Adiposity and hyperglycaemia in pregnancy and related health outcomes in European ethnic minorities of Asian and African origin: a review

Abstract

BackgroundEthnic minorities in Europe have high susceptibility to type 2 diabetes (T2DM) and, in some groups, also cardiovascular disease (CVD). Pregnancy can be considered a stress test that predicts future morbidity patterns in women and that affects future health of the child.ObjectiveTo review ethnic differences in: 1) adiposity, hyperglycaemia, and pre-eclampsia during pregnancy; 2) future risk in the mother of obesity, T2DM and CVD; and 3) prenatal development and possible influences of maternal obesity, hyperglycaemia, and pre-eclampsia on offspring's future disease risk, as relevant for ethnic minorities in Europe of Asian and African origin.DesignLiterature review.ResultsMaternal health among ethnic minorities is still sparsely documented. Higher pre-pregnant body mass index (BMI) is found in women of African and Middle Eastern descent, and lower BMI in women from East and South Asia compared with women from the majority population. Within study populations, risk of gestational diabetes mellitus (GDM) is considerably higher in many minority groups, particularly South Asians, than in the majority population. This increased risk is apparent at lower BMI and younger ages. Women of African origin have higher risk of pre-eclampsia. A GDM pregnancy implies approximately seven-fold higher risk of T2DM than normal pregnancies, and both GDM and pre-eclampsia increase later risk of CVD. Asian neonates have lower birth weights, and mostly also African neonates. This may translate into increased risks of later obesity, T2DM, and CVD. Foetal overgrowth can promote the same conditions. Breastfeeding represents a possible strategy to reduce risk of T2DM in both the mother and the child.ConclusionsEthnic minority women in Europe with Asian and African origin and their offspring seem to be at increased risk of T2DM and CVD, both currently and in the future. Pregnancy is an important window of opportunity for short and long-term disease prevention.

Pre-pregnancy body mass index and inter-pregnancy weight change among women of Russian, Somali and Kurdish origin and the general Finnish population

“…However, a few studies have compared the pre-pregnancy BMI among other migrant groups across different countries. A review article found that women originating from African and Middle Eastern countries had a higher pre-pregnancy BMI than the majority population in Norway, Switzerland and the Netherlands [23], which is similar to the findings from this study. A study from the Netherlands (n=6444) found that the prevalence of pre-pregnancy overweight and obesity was significantly higher in Dutch Antillean origin, Moroccan origin, Surinamese-Creole origin and Turkish origin women than in Dutch origin women [24].…”

Development and evaluation of an intervention for the prevention of childhood obesity in a multiethnic population: the Born in Bradford applied research programme

“…[21][22][23][24] Evidence suggests that this fat-thin insulin-resistant phenotype is present at birth and that pregnancy is an important window of opportunity for obesity prevention. 25,26 The adoption of Western urban lifestyles that result from migration to the UK has the potential to increase the risk of rapid postnatal growth and obesity contributing to the higher risks of diabetes and CVD.…”