Maternal obesity and long-term neuropsychiatric morbidity of the offspring

Neuhaus, Zipora Feiga; Gutvirtz, Gil; Pariente, Gali; Wainstock, Tamar; Landau, Daniella

doi:10.1007/s00404-020-05432-6

Cited by 20 publications

(31 citation statements)

References 35 publications

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“…A developmental model for the origins of disease suggests that nutrition during fetal life may affect fetal programing and its predisposition for disease may set the body’s organs and systems for future growth [ 23 ]. We suggest that this biological mechanism also impacts future central nerve system (CNS) development and may be associated with the increased neurological morbidity [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The Association Between Delivery of Small-for-Gestational-Age Neonate and Their Risk for Long-Term Neurological Morbidity

Hadar

Wainstock

2020

JCM

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Small-for-gestational-age (SGA) is defined as a birth weight below the 10th or below the 5th percentile for a specific gestational age and sex. Previous studies have demonstrated an association between SGA neonates and long-term pediatric morbidity. In this research, we aim to evaluate the possible association between small-for-gestational-age (SGA) and long-term pediatric neurological morbidity. A population-based retrospective cohort analysis was performed, comparing the risk of long-term neurological morbidities in SGA and non-SGA newborns delivered between the years 1991 to 2014 at a single regional medical center. The neurological morbidities included hospitalizations as recorded in hospital records. Neurological hospitalization rate was significantly higher in the SGA group (3.7% vs. 3.1%, OR = 1.2, 95% CI 1.1–1.3, p < 0.001). A significant association was noted between neonates born SGA and developmental disorders (0.2% vs. 0.1%, OR = 2.5, 95% CI 1.7–3.8, p < 0.001). The Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of neurological morbidity in the SGA group (log-rank p < 0.001). In the Cox proportional hazards model, which controlled for various Confounders, SGA was found to be an independent risk factor for long-term neurological morbidity (adjusted hazard ratio (HR) = 1.18, 95% CI 1.07–1.31, p < 0. 001). In conclusion, we found that SGA newborns are at an increased risk for long-term pediatric neurological morbidity.

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Section: Discussionmentioning

confidence: 99%

The Association Between Delivery of Small-for-Gestational-Age Neonate and Their Risk for Long-Term Neurological Morbidity

Hadar

Wainstock

2020

JCM

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“…The perinatal database from SUMC contains background information on the birthing mothers: ethnic group and country of immigration, date of immigration, smoking status, BMI and age [45][46][47]. The SUMC perinatal database also includes significant URO variables derived from ICD-Codes for complications of pregnancy, childbirth and the puerperium (Codes 630-677).…”

Section: Methodsmentioning

confidence: 99%

“…The SUMC perinatal database also includes significant URO variables derived from ICD-Codes for complications of pregnancy, childbirth and the puerperium (Codes 630–677). In this study we included: Background reproductive health and history–age, smoking, obesity (defined as BMI ≥ 30 kg/m 2 ), chronic hypertension, diabetes mellitus (pre-gestational), recurrent pregnancy loss, fertility treatments including all assisted reproductive techniques (ovulation induction, intrauterine insemination and in-vitro fertilization) Pregnancy complications-hypertensive disorders of pregnancy (gestational hypertension, pre-eclampsia and eclampsia), gestational diabetes, intrauterine growth restriction (IUGR) Delivery complications-premature rupture of membranes, meconium stained amniotic fluid, pathological presentation, prolonged first or second stage of labor, placental previa, placental abruption, malpresentation, postpartum hemorrhage, cesarean section, uterine rupture, blood transfusion Adverse birth outcomes-malformations, low Apgar scores (<7) at 5 min, perinatal mortality including: stillbirth, intrapartum death -IPD, postpartum death- PPD (up to 30 days post-partum), anemia (<10.0 hemoglobin), preterm delivery (<37 weeks), and macrosomia (birthweight > 4000 g) [ 45 , 46 , 47 ]. …”

Section: Methodsmentioning

confidence: 99%

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Reproductive Effects of Exposure to Low-Dose Ionizing Radiation: A Long-Term Follow-Up of Immigrant Women Exposed to the Chernobyl Accident

Cwikel

Sergienko

Gutvirtz

et al. 2020

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The Chernobyl accident in 1986 spread ionizing radiation over extensive areas of Belarus and Ukraine, leading to adverse health effects in exposed children. More than 30 years later, exposed children have grown and became parents themselves. This retrospective study from Israel was aimed to evaluate whether Chernobyl-exposed women are at higher risk for adverse reproductive outcomes. Exposed immigrants were identified as high or low exposure based on Caesium-137 soil contamination levels registered in the town they lived in. The exposed group was age matched with three comparison groups: non-exposed immigrant women from the Former Soviet Union (FSU) excluding Belarus and the Ukraine, immigrants from other countries (Non FSU) and Israeli-born women at a ratio of 1:10. Chernobyl-exposed women were more likely to be nulliparous and have fewer children (2.1 + 0.8 vs. 3.1 + 1.8, p < 0.001), were more likely to undergo fertility treatments (8.8% vs. 5.8%, adjusted OR = 1.8, 95%CI 1.04–3.2, p = 0.036), and were also more likely to have anemia after delivery (49.4% vs. 36.6%, OR = 1.7, 95%CI 1.2–2.3, p = 0.001), compared to women in the combined comparison groups. The overall fertility of Chernobyl-exposed women seems to be reduced as reflected by the lower number of children and their greater need for fertility treatments.

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“…For instance, altered levels of plasma ceramides in the offspring of obese mothers have been implicated as early predictors of metabolic disease [59]. Maternal obesity has been implicated as being an independent risk factor of short-and long-term neuropsychiatric disorders in the offspring [60]. Low-grade inflammation is a central feature of pregnancies complicated by maternal obesity.…”

Section: Stressful Events That Might Occur In Perinatal Lifementioning

confidence: 99%

NURR1 Alterations in Perinatal Stress: A First Step towards Late-Onset Diseases? A Narrative Review

et al. 2020

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Perinatal life represents a delicate phase of development where stimuli of all sorts, coming to or from the mother, can influence the programming of the future baby’s health. These stimuli may have consequences that persist throughout adulthood. Nuclear receptor related 1 protein (NURR1), a transcription factor with a critical role in the development of the dopaminergic neurons in the midbrain, mediates the response to stressful environmental stimuli in the perinatal period. During pregnancy, low-grade inflammation triggered by maternal obesity, hyperinsulinemia or vaginal infections alters NURR1 expression in human gestational tissues. A similar scenario is triggered by exposure to neurotoxic compounds, which are associated with NURR1 epigenetic deregulation in the offspring, with potential intergenerational effects. Since these alterations have been associated with an increased risk of developing late-onset diseases in children, NURR1, alone, or in combination with other molecular markers, has been proposed as a new prognostic tool and a potential therapeutic target for several pathological conditions. This narrative review describes perinatal stress associated with NURR1 gene deregulation, which is proposed here as a mediator of late-onset consequences of early life events.

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Maternal obesity and long-term neuropsychiatric morbidity of the offspring

Cited by 20 publications

References 35 publications

The Association Between Delivery of Small-for-Gestational-Age Neonate and Their Risk for Long-Term Neurological Morbidity

The Association Between Delivery of Small-for-Gestational-Age Neonate and Their Risk for Long-Term Neurological Morbidity

Reproductive Effects of Exposure to Low-Dose Ionizing Radiation: A Long-Term Follow-Up of Immigrant Women Exposed to the Chernobyl Accident

NURR1 Alterations in Perinatal Stress: A First Step towards Late-Onset Diseases? A Narrative Review

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