in case of newborns from mothers carrying the variant genotype.Excessive gestational weight gain was noticed in pregnant women that were obese and overweight before pregnancy. We found a positive association between the variant genotype of GNB3 rs5443 polymorphism and excessive gestational weight gain. Similarly, the presence of variant genotype of PNPLA3 rs738409 in mothers was associated with a lower PI in their newborns. Our study pointed out the most important factors that influence gestational weight gain and related birth outcomes.
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Affiliation(s)
| | - Cristina Oana Mărginean
- Department of Pediatrics, University of Medicine, Pharmacy, Sciences and Technology Târgu Mureş
| | - Claudia Bănescu
- Genetics Laboratory, Center for Advanced Medical and Pharmaceutical Research, University of Medicine, Pharmacy, Sciences and Technology Târgu Mureş
| | - Lorena Elena Meliţ
- Department of Pediatrics, University of Medicine, Pharmacy, Sciences and Technology Târgu Mureş
| | - Florin Tripon
- Genetics Laboratory, Center for Advanced Medical and Pharmaceutical Research, University of Medicine, Pharmacy, Sciences and Technology Târgu Mureş
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, Iuliu Haţieganu University of Medicine and Pharmacy Cluj Napoca, Romania
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28
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Hawkins SS, Baum CF, Rifas-Shiman SL, Oken E, Taveras EM. Examining Associations between Perinatal and Postnatal Risk Factors for Childhood Obesity Using Sibling Comparisons. Child Obes 2019; 15:254-261. [PMID: 30883194 PMCID: PMC6622557 DOI: 10.1089/chi.2018.0335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: One of the major criticisms of observational studies examining risk factors for childhood obesity is unmeasured confounding. We examined the associations between breastfeeding initiation, cesarean delivery, prenatal smoking, and gestational diabetes mellitus (GDM) with childhood obesity using both a traditional observational approach and a sibling-pair design with family fixed effects. Methods: We used data from the Linked the Collecting Electronic Nutrition Trajectory Data Using e-Records of Youth (CENTURY) Study, a clinical database created through the linkage of well-child visits with children's birth certificates, with obesity measured at 2 (N = 55,058) and 5 (N = 43,894) years of age. We conducted three sets of regression models: (1) full sample to examine the adjusted association between each risk factor and obesity with clustering by family; (2) rerun only among siblings with clustering by family; and (3) fixed effects analysis among siblings. Results: Across risk factors, 30%-39% of children had siblings. In the full sample, breastfeeding initiation was associated with a lower BMI z-score, while cesarean delivery and smoking during pregnancy were associated with a higher BMI z-score. Effect sizes were consistent in models with siblings only. However, in the fixed effects models, the coefficients attenuated and were no longer significant for each of these risk factors. We found no association between GDM and child BMI z-score in any of the models. Results were consistent for childhood obesity as a dichotomous measure and at 5 years of age. Conclusions: Our findings suggest that unmeasured genetic, environmental, and familial factors are likely confounding associations between breastfeeding, cesarean delivery, prenatal smoking, and GDM with childhood obesity in observational studies.
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Affiliation(s)
- Summer Sherburne Hawkins
- School of Social Work, Boston College, Chestnut Hill, MA.,Address correspondence to: Summer Sherburne Hawkins, PhD, MS, School of Social Work, Boston College, McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
| | - Christopher F. Baum
- School of Social Work, Boston College, Chestnut Hill, MA.,Department of Economics, Boston College, Chestnut Hill, MA.,Department of Macroeconomics, German Institute for Economic Research (DIW Berlin), Berlin, Germany
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Elsie M. Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA
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29
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Gupta V, Saxena R, Walia GK, Agarwal T, Vats H, Dunn W, Relton C, Sovio U, Papageorghiou A, Davey Smith G, Khadgawat R, Sachdeva MP. Gestational route to healthy birth (GaRBH): protocol for an Indian prospective cohort study. BMJ Open 2019; 9:e025395. [PMID: 31048433 PMCID: PMC6501957 DOI: 10.1136/bmjopen-2018-025395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/17/2018] [Accepted: 03/12/2019] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Pregnancy is characterised by a high rate of metabolic shifts from early to late phases of gestation in order to meet the raised physiological and metabolic needs. This change in levels of metabolites is influenced by gestational weight gain (GWG), which is an important characteristic of healthy pregnancy. Inadequate/excessive GWG has short-term and long-term implications on maternal and child health. Exploration of gestational metabolism is required for understanding the quantitative changes in metabolite levels during the course of pregnancy. Therefore, our aim is to study trimester-specific variation in levels of metabolites in relation to GWG and its influence on fetal growth and newborn anthropometric traits at birth. METHODS AND ANALYSIS A prospective longitudinal study is planned (start date: February 2018; end date: March 2023) on pregnant women that are being recruited in the first trimester and followed in subsequent trimesters and at the time of delivery (total 3 follow-ups). The study is being conducted in a hospital located in Bikaner district (66% rural population), Rajasthan, India. The estimated sample size is of 1000 mother-offspring pairs. Information on gynaecological and obstetric history, socioeconomic position, diet, physical activity, tobacco and alcohol consumption, depression, anthropometric measurements and blood samples is being collected for metabolic assays in each trimester using standardised methods. Mixed effects regression models will be used to assess the role of gestational weight in influencing metabolite levels in each trimester. The association of maternal levels of metabolites with fetal growth, offspring's weight and body composition at birth will be investigated using regression modelling. ETHICS AND DISSEMINATION The study has been approved by the ethics committees of the Department of Anthropology, University of Delhi and Sardar Patel Medical College, Rajasthan. We are taking written informed consent after discussing the various aspects of the study with the participants in the local language.
