Associations of Gestational Weight Gain With Offspring Body Mass Index and Blood Pressure at 21 Years of Age

Abstract

Background-Maternal weight gain in pregnancy is positively associated with offspring body mass index (BMI) and obesity risk in childhood, but whether this increased risk extends into adulthood or results in increases in other cardiovascular risk factors such as elevated blood pressure (BP) is unclear. Methods and Results-We used a population-based birth cohort of 2432 individuals (50% male) born in Brisbane, Australia, between 1981 and 1983 to prospectively examine the association between maternal gestational weight gain (GWG) and offspring BMI and BP at 21 years. On average, each mother gained 14.8 kg (SD, 5.1 kg) during her pregnancy. At 21 years of age, offspring mean BMI, systolic BP, and diastolic BP were 24.2 kg/m 2 (SD, 4.9 kg/m 2 ), 116.4 mm Hg (SD, 14.5 mm Hg), and 67.7 mm Hg (SD, 8.5 mm Hg), respectively. Offspring BMI was on average 0.3 kg/m 2 (95% confidence interval, 0.1 to 0.4 kg/m 2 ) higher for each 0.1-kg/wk greater GWG after adjustment for potential confounding factors. Systolic BP also was greater (0.2 mm Hg per 0.1 kg; 95% confidence interval, Ϫ0.2 to 0.6) in offspring whose mothers had higher GWG. Although this association was not statistically significant, it was consistent in magnitude with the association of maternal GWG with offspring BMI and of offspring BMI with BP. Conclusions-Our findings show that greater GWG is associated with greater offspring BMI into early adulthood and that this may translate into higher systolic BP in offspring. Further large studies are required to confirm an effect of GWG on a range of offspring cardiovascular risk factors. Key Words: blood pressure Ⅲ cardiovascular diseases Ⅲ epidemiology Ⅲ obesity Ⅲ pregnancy Ⅲ young adult A number of studies have examined the association between maternal gestational weight gain (GWG) and later body mass index (BMI) or obesity in offspring, with all but one of them 1 finding an association between greater weight gain during pregnancy and greater mean BMI or increased risk of obesity in offspring. [2][3][4][5][6][7][8][9] In 2 studies able to adjust for potential confounding factors, this association appears to be robust to adjustment for indicators of socioeconomic position, maternal prepregnancy or early pregnancy BMI, and infant birth size. 3,4 In by far the largest study to date (a record linkage study of 165 130 children, currently published only in abstract form), the effect was modified by maternal prepregnancy BMI, with an effect only among underweight/normal weight mothers. 7 A recent study by Wrotniak and colleagues 8 based on a retrospective cohort study of 10 226 participants also found that the association between GWG and offspring overweight at 7 years of age was strongest for women who were underweight before pregnancy. However, other studies either have not examined this interaction or have had too little statistical power to detect it. 4 Clinical Perspective p 1727The majority of studies to date have examined associations with offspring BMI assessed in childhood or adolescence. From a public health persp...

Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood

“…26 GWG is positively associated with birth weight even when stratifying on factors such as maternal BMI, age, parity and educational level. 27 In accordance with others, [11][12][13][14][15][16] our data suggest that birth weight is not a predominant mediator of the effect of GWG on offspring BMI. Instead, these intrauterine effects could be related to permanent modulation of appetite control, neuro-endocrine pathways influencing adipose tissue development and function or Gestational weight gain and offspring obesity L Schack-Nielsen et al energy metabolism causing development of obesity in later life.…”

“…16 In three of these studies, [11][12][13] the prevalence of maternal and childhood overweight was higher than in our study. This consistency is particularly important because our cohort had an overrepresentation of mothers with previous or current pregnancy complications as well as single mothers, whereas the study populations of the other studies were characterized as socially advantaged, 11,15 nationally representative 12 or multiethnic.…”

“…7,9,10 Such acceleration has been observed in the stepwise development of the obesity epidemic in Denmark, where the second phase was much steeper than the first phase. 1 Furthermore, a high gestational weight gain (GWG) has recently been associated with an increased risk of overweight in children aged 2-14 years [11][12][13][14][15] and in 21-year olds, 16 after adjusting for maternal BMI. Thus, recommenda-tions for GWG may also need to take into account the longterm effects on the offspring.…”

Maternal over-nutrition and offspring obesity predisposition: targets for preventative interventions

“…There are a number of components of maternal obesity that have been associated with offspring obesity and metabolic health. These include pre-pregnancy BMI, 16,17 maternal weight gain, 18 as well as consumption of an obesogenic diet. Dis-entangling how these related parameters mediate their effects on offspring health is therefore extremely complex and will only be defined by intervention studies targeted at individual components.…”

Body mass index and gestational weight gain in two selected Medical Officer of Health areas in the Gampaha District

“…[11][12][13] Excessive gestational weight gain too results in both maternal and fetal adverse pregnancy outcomes and delivery complications. Children of mothers who gained more than the recommended weight gain had a greater risk of being overweight at seven years of age 14,15 than for children of mothers who met the weight gain recommendations. Being an overweight child was associated with higher systolic blood pressure in later life.…”