Maternal Metabolic Complications in Pregnancy and Offspring Behavior Problems at 2 Years of Age

Krzeczkowski, John E.; Lau, Amanda; Fitzpatrick, Jennifer; Tamana, Sukhpreet K.; Smithson, Lisa; Souza, Russell J. de; Kozyrskyj, Anita L.; Lefebvre, Diana L.; Becker, Allan B.; Subbarao, Padmaja; Turvey, Stuart E.; Pei, Jacqueline; Sears, Malcolm R.; Lieshout, Ryan J. Van; Mandhane, Piush J.; Investigators, Child Study

doi:10.1007/s10995-018-2691-y

Cited by 17 publications

(17 citation statements)

References 38 publications

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“…Two studies have demonstrated that maternal obesity is associated with an increased risk of negative emotions and emotional dysregulation in offspring, as well as increased risk of internalizing problems (withdrawal, depression) 38,47 . A recent study also found an association between maternal obesity and gestational diabetes with offspring internalizing and externalizing behaviors, although the associations did not maintain significance after adjusting for gestational diet, socioeconomic status, and postpartum depression 48 …”

Section: Maternal Obesity and Neurodevelopmental And Psychiatric Morbidity In Offspringmentioning

confidence: 99%

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Fetal brain and placental programming in maternal obesity: A review of human and animal model studies

2020

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Both human epidemiologic and animal model studies demonstrate that prenatal and lactational exposure to maternal obesity and high‐fat diet are associated with adverse neurodevelopmental outcomes in offspring. Neurodevelopmental outcomes described in offspring of obese women include cognitive impairment, autism spectrum disorder (ASD), attention deficit hyperactivity disorder, anxiety and depression, disordered eating, and propensity for reward‐driven behavior, among others. This review synthesizes human and animal data linking maternal obesity and high‐fat diet consumption to abnormal fetal brain development, and neurodevelopmental and psychiatric morbidity in offspring. It highlights key mechanisms by which maternal obesity and maternal diet impact fetal and offspring development, and sex differences in offspring programming. In addition, we review placental effects of maternal obesity, and the role the placenta might play as an indicator vs mediator of fetal programming.

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Section: Maternal Obesity and Neurodevelopmental And Psychiatric Morbidity In Offspringmentioning

confidence: 99%

“…38,47 A recent study also found an association between maternal obesity and gestational diabetes with offspring internalizing and externalizing behaviors, although the associations did not maintain significance after adjusting for gestational diet, socioeconomic status, and postpartum depression. 48…”

Section: Anxiety and Depressionmentioning

confidence: 99%

Fetal brain and placental programming in maternal obesity: A review of human and animal model studies

2020

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“…To be consistent with prior studies and facilitate a comparison of results, substance use was treated as a binary variable, as were obstetric complications, although their effects on child psychopathology may be dose-dependent [74]. Other prenatal factors that are known to influence psychopathology risk, including maternal infection [11,12], nutrition [75,76], stressful events [52] and mental health [77][78][79], were not measured in the ABCD study; as such the adversity loading model presented here, while accounting for substantially more variance in risk than individual factors, is certainly incomplete. These findings may provide proof-of-concept for fully prospective longitudinal studies that thoroughly canvass the prenatal environment.…”

Section: Plos Onementioning

confidence: 99%

Association of adverse prenatal exposure burden with child psychopathology in the Adolescent Brain Cognitive Development (ABCD) Study

et al. 2021

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Objective Numerous adverse prenatal exposures have been individually associated with risk for psychiatric illness in the offspring. However, such exposures frequently co-occur, raising questions about their cumulative impact. We evaluated effects of cumulative adverse prenatal exposure burden on psychopathology risk in school-aged children. Methods Using baseline surveys from the U.S.-based Adolescent Brain and Cognitive Development (ABCD) Study (7,898 non-adopted, unrelated children from 21 sites, age 9–10, and their primary caregivers), we examined 8 retrospectively-reported adverse prenatal exposures in relation to caregiver-reported total and subscale Child Behavior Checklist (CBCL) scores. We also assessed cumulative effects of these factors on CBCL total as a continuous measure, as well as on odds of clinically significant psychopathology (CBCL total ≥60), in both the initial set and a separate ABCD sample comprising an additional 696 sibling pairs. Analyses were conducted before and after adjustment for 14 demographic and environmental covariates. Results In minimally and fully adjusted models, 6 exposures (unplanned pregnancy; maternal alcohol, marijuana, and tobacco use early in pregnancy; pregnancy complications; and birth complications) independently associated with significant but small increases in CBCL total score. Among these 6, none increased the odds of crossing the threshold for clinically significant symptoms by itself. However, odds of exceeding this threshold became significant with 2 exposures (OR = 1.86, 95% CI 1.47–2.36), and increased linearly with each level of exposure (OR = 1.39, 95% CI 1.31–1.47), up to 3.53-fold for ≥4 exposures versus none. Similar effects were observed in confirmatory analysis among siblings. Within sibling pairs, greater discordance for exposure load associated with greater CBCL total differences, suggesting that results were not confounded by unmeasured family-level effects. Conclusion Children exposed to multiple common, adverse prenatal events showed dose-dependent increases in broad, clinically significant psychopathology at age 9–10. Fully prospective studies are needed to confirm and elaborate upon this pattern.