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Affiliation(s)
- Vipin Gupta
- Department of Anthropology, University of Delhi, Delhi, India
| | - Ruchi Saxena
- Department of Obstetrics and Gynaecology, Sardar Patel Medical College, Bikaner, Rajasthan, India
| | | | | | - Harsh Vats
- Department of Anthropology, University of Delhi, Delhi, India
| | - Warwick Dunn
- School of Biosciences, Phenome Centre Birmingham and Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Caroline Relton
- MRC Integrative Epidemiology Unit and Bristol Medical School, University of Bristol, Bristol, UK
| | - Ulla Sovio
- Obstetrics and Gyneacology, University of Cambridge, Cambridge, UK
| | - Aris Papageorghiou
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit and Bristol Medical School, University of Bristol, Bristol, UK
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Hutcheon JA, Stephansson O, Cnattingius S, Bodnar LM, Johansson K. Is the Association Between Pregnancy Weight Gain and Fetal Size Causal?: A Re-examination Using a Sibling Comparison Design. Epidemiology 2019; 30:234-242. [PMID: 30516650 PMCID: PMC6369897 DOI: 10.1097/ede.0000000000000959] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/27/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Observational cohort studies have consistently shown that maternal weight gain in pregnancy is positively associated with fetal size, but it is unknown whether the association is causal. This study investigated the effect of pregnancy weight gain on fetal growth using a sibling comparison design to control for unmeasured confounding by genetic and shared environmental factors. METHODS Our study population included 44,457 infants (21,680 women) with electronic medical records in the Stockholm-Gotland Obstetrical Database, 2008-2014. We standardized pregnancy weight gain into gestational age-specific z-scores. Fetal size was classified as birthweight (gram), and as small- and large-for-gestational-age birth (birthweight <10th or >90th percentiles, respectively). Our sibling comparison analyses used multivariable linear fixed effects models for birthweight and hybrid logistic fixed effects models for small- and large-for-gestational-age birth (SGA and LGA). We repeated analyses using conventional (unmatched) regression models. RESULTS Sibling comparison analyses showed a clinically meaningful association between weight gain and fetal size (e.g., adjusted difference of +89 g birthweight [95% CI = 82, 95 g]; adjusted risk ratios [aRR] for SGA of 0.80 [95% CI = 0.75, 0.86] per 1 z-score increase in weight gain for a woman of body mass index [BMI] = 25). These findings were consistent across the range of BMI. Estimates were only modestly attenuated compared with conventional approach (+97 g [95% CI = 92, 102 g], aRR for SGA of 0.70 [95% CI = 0.67, 0.73] per 1 z-score increase in weight gain). CONCLUSION The positive association between pregnancy weight gain and fetal size we found using a sibling comparison design suggests that this relation has minimal confounding by familial factors that remain constant between pregnancies.
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Affiliation(s)
- Jennifer A. Hutcheon
- From the Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - Olof Stephansson
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
- Division of Obstetrics and Gynecology, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Sven Cnattingius
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
| | - Lisa M. Bodnar
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Kari Johansson
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
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Liu J, Boghossian NS, Frongillo EA, Cai B, Hazlett LJ, Liu J. Associations of maternal gestational weight gain with the risk of offspring obesity and body mass index Z scores beyond the mean. Ann Epidemiol 2019; 32:64-71.e2. [PMID: 30799201 DOI: 10.1016/j.annepidem.2019.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 12/09/2018] [Accepted: 01/22/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE We examined the association of meeting the 2009 Institute of Medicine gestational weight gain (GWG) guidelines with offspring obesity and body mass index Z score (BMIZ) at age six overall and by maternal weight status. METHODS Data were from the Infant Feeding Practices Survey II Study (2005-2007) and their Year Six Follow-Up Study (2012). Logistic regression and quantile regression models were used. RESULTS Eleven percent of children were obese. Children born to mothers who gained excessive weight during pregnancy had an increased risk of obesity as compared with those born to mothers who gained adequate weight (adjusted odds ratio: 1.67). The association was stronger among normal-weight mothers (adjusted odds ratio: 3.50). Inadequate GWG was not associated with offspring obesity overall or in subsamples by maternal prepregnancy BMI. Children born to mothers who gained excessive weight had higher BMIZ. This distributional association was more pronounced among normal-weight mothers. Children born to obese mothers who gained inadequate weight had lower BMIZ at some percentiles of the BMIZ distribution. CONCLUSIONS Excessive GWG was associated with increased risk of offspring obesity and higher BMIZ at age six, whereas inadequate GWG was protective of high BMIZ among children born to obese mothers.
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Affiliation(s)
- Junxiu Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Nansi S Boghossian
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia
| | - Bo Cai
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Linda J Hazlett
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia.
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32
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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.
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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.
