Association Between Maternal Prepregnancy Body Mass Index and Anthropometric Parameters, Blood Pressure, and Retinal Microvasculature in Children Age 4 to 6 Years

Cox, Bianca; Luyten, Leen J.; Dockx, Yinthe; Provost, Eline B.; Madhloum, Narjes; Boever, Patrick De; Neven, Kristof Y.; Sassi, Franco; Sleurs, Hanne; Vrijens, Karen; Víneis, Paolo; Plusquin, Michelle; Nawrot, Tim S.

doi:10.1001/jamanetworkopen.2020.4662

Cited by 25 publications

(18 citation statements)

References 55 publications

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“…39 The results from this study reinforce previous findings and provide insight into possible mechanisms. Several birth cohort studies (including the one used here) demonstrated that higher maternal pre-pregnancy BMI is positively associated elevated blood pressure at 4-6, 40 9 41 and 15 years of age. 2 Similar associations have been found with exposure to gestational diabetes in utero .…”

Section: Discussionmentioning

confidence: 73%

Maternal obesity before pregnancy predicts offspring blood pressure at 18 years of age: A causal mediation analysis

Brunton

Dufault

Dart

et al. 2020

Preprint

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ImportanceHypertension is the second most common pediatric chronic disease in Westernized countries. Understanding the natural history of hypertension is key to identifying prevention strategies.ObjectiveExamine the relationship between maternal pre-pregnancy body mass index (BMI) and offspring blood pressure at 18 years and the mediating role of growth throughout childhood and adolescence.Design, Setting, and ParticipantsWe performed multivariable regression and causal mediation analyses within 3217 mother - offspring pairs from the Avon Longitudinal Study of Parents and Children (ALSAPC) prospective birth cohort. Latent trajectory analysis (LTA) was used to quantify the mediating variable of offspring BMI from 7 to 18 years of age.ExposuresThe main exposure was maternal pre-pregnancy BMI. Analyses were adjusted for relevant confounders including maternal education, maternal blood pressure, and weeks gestation at delivery.Main Outcomes and MeasuresThe main outcome was offspring blood pressure at 18 years of age categorized as normal (SBP < 120 mmHg or DBP < 80mmHg) or elevated (SBP ≥ 120 mmHg or DBP ≥ 80 mmHg) as per the 2017 American Academy of Pediatrics guidelines.ResultsAt 18 years of age, among 3217 offspring, 676 (21%) were overweight or obese, 865 (27%) had elevated blood pressure, and 510 (16%) were hypertensive. LTA identified five distinct offspring BMI trajectories. Multivariate logistic regression revealed that for every 1 unit increase in maternal BMI the risk of elevated blood pressure at 18 years of age increased by 5% (aOR: 1.05, 95% CI: 1.03 – 1.07; p <0.001) and this effect was reduced after adjusting for offspring BMI trajectory (aOR: 1.03, 95% CI: 1.00 – 1.05; p = 0.017). Causal mediation analysis confirmed offspring BMI trajectory as a mediator accounting for 46% of the total effect of maternal BMI on elevated offspring blood pressure (aOR 1.22; 95% CI: 1.07-1.39).Conclusion and RelevanceMaternal BMI prior to pregnancy is associated with an increased risk of elevated blood pressure in offspring at 18 years of age and is mediated, in part, by offspring BMI trajectory throughout childhood and adolescence.

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Section: Discussionmentioning

confidence: 73%

Maternal obesity before pregnancy predicts offspring blood pressure at 18 years of age: A causal mediation analysis

Brunton

Dufault

Dart

et al. 2020

Preprint

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“…Nine studies report positive associations between MppBMI and offspring childhood anthropometrics ( 30 , 31 , 33 , 35 – 38 , 40 , 41 ). Of these, three studies had critical and two had severe risk of bias, predominantly due to confounding and selection bias ( Table 5 and Supplementary Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies measured the impact of MppBMI on offspring BP. Five studies found that MppBMI was significantly associated with higher BP in the offspring ( 30 , 33 , 34 , 37 , 38 ) ( Table 5 ). Perng et al.…”

Section: Resultsmentioning

confidence: 99%

The Impact of Maternal Obesity on Offspring Cardiovascular Health: A Systematic Literature Review

Kankowski¹,

Ardissino

McCracken

et al. 2022

Front. Endocrinol.

