A prospective study of maternal prenatal weight and offspring cardiometabolic health in midchildhood

Abstract

Purpose: To examine the relations of maternal prepregnancy body mass index (ppBMI) and gestational weight gain (GWG) with offspring cardiometabolic health.

Design: We studied 1090 mother-child pairs in Project Viva, a Boston-area prebirth cohort. We measured overall (dual x-ray absorptiometry total fat; body mass index z-score) and central adiposity (dual x-ray absorptiometry trunk fat), and systolic blood pressure in offspring at 6 to 10 years. Fasting bloods (n = 687) were assayed for insulin and glucose (for calculation of homeostatic model assessment of insulin resistance), triglycerides, leptin, adiponectin, high sensitivity C-reactive protein, and interleukin 6. Using multivariable linear regression, we examined differences in offspring outcomes per 1 SD maternal ppBMI and GWG.

Results: After adjustment for confounders, each 5 kg/m² higher ppBMI corresponded with 0.92 kg (95% confidence interval, 0.70-1.14) higher total fat, 0.27 BMI z-score (0.21-0.32), and 0.39 kg (0.29-0.49) trunk fat. ppBMI was also positively associated with homeostatic model assessment of insulin resistance, leptin, high sensitivity C-reactive protein, interleukin 6, and systolic blood pressure; and lower adiponectin. Each 5 kg of GWG predicted greater adiposity (0.33 kg [0.11-0.54] total fat; 0.14 kg [0.04-0.23] trunk fat) and higher leptin (6% [0%-13%]) in offspring after accounting for confounders and ppBMI.

Conclusions: Children born to heavier mothers have more overall and central fat and greater cardiometabolic risk. Offspring of women with higher GWG had greater adiposity and higher leptin.

Keywords: Adiposity; Cardiometabolic health; Childhood obesity; Dual x-ray absorptiometry; Gestational weight gain; Lean mass; Prenatal.

Figure 1. Associations of offspring adiposity and cardiometabolic risk biomarkers according to maternal pre-pregnancy BMI and gestational weight gaina

Footnotes: a Estimates are derived from imputed data. Associations for pre-pregnancy BMI are adjusted for mother’s race/ethnicity, parity, and smoking habits during pregnancy, father’s BMI, annual household income, and child’s sex and age (Model 2). b Cardiometabolic outcomes are natural log transformed due to non-normal distributions. c Estimates for SBP are additionally adjusted for height z-score.

Figure 2. Associations of overall and central adiposity indicators for children of underweight, overweight, and mothers, versus those of normal weight mothers, stratified by Institute of Medicine 2009 gestational weight gain guidelinesa

Footnotes: a Estimates are derived from imputed data. Associations are adjusted for mother’s race/ethnicity, parity, and smoking habits during pregnancy, father’s BMI, annual household income, and child’s age and sex (Model 2).