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Briffa JF, Wlodek ME, Moritz KM. Transgenerational programming of nephron deficits and hypertension. Semin Cell Dev Biol 2018; 103:94-103. [PMID: 29859996 DOI: 10.1016/j.semcdb.2018.05.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/28/2018] [Accepted: 05/29/2018] [Indexed: 01/16/2023]
Abstract
Exposure to a sub-optimal environment in the womb can result in poor fetal growth and impair the normal development of organs. The kidney, specifically the process of nephrogenesis, has been shown to be impacted by many common pregnancy exposures including an inadequate diet, poor placental function, maternal stress as well as maternal smoking and alcohol consumption. This can result in offspring being born with a reduced nephron endowment, which places these individuals at increased risk of hypertension and chronic kidney disease (CKD). Of recent interest is whether this disease risk can be passed on to subsequent generations and, if so, what are the mechanisms and pathways involved. In this review, we highlight the growing body of evidence that a low birth weight and hypertension, which are both major risk factors for cardiovascular and CKD, can be transmitted across generations. However, as yet there is little data as to whether a low nephron endowment contributes to this disease transmission. The emerging data suggests transmission can occur both through both the maternal and paternal lines, which likely involves epigenetic mechanisms such chromatin remodelling (DNA methylation and histone modification) and non-coding RNA modifications. In addition, females who were born small and/or have a low nephron endowment are at an increased risk for pregnancy complications, which can influence the growth and development of the next generation. Future animal studies in this area should include examining nephron endowment across multiple generations and determining adult renal function. Clinically, long term follow-up studies of large birth cohorts need to be undertaken to more clearly determine the impact a sub-optimal environment in one generation has on the health outcomes in the second, and subsequent, generation.
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Affiliation(s)
- Jessica F Briffa
- Department of Physiology, The University of Melbourne, Parkville, VIC, Australia
| | - Mary E Wlodek
- Department of Physiology, The University of Melbourne, Parkville, VIC, Australia
| | - Karen M Moritz
- Child Health Research Centre and School of Biomedical Sciences, The University of Queensland, St. Lucia, QLD, Australia.
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34
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Warrington NM, Richmond R, Fenstra B, Myhre R, Gaillard R, Paternoster L, Wang CA, Beaumont RN, Das S, Murcia M, Barton SJ, Espinosa A, Thiering E, Atalay M, Pitkänen N, Ntalla I, Jonsson AE, Freathy R, Karhunen V, Tiesler CMT, Allard C, Crawford A, Ring SM, Melbye M, Magnus P, Rivadeneira F, Skotte L, Hansen T, Marsh J, Guxens M, Holloway JW, Grallert H, Jaddoe VWV, Lowe Jr WL, Roumeliotaki T, Hattersley AT, Lindi V, Pahkala K, Panoutsopoulou K, Standl M, Flexeder C, Bouchard L, Aagaard Nohr E, Marina LS, Kogevinas M, Niinikoski H, Dedoussis G, Heinrich J, Reynolds RM, Lakka T, Zeggini E, Raitakari OT, Chatzi L, Inskip HM, Bustamante M, Hivert MF, Jarvelin MR, Sørensen TIA, Pennell C, Felix JF, Jacobsson B, Geller F, Evans DM, Lawlor DA. Maternal and fetal genetic contribution to gestational weight gain. Int J Obes (Lond) 2018; 42:775-784. [PMID: 28990592 PMCID: PMC5784805 DOI: 10.1038/ijo.2017.248] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 08/27/2017] [Accepted: 09/03/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Clinical recommendations to limit gestational weight gain (GWG) imply high GWG is causally related to adverse outcomes in mother or offspring, but GWG is the sum of several inter-related complex phenotypes (maternal fat deposition and vascular expansion, placenta, amniotic fluid and fetal growth). Understanding the genetic contribution to GWG could help clarify the potential effect of its different components on maternal and offspring health. Here we explore the genetic contribution to total, early and late GWG. PARTICIPANTS AND METHODS A genome-wide association study was used to identify maternal and fetal variants contributing to GWG in up to 10 543 mothers and 16 317 offspring of European origin, with replication in 10 660 mothers and 7561 offspring. Additional analyses determined the proportion of variability in GWG from maternal and fetal common genetic variants and the overlap of established genome-wide significant variants for phenotypes relevant to GWG (for example, maternal body mass index (BMI) and glucose, birth weight). RESULTS Approximately 20% of the variability in GWG was tagged by common maternal genetic variants, and the fetal genome made a surprisingly minor contribution to explain variation in GWG. Variants near the pregnancy-specific beta-1 glycoprotein 5 (PSG5) gene reached genome-wide significance (P=1.71 × 10-8) for total GWG in the offspring genome, but did not replicate. Some established variants associated with increased BMI, fasting glucose and type 2 diabetes were associated with lower early, and higher later GWG. Maternal variants related to higher systolic blood pressure were related to lower late GWG. Established maternal and fetal birth weight variants were largely unrelated to GWG. CONCLUSIONS We found a modest contribution of maternal common variants to GWG and some overlap of maternal BMI, glucose and type 2 diabetes variants with GWG. These findings suggest that associations between GWG and later offspring/maternal outcomes may be due to the relationship of maternal BMI and diabetes with GWG.