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“…Maternal abnormal pre-pregnancy BMI and inappropriate GWG are other common factors in the context of child development [ 21 , 22 ]. The existing literature from animals and humans has reported adverse effects of maternal pre-pregnancy overweight/obesity on child EBPs.…”

Section: Introductionmentioning

confidence: 99%

Maternal Pre-Pregnancy BMI and Gestational Weight Gain Modified the Association between Prenatal Depressive Symptoms and Toddler’s Emotional and Behavioral Problems: A Prospective Cohort Study

Zhang

Qian

et al. 2022

Nutrients

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Background: Maternal prenatal depressive symptoms and abnormal pre-pregnancy BMI have been scarcely reported to play interactive effects on child health. In this prospective cohort, we aimed to examine the interactive effects of maternal prenatal depressive symptoms and pre-pregnancy BMI as well as gestational weight gain (GWG) on offspring emotional and behavioral problems (EPBs). Methods: The study samples comprised 1216 mother–child pairs from Shanghai Maternal–Child Pairs Cohort recruited from 2016 to 2018. Maternal pre-pregnancy BMI and GWG were obtained from medical records, and maternal depressive symptoms were assessed via the Center for Epidemiological Studies Depression Scale (CES-D) at 32–36 gestational weeks. The child completed the behavioral measurement via the Strengths and Difficulties Questionnaire (SDQ) at 24 months postpartum. Results: There were 12.01% and 38.65% women with prenatal depressive symptoms and sub-threshold depressive symptoms during late pregnancy. Both maternal depressive symptoms and prenatal sub-threshold depressive symptoms were associated with higher internalizing (OR = 1.69, 95% CI, 1.05–2.72; OR = 1.48, 95% CI, 1.06–2.07) and externalizing (OR = 2.06, 95% CI, 1.30–3.25; OR = 1.42, 95% CI, 1.02–1.99) problems in children. Maternal pre-pregnancy BMI and GWG modified the association between prenatal depressive symptoms and child externalizing or total difficulties problems (p < 0.10 for interaction). Among the overweight/obese pregnant women, maternal prenatal depressive symptoms were associated with a higher risk of externalizing problems (OR = 2.75, 95% CI, 1.06–7.11) in children. Among the women who gained inadequate GWG, maternal prenatal sub-threshold depressive symptoms were associated with 2.85-fold (95% CI 1.48–5.48) risks for child externalizing problems, and maternal depressive symptoms were associated with higher externalizing and total difficulties problems (OR = 4.87, 95% CI, 2.03–11.70 and OR = 2.94, 95% CI, 1.28–6.74, respectively), but these associations were not significant in the appropriate or excessive GWG group. Conclusions: Both maternal prenatal sub-threshold depressive symptoms and depressive symptoms increased the risks of child internalizing and externalizing problems at 24 months of age, while the effects on child externalizing problems were stronger among overweight/obese or inadequate GWG pregnant women. Our study highlights the importance of simultaneously controlling the weight of pregnant women before and throughout pregnancy and prompting mental health in pregnant women, which might benefit their offspring’s EBPs.

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Maternal Metabolic Complications in Pregnancy and Offspring Behavior Problems at 2 Years of Age

Cited by 17 publications

References 38 publications

Fetal brain and placental programming in maternal obesity: A review of human and animal model studies

Fetal brain and placental programming in maternal obesity: A review of human and animal model studies

Association of adverse prenatal exposure burden with child psychopathology in the Adolescent Brain Cognitive Development (ABCD) Study

Maternal Pre-Pregnancy BMI and Gestational Weight Gain Modified the Association between Prenatal Depressive Symptoms and Toddler’s Emotional and Behavioral Problems: A Prospective Cohort Study

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