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ObjectiveObesity and cardiovascular disease are major global public health problems. Maternal obesity has been linked to multiple adverse health consequences for both mother and baby. Obesity during pregnancy may adversely alter the intrauterine environment, which has been hypothesised to predispose the offspring to poorer cardiovascular health throughout life. In this paper, we systematically review current literature examining the links between maternal obesity and offspring cardiovascular health.MethodsThis study is registered with PROSPERO (CRD42021278567) and was conducted in accordance with the PRISMA guidelines. A comprehensive systematic literature search was conducted, including two electronic databases (Ovid Medline, Embase), cross-referencing, author searching, and grey literature searches. We selected studies exploring the relationship between maternal obesity and offspring cardiovascular health, using pre-defined eligibility criteria. Studies were critically appraised using the ROBINS-I tool.ResultsFrom 1,214 results, 27 articles met the eligibility criteria. Multiple cardiovascular outcomes were considered, including congenital heart disease, cardiometabolic parameters, and cardiovascular diseases in neonates, children, and adults. In these studies, maternal obesity was consistently associated with congenital heart disease, several adverse cardiometabolic parameters throughout life including higher body mass index and insulin levels, and greater risk of cardiovascular disease in adulthood. Hypothesized underlying mechanisms are complex and multifactorial comprising genetic, environmental, and socioeconomic components, which can be difficult to quantify. Heterogeneity in study designs, highly selected study samples, and high risk of bias in some studies limit conclusions regarding causality.ConclusionsWe identified consistent evidence of links between maternal obesity and poorer offspring cardiovascular health throughout the lifecourse, extending from the neonatal period into adulthood. Although underlying mechanisms are unclear, our findings support consideration of targeted maternal obesity prevention for promotion of offspring cardiovascular health. This all-encompassing systematic review provides critical appraisal of the latest evidence, defines gaps and biases of existing literature, and may inform potential new public health strategies for cardiovascular disease prevention.Systematic Review Registration[https://www.crd.york.ac.uk/prospero], identifier PROSPERO (CRD42021278567).

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“…Inability to vasodilate to meet the demands of the organ are related to the lack of production of NO, prostaglandins and endothelium derived hyperpolarization factors which are effected by inflammation, oxidative stress ( 48 ) and changes in the gene function ( 49 ). These changes have been demonstrated in murine and non-human primates, and more recently these were demonstrated as an abnormality in the retinal microvasculature of children born to women with obesity ( 50 ).…”

Section: Cardiopulmonary Complications Among Offsprings Of Women With...mentioning

confidence: 92%

The Epidemiology and Mechanisms of Lifetime Cardiopulmonary Morbidities Associated With Pre-Pregnancy Obesity and Excessive Gestational Weight Gain

Rastogi

2022

Front. Cardiovasc. Med.

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Obesity has reached pandemic proportions in the last few decades. The global increase in obesity has contributed to an increase in the number of pregnant women with pre-pregnancy obesity or with excessive gestational weight gain. Obesity during pregnancy is associated with higher incidence of maternal co-morbidities such as gestational diabetes and hypertension. Both obesity during pregnancy and its associated complications are not only associated with immediate adverse outcomes for the mother and their newborns during the perinatal period but, more importantly, are linked with long-term morbidities in the offsprings. Neonates born to women with obesity are at higher risk for cardiac complications including cardiac malformations, and non-structural cardiac issues such as changes in the microvasculature, e.g., elevated systolic blood pressure, and overt systemic hypertension. Pulmonary diseases associated with maternal obesity include respiratory distress syndrome, asthma during childhood and adolescence, and adulthood diseases, such as chronic obstructive pulmonary disease. Sequelae of short-term complications compound long-term outcomes such as long-term obesity, hypertension later in life, and metabolic complications including insulin resistance and dyslipidemia. Multiple mechanisms have been proposed to explain these adverse outcomes and are related to the emerging knowledge of pathophysiology of obesity in adults. The best investigated ones include the role of obesity-mediated metabolic alterations and systemic inflammation. There is emerging evidence linking metabolic and immune derangements to altered biome, and alteration in epigenetics as one of the intermediary mechanisms underlying the adverse outcomes. These are initiated as part of fetal adaptation to obesity during pregnancy which are compounded by rapid weight gain during infancy and early childhood, a known complication of obesity during pregnancy. This newer evidence points toward the role of specific nutrients and changes in biome that may potentially modify the adverse outcomes observed in the offsprings of women with obesity.

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Association Between Maternal Prepregnancy Body Mass Index and Anthropometric Parameters, Blood Pressure, and Retinal Microvasculature in Children Age 4 to 6 Years

Cited by 25 publications

References 55 publications

Maternal obesity before pregnancy predicts offspring blood pressure at 18 years of age: A causal mediation analysis

Maternal obesity before pregnancy predicts offspring blood pressure at 18 years of age: A causal mediation analysis

The Impact of Maternal Obesity on Offspring Cardiovascular Health: A Systematic Literature Review

The Epidemiology and Mechanisms of Lifetime Cardiopulmonary Morbidities Associated With Pre-Pregnancy Obesity and Excessive Gestational Weight Gain

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