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Affiliation(s)
- N M Warrington
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
| | - R Richmond
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - B Fenstra
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - R Myhre
- Norwegian Institute of Public Health, Oslo, Norway
| | - R Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - L Paternoster
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - C A Wang
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
| | - R N Beaumont
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, University of Exeter, Royal Devon and Exeter Hospital, Exeter, UK
| | - S Das
- Department of Public Health and Primary Care, School of Public Health, Imperial College London, London, UK
| | - M Murcia
- Epidemiology and Environmental Health Joint Research Unit, FISABIO–Universitat Jaume I–Universitat de València, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - S J Barton
- MRC Lifecourse Epidemiology Unit, Faulty of Medicine, University of Southampton, Southampton, UK
| | - A Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - E Thiering
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - M Atalay
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - N Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - I Ntalla
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - A E Jonsson
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, and Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - R Freathy
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, University of Exeter, Royal Devon and Exeter Hospital, Exeter, UK
| | - V Karhunen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - C M T Tiesler
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - C Allard
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada
| | - A Crawford
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - S M Ring
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- ALSPAC (Children of the 90s), School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - M Melbye
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
- Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - P Magnus
- Norwegian Institute of Public Health, Oslo, Norway
| | - F Rivadeneira
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - L Skotte
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - T Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, and Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Marsh
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
| | - M Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - J W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - H Grallert
- Institute of Epidemiology II, Research Unit of Molecular Epidemiology, Helmholtz Zentrum München Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- Clinical Cooperation Group Nutrigenomics and Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- Technische Universität München, Freising, Germany
| | - V W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - W L Lowe Jr
- Department of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - T Roumeliotaki
- Department of Social Medicine, University of Crete, Crete, Greece
| | - A T Hattersley
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, University of Exeter, Royal Devon and Exeter Hospital, Exeter, UK
| | - V Lindi
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - K Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland
| | - K Panoutsopoulou
- Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, UK
| | - M Standl
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
| | - C Flexeder
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
| | - L Bouchard
- Department of Biochemistry, Faculty of medicine and life sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - E Aagaard Nohr
- Public Health Division of Gipuzkoa, Basque Government, Vitoria-Gasteiz, Spain
| | - L Santa Marina
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Health Research Institute, Biodonostia, San Sebastián, Gipuzkoa, Spain
- Health Research Institute, Biodonostia, San Sebastián, Spain
| | - M Kogevinas
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - H Niinikoski
- Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - G Dedoussis
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - J Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - R M Reynolds
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - T Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - E Zeggini
- Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, UK
| | - O T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - L Chatzi
- Department of Social Medicine, University of Crete, Crete, Greece
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Social Medicine, University of Crete, Crete, Greece
- Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - H M Inskip
- MRC Lifecourse Epidemiology Unit, Faulty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - M Bustamante
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - M-F Hivert
- Department of Population Medicine at Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - M-R Jarvelin
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC–PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - T I A Sørensen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, and Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Epidemiology (formally the Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - C Pennell
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
| | - J F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - B Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway
| | - F Geller
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - D M Evans
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - D A Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
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35
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Gallagher D, Rosenn B, Toro-Ramos T, Paley C, Gidwani S, Horowitz M, Crane J, Lin S, Thornton J, Pi-Sunyer X. Greater Neonatal Fat-Free Mass and Similar Fat Mass Following a Randomized Trial to Control Excess Gestational Weight Gain. Obesity (Silver Spring) 2018; 26:578-587. [PMID: 29464905 PMCID: PMC5824435 DOI: 10.1002/oby.22079] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/25/2017] [Accepted: 10/30/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this study was to determine the effectiveness of controlling maternal gestational weight gain (GWG) in the second and third trimesters on neonate body composition. METHODS Two hundred ten healthy women with overweight (25 > BMI < 30) or obesity (BMI ≥ 30) were randomly assigned to a lifestyle intervention (LI) program focused on controlling GWG through nutrition and activity behaviors or to usual obstetrical care (UC). Infant fat and fat-free mass (FFM) at birth were measured by using air displacement plethysmography (PEA POD) and by using quantitative magnetic resonance (QMR). RESULTS At baseline, there were no between-group differences in maternal characteristics (mean [SD]): age: 33.8 (4.3) years, weight: 81.9 (13.7) kg, BMI: 30.4 (4.5), and gestational age at randomization: 14.9 (0.8) weeks. GWG was less in the LI group by 1.79 kg (P = 0.003) or 0.0501 kg/wk (P = 0.002). Compared with UC infants, LI infants had greater weight (131 ± 59 g P = 0.03), FFM (98 ± 45 g; P = 0.03) measured by PEA POD, and lean mass (105 ± 38 g; P = 0.006) measured by QMR. Fat mass and percent fat were not significantly different. CONCLUSIONS Intervening in women with overweight and obesity through behaviors promoting healthy diet and physical activity to control GWG resulted in neonates with similar fat and greater FFM.
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Affiliation(s)
- Dympna Gallagher
- New York Obesity Research Center, Dept. of Medicine, College of Physicians and Surgeons, Columbia University
- Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University
| | - Barak Rosenn
- Department Obstetrics and Gynecology, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine
| | - Tatiana Toro-Ramos
- New York Obesity Research Center, Dept. of Medicine, College of Physicians and Surgeons, Columbia University
| | - Charles Paley
- Department of Pediatrics, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine
