Metabolic Profile in Early Pregnancy Is Associated with Offspring Adiposity at 4 Years of Age: The Rhea Pregnancy Cohort Crete, Greece

Abstract

ContextMaternal pre-pregnancy obesity may increase the risk of childhood obesity but it is unknown whether other metabolic factors in early pregnancy such as lipid profile and hypertension are associated with offspring cardiometabolic traits.ObjectiveOur objective was to investigate whether fasting lipid, glucose, and insulin levels during early pregnancy and maternal pre-pregnancy weight status, are associated with offspring adiposity measures, lipid levels and blood pressure at preschool age.Design and MethodsThe study included 618 mother-child pairs of the pregnancy cohort “Rhea” study in Crete, Greece. Pregnant women were recruited at the first prenatal visit (mean: 12weeks, SD: 0.7). A subset of 348 women provided fasting serum samples for glucose and lipid measurements. Outcomes measures were body mass index, abdominal circumference, sum of skinfold thickness, and blood pressure measurements at 4 years of age. A subsample of 525 children provided non-fasting blood samples for lipid measurements.ResultsPre-pregnancy overweight/obesity was associated with greater risk of offspring overweight/obesity (RR: 1.83, 95%CI: 1.19, 2.81), central adiposity (RR: 1.97, 95%CI: 1.11, 3.49), and greater fat mass by 5.10mm (95%CI: 2.49, 7.71) at 4 years of age. These associations were more pronounced in girls. An increase of 40mg/dl in fasting serum cholesterol levels in early pregnancy was associated with greater skinfold thickness by 3.30mm (95%CI: 1.41, 5.20) at 4 years of age after adjusting for pre-pregnancy BMI and several other confounders. An increase of 10mmHg in diastolic blood pressure in early pregnancy was associated with increased risk of offspring overweight/obesity (RR: 1.22, 95%CI: 1.03, 1.45), and greater skinfold thickness by 1.71mm (95% CI: 0.57, 2.86) at 4 years of age.ConclusionsMetabolic dysregulation in early pregnancy may increase the risk of obesity at preschool age.

Maternal insulin resistance, triglycerides and cord blood insulin are not determinants of offspring growth and adiposity up to 5 years: a follow‐up study

“…We observed no significant relationships between prenatal maternal insulin levels and offspring adiposity in our cohort. Our findings are consistent with earlier research [14] and suggest that minor changes in glucose metabolism and insulin sensitivity in healthy, non-obese pregnant women without gestational diabetes (GDM) do not have adverse effects on weight development in offspring up to the age of 5 years.…”

Relationships of maternal body mass index and plasma biomarkers with childhood body mass index and adiposity at 6 years: The Children of SCOPE study

“…Higher blood pressure may reflect poor placental function, resulting in increased risk of childhood metabolic outcomes and obesity. Similar results have been reported in a cohort of 618 mother and child dyads; 47 the authors found associations between maternal hypertension and offspring risk of overweight or obesity at 4 years of age. Similarly, there are previous reports of an association between maternal GDM and offspring adiposity, although a recent systematic review concluded that the relationship between GDM and offspring BMI z-score was not evident following adjustment for maternal BMI.…”

Malprogramming of Hepatic Lipid Metabolism due to Excessive Early Cholesterol Exposure in Adult Progeny

“…Furthermore, although there is a normal physiological increase in maternal cholesterol (+25–50%) during pregnancy which is vital for embryogenesis and early organ development, an excessive increase in maternal serum cholesterol can manifest during pregnancy, particularly in women with elevated cholesterol prior to conception . Such an exaggerated rise in early cholesterol exposure has been associated with pre‐term delivery and low birth weight, increased childhood body mass index and adiposity, increased blood lipids in the neonatal, adolescent, and adult periods, and fetal fatty streaks that develop faster in childhood . It has been estimated that 10–25% of US women of childbearing years are hypercholesterolemic, having blood total cholesterol (TC) concentrations >240 mg dL −1 .…”