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McPherson NO, Vincent AD, Zander-Fox D, Grieger JA. Birthweight associations with parental obesity: retrospective analysis of 1,778 singleton term births following assisted reproductive treatment. F S Rep 2021; 2:405-412. [PMID: 34934980 PMCID: PMC8655430 DOI: 10.1016/j.xfre.2021.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/24/2021] [Accepted: 04/24/2021] [Indexed: 11/06/2022] Open
Abstract
Objective To determine the association of combined parental preconception overweight and obesity on infant birthweight. Design Retrospective study of fresh in vitro fertilization or intracytoplasmic sperm injection cycles (2009–2017). Setting Repromed, South Australia, assisted reproductive technology clinic. Patients Couples undergoing in vitro fertilization/intracytoplasmic sperm injection insemination with their own gametes and transfer of a fresh single blastocyst (N = 1,778). Intervention(s) None. Main Outcome Measures Parental body mass index (BMI) was recorded prior to cycle initiation. Infant birthweight was recorded at delivery. The impact of parental obesity and their interaction on first singleton term (≥37 weeks’ gestation) birthweight was assessed using linear regressions assessing nonlinearity and a pairwise linear interactions. Results In the base model where parental BMI is assumed linear, there was strong evidence for higher birthweight with increasing maternal BMI (11.2 g per maternal kg/m2; 95% confidence interval, 7.2, 15.1) but not paternal BMI. The inclusion of a pairwise linear interaction indicated that paternal BMI attenuates the positive association between maternal BMI and infant birthweight (interaction −0.88; 95% confidence interval, −1.49, −0.27). The inclusion of nonlinear maternal BMI terms did not change the conclusions. Conclusions Increases in the mean infant birthweight associated with maternal obesity are attenuated when the father is obese. While maternal BMI contributed more to the mean infant birthweight than paternal BMI, a couple-centered approach to preconception health advice is recommended, given the documented relationships between parental obesity and childhood weight beyond infancy. Further studies in both assisted reproductive technology and general population cohorts assessing the parental BMI interaction on infant birthweight are warranted.
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Affiliation(s)
- Nicole O McPherson
- Freemasons Center for Male Health and Wellbeing, University of Adelaide, South Australia, Australia.,Robinson Research Institute, University of Adelaide, South Australia, Australia.,Repromed, Dulwich, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia
| | - Andrew D Vincent
- Freemasons Center for Male Health and Wellbeing, University of Adelaide, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia.,South Australian Health and Medical Research Institute, South Australia, Australia
| | - Deirdre Zander-Fox
- Robinson Research Institute, University of Adelaide, South Australia, Australia.,Repromed, Dulwich, South Australia, Australia.,Monash IVF Group, Clayton, Victoria, Australia.,Faculty of Science, Monash University, Clayton, Victoria, Australia.,Future Industries Institute, University of South Australia, Mawson Lakes, South Australia, Australia
| | - Jessica A Grieger
- Robinson Research Institute, University of Adelaide, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia
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Yajnik CS, Chandak GR, Joglekar C, Katre P, Bhat DS, Singh SN, Janipalli CS, Refsum H, Krishnaveni G, Veena S, Osmond C, Fall CHD. Maternal homocysteine in pregnancy and offspring birthweight: epidemiological associations and Mendelian randomization analysis. Int J Epidemiol 2014; 43:1487-97. [PMID: 25052622 DOI: 10.1093/ije/dyu132] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Disturbed one-carbon (1-C) metabolism in the mother is associated with poor fetal growth but causality of this relationship has not been established. METHODS We studied the association between maternal total homocysteine and offspring birthweight in the Pune Maternal Nutrition Study (PMNS, Pune, India) and Parthenon Cohort Study (Mysore, India). We tested for evidence of causality within a Mendelian randomization framework, using a methylenetetrahydrofolatereductase (MTHFR) gene variant rs1801133 (earlier known as 677C→T) by instrumental variable and triangulation analysis, separately and using meta-analysis. RESULTS Median (IQR) homocysteine concentration and mean (SD) birthweight were 8.6 µmol/l (6.7,10.8) and 2642 g (379) in the PMNS and 6.0 µmol/l (5.1,7.1) and 2871 g (443) in the Parthenon study. Offspring birthweight was inversely related to maternal homocysteine concentration-PMNS: -22 g/SD [95% confidence interval (CI): (-50, 5), adjusted for gestational age and offspring gender]; Parthenon: -57 g (-92, -21); meta-analysis: -40 g (-62, -17)]. Maternal risk genotype at rs1801133 predicted higher homocysteine concentration [PMNS: 0.30 SD/allele (0.14, 0.46); Parthenon: 0.21 SD (0.02, 0.40); meta-analysis: 0.26 SD (0.14, 0.39)]; and lower birthweight [PMNS: -46 g (-102, 11, adjusted for gestational age, offspring gender and rs1801133 genotype); Parthenon: -78 g (-170, 15); meta-analysis: -61 g (-111, -10)]. Instrumental variable and triangulation analysis supported a causal association between maternal homocysteine concentration and offspring birthweight. CONCLUSIONS Our findings suggest a causal role for maternal homocysteine (1-C metabolism) in fetal growth. Reducing maternal homocysteine concentrations may improve fetal growth.
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Affiliation(s)
- Chittaranjan S Yajnik
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Giriraj R Chandak
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Charudatta Joglekar
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Prachi Katre
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Dattatray S Bhat
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Suraj N Singh
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Charles S Janipalli
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Helga Refsum
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Ghattu Krishnaveni
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Sargoor Veena
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Clive Osmond
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Caroline H D Fall
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, India, CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, India, Adjunct Group Leader, Adjunct Group, Genome Institute of Singapore, Singapore, Persistent Systems Ltd, Pune, India, Department of Nutrition, University of Oslo, Oslo, Norway, Department of Pharmacology, University of Oxford, Oxford, UK, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India and MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
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