| | - Sonia Gidwani
- Department of Pediatrics, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine
| | - Michelle Horowitz
- New York Obesity Research Center, Dept. of Medicine, College of Physicians and Surgeons, Columbia University
| | - Janet Crane
- New York Obesity Research Center, Dept. of Medicine, College of Physicians and Surgeons, Columbia University
| | - Susan Lin
- Center for Family and Community Medicine, Columbia University
| | | | - Xavier Pi-Sunyer
- New York Obesity Research Center, Dept. of Medicine, College of Physicians and Surgeons, Columbia University
- Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University
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Agarwal P, Morriseau TS, Kereliuk SM, Doucette CA, Wicklow BA, Dolinsky VW. Maternal obesity, diabetes during pregnancy and epigenetic mechanisms that influence the developmental origins of cardiometabolic disease in the offspring. Crit Rev Clin Lab Sci 2018; 55:71-101. [DOI: 10.1080/10408363.2017.1422109] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Prasoon Agarwal
- Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
| | - Taylor S. Morriseau
- Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
| | - Stephanie M. Kereliuk
- Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
| | - Christine A. Doucette
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
- Department of Physiology & Pathophysiology, University of Manitoba, Winnipeg, Canada
| | - Brandy A. Wicklow
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada
| | - Vernon W. Dolinsky
- Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
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Extravascular renal denervation ameliorates juvenile hypertension and renal damage resulting from experimental hyperleptinemia in rats. J Hypertens 2017; 35:2537-2547. [DOI: 10.1097/hjh.0000000000001472] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Groth SW, Holland ML, Smith JA, Meng Y, Kitzman H. Effect of Gestational Weight Gain and Prepregnancy Body Mass Index in Adolescent Mothers on Weight and Body Mass Index of Adolescent Offspring. J Adolesc Health 2017; 61:626-633. [PMID: 28711316 PMCID: PMC5654683 DOI: 10.1016/j.jadohealth.2017.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 04/26/2017] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of the study was to examine the association of the gestational weight gain and prepregnancy body mass index (BMI) of low-income adolescent mothers with the risk of their children being overweight and/or obese in late adolescence. METHODS Study subjects were low-income, primiparous adolescents (n = 360) who self-identified as black and participated in the New Mothers Study in Memphis, Tennessee, and their children. Gestational weight gain was examined as a continuous variable and also categorized into overgain, recommended gain, and undergain following the 2009 Institute of Medicine guidelines. The effects of maternal prepregnancy BMI percentiles and calculated BMI were also considered. Multivariable logistic and linear regression models were used. The main outcome measures were offspring overweight, obesity, and BMI. RESULTS Thirty-nine percent of offspring were overweight or obese. Higher maternal gestational weight gain increased the risk for offspring overweight and obesity. There was an interaction between gestational weight gain and prepregnancy BMI: offspring of mothers with a BMI percentile ≤76 were at greater risk of obesity with higher maternal weight gain. If mothers with a BMI percentile between the 29th and 83rd percentiles overgained, offspring were at greater risk for overweight. Using calculated BMIs, if a mother's BMI was ≤26 kg/m2, offspring risk for obesity was greater with higher gestational weight gain. CONCLUSIONS High gestational weight gain had a larger effect on offspring overweight and obesity if maternal prepregnancy BMI percentile was ≤76. The gestational weight gain of primiparous adolescents who self-identified as black had an effect on offspring weight.
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Affiliation(s)
- Susan W Groth
- School of Nursing, University of Rochester, Rochester, New York.
| | - Margaret L Holland
- School of Nursing, Yale University, P. O. Box 27399, West Haven, CT 06516-7399, USA
| | - Joyce A Smith
- University of Rochester, School of Nursing 601 Elmwood Ave., Box SON, Rochester, NY 14642, USA
| | - Ying Meng
- University of Rochester, School of Nursing 601 Elmwood Ave., Box SON, Rochester, NY 14642, USA
| | - Harriet Kitzman
- University of Rochester, School of Nursing 601 Elmwood Ave., Box SON, Rochester, NY 14642, USA
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The importance of gene-environment interactions in human obesity. Clin Sci (Lond) 2017; 130:1571-97. [PMID: 27503943 DOI: 10.1042/cs20160221] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/23/2016] [Indexed: 12/16/2022]
Abstract
The worldwide obesity epidemic has been mainly attributed to lifestyle changes. However, who becomes obese in an obesity-prone environment is largely determined by genetic factors. In the last 20 years, important progress has been made in the elucidation of the genetic architecture of obesity. In parallel with successful gene identifications, the number of gene-environment interaction (GEI) studies has grown rapidly. This paper reviews the growing body of evidence supporting gene-environment interactions in the field of obesity. Heritability, monogenic and polygenic obesity studies provide converging evidence that obesity-predisposing genes interact with a variety of environmental, lifestyle and treatment exposures. However, some skepticism remains regarding the validity of these studies based on several issues, which include statistical modelling, confounding, low replication rate, underpowered analyses, biological assumptions and measurement precision. What follows in this review includes (1) an introduction to the study of GEI, (2) the evidence of GEI in the field of obesity, (3) an outline of the biological mechanisms that may explain these interaction effects, (4) methodological challenges associated with GEI studies and potential solutions, and (5) future directions of GEI research. Thus far, this growing body of evidence has provided a deeper understanding of GEI influencing obesity and may have tremendous applications in the emerging field of personalized medicine and individualized lifestyle recommendations.
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Ribaroff GA, Wastnedge E, Drake AJ, Sharpe RM, Chambers TJG. Animal models of maternal high fat diet exposure and effects on metabolism in offspring: a meta-regression analysis. Obes Rev 2017; 18:673-686. [PMID: 28371083 PMCID: PMC5434919 DOI: 10.1111/obr.12524] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/23/2017] [Accepted: 01/23/2017] [Indexed: 01/28/2023]
Abstract
Animal models of maternal high fat diet (HFD) demonstrate perturbed offspring metabolism although the effects differ markedly between models. We assessed studies investigating metabolic parameters in the offspring of HFD fed mothers to identify factors explaining these inter-study differences. A total of 171 papers were identified, which provided data from 6047 offspring. Data were extracted regarding body weight, adiposity, glucose homeostasis and lipidaemia. Information regarding the macronutrient content of diet, species, time point of exposure and gestational weight gain were collected and utilized in meta-regression models to explore predictive factors. Publication bias was assessed using Egger's regression test. Maternal HFD exposure did not affect offspring birthweight but increased weaning weight, final bodyweight, adiposity, triglyceridaemia, cholesterolaemia and insulinaemia in both female and male offspring. Hyperglycaemia was found in female offspring only. Meta-regression analysis identified lactational HFD exposure as a key moderator. The fat content of the diet did not correlate with any outcomes. There was evidence of significant publication bias for all outcomes except birthweight. Maternal HFD exposure was associated with perturbed metabolism in offspring but between studies was not accounted for by dietary constituents, species, strain or maternal gestational weight gain. Specific weaknesses in experimental design predispose many of the results to bias.
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Affiliation(s)
- G A Ribaroff
- Edinburgh Medical School, Chancellor's Building, University of Edinburgh, Edinburgh, UK
| | - E Wastnedge
- NHS Lothian, University Hospitals Division, Royal Hospital for Sick Children, Edinburgh, UK
| | - A J Drake
- NHS Lothian, University Hospitals Division, Royal Hospital for Sick Children, Edinburgh, UK.,University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - R M Sharpe
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - T J G Chambers
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.,NHS Lothian, University Hospitals Division, Metabolic Unit, Western General Hospital, Edinburgh, UK
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Puma JE, Thompson D, Baer K, Haemer MA, Gilbert K, Hambidge M, Krebs NF. Enhancing Periconceptional Health by Targeting Postpartum Mothers at Rural WIC Clinics. Health Promot Pract 2017; 19:390-399. [PMID: 28438036 DOI: 10.1177/1524839917699553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The overall goal of this pilot quality improvement (QI) intervention was to (1) assess the feasibility of making a WIC (Women, Infants, and Children) systems-level change that added measurement of maternal weight and discussion of maternal health habits into each postpartum maternal and offspring visit in rural clinics in Colorado and (2) assess the impacts of the intervention on maternal diet, physical activity, and weight status. A mixed-method evaluation approach was used involving the collection of quantitative data (HeartSmartMoms usage reports, manual WIC chart reviews [to calculate screening rates], pre-/postsurveys, and weight status [body mass index]) and qualitative data (focus groups and project team meeting minutes). It was determined it is feasible to make a short-term systems-level change; however, many barriers were encountered in doing so, and the results were not sustained. The QI intervention did decrease participants' daily consumption of sugar-sweetened beverages and maternal weight status (controlling for maternal age and language), but did not improve any other eating/physical activity behaviors. Lessons learned and recommendations to improve the implementation of health promotion interventions aimed at improving postpartum maternal health, which can increase health during the periconceptional phase, and in turn, improve the health outcomes for a child, are discussed.
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Affiliation(s)
- Jini E Puma
- 1 University of Colorado Denver, Denver, CO, USA
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Kadawathagedara M, Kersuzan C, Wagner S, Tichit C, Gojard S, Charles MA, Lioret S, de Lauzon-Guillain B. Adéquation des consommations alimentaires des femmes enceintes de l’étude ELFE aux recommandations du Programme national nutrition santé. CAHIERS DE NUTRITION ET DE DIETETIQUE 2017. [DOI: 10.1016/j.cnd.2016.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ester WA, Houghton LC, Lumey LH, Michels KB, Hoek HW, Wei Y, Susser ES, Cohn BA, Terry MB. Maternal and Early Childhood Determinants of Women's Body Size in Midlife: Overall Cohort and Sibling Analyses. Am J Epidemiol 2017; 185:385-394. [PMID: 28200097 PMCID: PMC5391711 DOI: 10.1093/aje/kww222] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/18/2016] [Indexed: 12/12/2022] Open
Abstract
Observational evidence suggests that adult body size has its roots earlier in life, yet few life-course studies have data on siblings with which to control for family-level confounding. Using prospective data from the Early Determinants of Mammographic Density Study (n = 1,108; 1959-2008), we examined the association of maternal prepregnancy body mass index (BMI; weight (kg)/height (m)2), gestational weight gain (GWG), birth size, and childhood growth factors with adult BMI in daughters at midlife using quantile, linear, and logistic regression models. We compared overall cohort findings (n = 1,108) with sibling differences (n = 246 sibling sets). Results derived by all 3 regression methods supported positive and independent associations of prepregnancy BMI, GWG, and percentile change in early childhood growth with BMI in daughters at midlife. Sibling analyses demonstrated that higher GWG was independently related to a higher adult BMI in daughters, particularly for the highest 90th quantile of adult BMI (β = 0.64 (standard error, 0.26) BMI units). Greater increases in weight percentiles between 1 and 4 years of age within siblings were also associated with higher adult BMI in the 75th quantile (β = 0.06 (standard error, 0.03) kg). Thus, even after consideration of the role of family-level fixed effects, maternal GWG and childhood weight gain are associated with adult body size in midlife.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mary Beth Terry
- Correspondence to Dr. Mary Beth Terry, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032 (e-mail: )
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Houghton LC, Ester WA, Lumey LH, Michels KB, Wei Y, Cohn BA, Susser E, Terry MB. Maternal weight gain in excess of pregnancy guidelines is related to daughters being overweight 40 years later. Am J Obstet Gynecol 2016; 215:246.e1-246.e8. [PMID: 26901274 DOI: 10.1016/j.ajog.2016.02.034] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/03/2016] [Accepted: 02/13/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Exceeding the Institute of Medicine guidelines for pregnancy weight gain increases childhood and adolescent obesity. However, it is unknown if these effects extend to midlife. OBJECTIVE We sought to determine if exceeding the Institute of Medicine guidelines for pregnancy weight gain increases risk of overweight/obesity in daughters 40 years later. STUDY DESIGN This cohort study is based on adult offspring in the Child Health and Development Studies and the Collaborative Perinatal Project pregnancy cohorts originally enrolled in the 1960s. In 2005 through 2008, 1035 daughters in their 40s were recruited to the Early Determinants of Mammographic Density study. We classified maternal pregnancy weight gain as greater than vs less than or equal to the 2009 clinical guidelines. We used logistic regression to compare the odds ratios of daughters being overweight/obese (body mass index [BMI] ≥25) at a mean age of 44 years between mothers who did not gain or gained more than pregnancy weight gain guidelines, accounting for maternal prepregnant BMI, and daughter body size at birth and childhood. We also examined potential family related confounding through a comparison of sisters using generalized estimating equations, clustered on sibling units and adjusted for maternal age and race. RESULTS Mothers who exceeded guidelines for weight gain in pregnancy were more likely to have daughters who were overweight/obese in their 40s (odds ratio [OR], 3.4; 95% confidence interval {CI}, 2.0-5.7). This magnitude of association translates to a relative risk (RR) increase of 50% (RR = 1.5; 95% CI, 1.3-1.6). The association was of the same magnitude when examining only the siblings whose mother exceeded guidelines in 1 pregnancy and did not exceed the guidelines in the other pregnancy. The association was stronger with increasing maternal prepregnancy BMI (P trend < .001). Compared to mothers with BMI <25 who did not exceed guidelines, the relative risks (RR) for having an overweight/obese adult daughter were 1.3 (95% CI, 1.1-1.7), 1.7 (95% CI, 1.4-2.1) and 1.8 (95% CI, 1.5-2.1), respectively, if mothers exceeded guidelines and their prepregnancy BMI was <25, overweight (BMI 25-<30), or obese (BMI >30). This pattern held irrespective of daughters' weight status at birth, at age 4 years, or at age 20 years. CONCLUSION Our findings support that obesity prevention before pregnancy and strategies to maintain weight gain during pregnancy within the IOM guidelines might reduce the risk of being overweight in midlife for the offspring.
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Affiliation(s)
- L C Houghton
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722W 168th Street, New York, NY 10032, USA
| | - W A Ester
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722W 168th Street, New York, NY 10032, USA
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH, The Hague, The Netherlands
| | - L H Lumey
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722W 168th Street, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia Medical Center, New York, NY, USA
| | - K B Michels
- Obstetrics, and Gynecology Epidemiology Center, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Institute for Prevention and Cancer Epidemiology, University Medical Center Freiburg, University of Freiburg, Germany
| | - Y Wei
- Department of Biostatistics, Columbia University, Mailman School of Public Health, Street, New York, NY 10032, USA
| | - B A Cohn
- The Center for Research on Women and Children's Health, The Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA
| | - E Susser
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722W 168th Street, New York, NY 10032, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - M B Terry
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722W 168th Street, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia Medical Center, New York, NY, USA
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Mărginean C, Mărginean CO, Bănescu C, Meliţ L, Tripon F, Iancu M. Impact of demographic, genetic, and bioimpedance factors on gestational weight gain and birth weight in a Romanian population: A cross-sectional study in mothers and their newborns: the Monebo study (STROBE-compliant article). Medicine (Baltimore) 2016; 95:e4098. [PMID: 27399105 PMCID: PMC5058834 DOI: 10.1097/md.0000000000004098] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The present study had 2 objectives, first, to investigate possible relationships between increased gestational weight gain and demographic, clinical, paraclinical, genetic, and bioimpedance (BIA) characteristics of Romanian mothers, and second, to identify the influence of predictors (maternal and newborns characteristics) on our outcome birth weight (BW).We performed a cross-sectional study on 309 mothers and 309 newborns from Romania, divided into 2 groups: Group I-141 mothers with high gestational weight gain (GWG) and Group II-168 mothers with normal GWG, that is, control group.The groups were evaluated regarding demographic, anthropometric (body mass index [BMI], middle upper arm circumference, tricipital skinfold thickness, weight, height [H]), clinical, paraclinical, genetic (interleukin 6 [IL-6]: IL-6 -174G>C and IL-6 -572C>G gene polymorphisms), and BIA parameters.We noticed that fat mass (FM), muscle mass (MM), bone mass (BM), total body water (TBW), basal metabolism rate (BMR) and metabolic age (P < 0.001), anthropometric parameters (middle upper arm circumference, tricipital skinfold thickness; P < 0.001/P = 0.001) and hypertension (odds ratio = 4.65, 95% confidence interval: 1.27-17.03) were higher in mothers with high GWG. BW was positively correlated with mothers' FM (P < 0.001), TBW (P = 0.001), BMR (P = 0.02), while smoking was negatively correlated with BW (P = 0.04). Variant genotype (GG+GC) of the IL-6 -572C>G polymorphism was higher in the control group (P = 0.042).We observed that high GWG may be an important predictor factor for the afterward BW, being positively correlated with FM, TBW, BMR, metabolic age of the mothers, and negatively with the mother's smoking status. Variant genotype (GG+GC) of the IL-6 -572C>G gene polymorphism is a protector factor against obesity in mothers. All the variables considered explained 14.50% of the outcome variance.
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Affiliation(s)
| | | | - Claudia Bănescu
- Department of Genetics, University of Medicine and Pharmacy, Tîrgu Mureţ
- Correspondence: Claudia Bănescu, Department of Medical Genetics, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania (e-mail: )
| | | | - Florin Tripon
- Department of Genetics, University of Medicine and Pharmacy, Tîrgu Mureţ
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Cluj Napoca, Romania
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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.
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Patel S, Lawlor DA, Callaway M, Macdonald-Wallis C, Sattar N, Fraser A. Association of maternal diabetes/glycosuria and pre-pregnancy body mass index with offspring indicators of non-alcoholic fatty liver disease. BMC Pediatr 2016; 16:47. [PMID: 27036545 PMCID: PMC4818433 DOI: 10.1186/s12887-016-0585-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 03/18/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Little is known about early life determinants of non-alcoholic fatty liver disease (NAFLD). We examined associations of maternal pregnancy diabetes/glycosuria and pre-pregnancy body mass index (BMI) with offspring markers of NAFLD and liver pathology and examined mediation by birthweight and concurrent offspring adiposity. METHODS We used data from a UK prospective pregnancy cohort. Offspring underwent abdominal ultrasonography (USS) at mean age 17.8 years. Outcomes included USS-assessed fatty liver, estimated liver volume and shear velocity, a variant of elastography (a marker of liver fibrosis) (N = 1 215) and blood-based markers of liver pathology [alanine amino transferase, aspartate amino transferase, gamma- glutamyltransferase and haptoglobin] (N = 2 359). RESULTS 2.1 % (N = 25) of participants had USS-assessed fatty liver [maternal diabetes/glycosuria (N = 7) and no diabetes/glycosuria (N = 18)]. Maternal diabetes/glycosuria was associated with greater odds of offspring USS fatty liver in confounder adjusted models [adjusted odds ratio (aOR) 6.74 (95 % confidence interval (CI) 2.47, 18.40)] and higher shear velocity [adjusted ratio of geometric mean (aRGM):1.10 (95 % CI 1.05, 1.15)]. These associations were not mediated by offspring birthweight or concurrent adiposity. Maternal diabetes/glycosuria was not associated with liver volume or blood-based outcomes. Greater maternal pre-pregnancy BMI was associated with greater odds of offspring USS fatty liver [aOR 2.72 (95 % CI: 1.20, 6.15)], higher liver volume [aRGM 1.03 (95 % CI 1.00, 1.07)] and shear velocity [aRGM1.03 (95 % CI: 1.01, 1.06)] in confounder adjusted models. These associations were largely mediated by offspring adiposity. Maternal pre-pregnancy BMI was not consistently associated with blood-based outcomes. CONCLUSIONS Results suggest that maternal pregnancy diabetes/glycosuria is associated with offspring NAFLD through mechanisms other than offspring's own adiposity.
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Affiliation(s)
- Sumaiya Patel
- School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Road, Bristol, UK
| | - Debbie A Lawlor
- School of Social and Community Medicine, University of Bristol, UK & MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Mark Callaway
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Corrie Macdonald-Wallis
- School of Social and Community Medicine, University of Bristol, UK & MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Naveed Sattar
- Institute of Cardiovascular & Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Faculty of Medicine, University of Glasgow, Glasgow, UK
| | - Abigail Fraser
- School of Social and Community Medicine, University of Bristol, UK & MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
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Ethnic Differences in Gestational Weight Gain: A Population-Based Cohort Study in Norway. Matern Child Health J 2016; 20:1485-96. [DOI: 10.1007/s10995-016-1947-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hawkins SS, Gillman MW, Rifas-Shiman SL, Kleinman KP, Mariotti M, Taveras EM. The Linked CENTURY Study: linking three decades of clinical and public health data to examine disparities in childhood obesity. BMC Pediatr 2016; 16:32. [PMID: 26961130 PMCID: PMC4784443 DOI: 10.1186/s12887-016-0567-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 02/29/2016] [Indexed: 01/07/2023] Open
Abstract
Background Despite the need to identify the causes of disparities in childhood obesity, the existing epidemiologic studies of early life risk factors have several limitations. We report on the construction of the Linked CENTURY database, incorporating CENTURY (Collecting Electronic Nutrition Trajectory Data Using Records of Youth) Study data with birth certificates; and discuss the potential implications of combining clinical and public health data sources in examining the etiology of disparities in childhood obesity. Methods We linked the existing CENTURY Study, a database of 269,959 singleton children from birth to age 18 years with measured heights and weights, with each child’s Massachusetts birth certificate, which captures information on their mothers’ pregnancy history and detailed socio-demographic information of both mothers and fathers. Results Overall, 74.2 % were matched, resulting in 200,343 children in the Linked CENTURY Study with 1,580,597 well child visits. Among this cohort, 94.0 % (188,334) of children have some father information available on the birth certificate and 60.9 % (121,917) of children have at least one other sibling in the dataset. Using maternal race/ethnicity from the birth certificate as an indicator of children’s race/ethnicity, 75.7 % of children were white, 11.6 % black, 4.6 % Hispanic, and 5.7 % Asian. Based on socio-demographic information from the birth certificate, 20.0 % of mothers were non-US born, 5.9 % smoked during pregnancy, 76.3 % initiated breastfeeding, and 11.0 % of mothers had their delivery paid for by public health insurance. Using clinical data from the CENTURY Study, 22.7 % of children had a weight-for-length ≥ 95th percentile between 1 and 24 months and 12.0 % of children had a body mass index ≥ 95th percentile at ages 5 and 17 years. Conclusions By linking routinely-collected data sources, it is possible to address research questions that could not be answered with either source alone. Linkage between a clinical database and each child’s birth certificate has created a unique dataset with nearly complete racial/ethnic and socio-demographic information from both parents, which has the potential to examine the etiology of racial/ethnic and socioeconomic disparities in childhood obesity.
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Affiliation(s)
- Summer Sherburne Hawkins
- Boston College, School of Social Work, McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA, USA.
| | - Matthew W Gillman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
| | - Sheryl L Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
| | - Ken P Kleinman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
| | - Megan Mariotti
- Penn Center for Health Care Innovation, Philadelphia, PA, USA.
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA. .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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The Effects of Maternal Obesity on Neonates, Infants, Children, Adolescents, and Adults. Clin Obstet Gynecol 2016; 59:216-27. [DOI: 10.1097/grf.0000000000000179] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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