Mild maternal sleep-disordered breathing during pregnancy and offspring growth and adiposity in the first 3 years of life

Abstract

Sleep-disordered breathing (SDB) during pregnancy has been linked to adverse fetal outcomes. Since the intrauterine milieu plays a critical role in childhood growth, we explored the interactions between maternal SDB and offspring growth and adiposity patterns during infancy. Fifty-eight healthy women with uncomplicated pregnancies underwent an objective sleep study and laboratory evaluation during the third trimester, their offspring underwent a 3-year growth surveillance. The 14 (24.1%) women with SDB had a higher body mass index (BMI) (P = 0.003), elevated C-reactive protein levels (P = 0.003), and decreased HDL-cholesterol levels (P = 0.009) than the women without SDB. A general linear model evaluated the interactions between maternal SDB and offspring growth and adiposity measurements after controlling for gestational age and maternal and paternal BMIs. The offspring of mothers with SDB had a significantly smaller head circumference at birth (P = 0.004), with a distinctive pattern of catchup growth by the end of the first year of life (P = 0.018). Their growth pattern was distinguished by compromised birth weight-to-length, rapid catch-up growth, and an increase in both weight-to-length and triceps thickness by the age of three (P < 0.001 and P = 0.001, respectively). Our findings suggest that maternal SDB during pregnancy affects head circumference growth and adiposity acquisition from birth through infancy.

The risk prediction of intergenerational transmission of overweight and obesity between mothers and infants during pregnancy

“…These infants were more likely to develop catch-up growth in early life and be overweight and obese by the age of 3 years. The above-mentioned phenomenon is more likely to occur in mothers who are overweight and obese before pregnancy [ 42 ]. Meng M. et al found that newborns born to overweight and obese mothers with insufficient sleep time in the second and third trimesters had lower leptin levels and higher triglyceride levels in the cord blood, thus, affecting their development [ 43 ].…”

Obstructive Sleep Apnea-Associated Intermittent Hypoxia-Induced Immune Responses in Males, Pregnancies, and Offspring

“…Despite the controversy over OSA-associated fetoplacental hypoxia, recent studies consistently highlight adverse fetal and offspring outcomes of gestational OSA. In humans, gestational OSA is associated with low birth weight, accelerated fetal growth, increased adiposity acquisition indicative of potential metabolic disorders, and impaired neurodevelopment in early childhood [169][170][171]. Correspondingly, animal models suggest that gestational IH leads to compromised social and cognitive function [165,172,173], as well as cardiovascular [174][175][176] and metabolic [177][178][179] dysfunctions.…”

Common sleep disorders in pregnancy: a review

“…Wilson et al ( 145 ) found that mild SDB did not adversely affect fetal growth or size at birth in pregnancies with HDP nor in normotensive pregnancies. Brenner et al ( 135 ) demonstrated that offspring of mothers with SDB in pregnancy had a significantly smaller head circumference at birth and compromised birth weight-to-length followed by rapid catch up growth and an increase in both weight-to-length and tricep thickness by age three. In another study not captured by any metaanalysis to date, Hawkins et al ( 146 ) did not find an association between SDB in early- or mid-pregnancy, SGA, or LGA; however, they did report an association between some measures nocturnal hypoxemia and LGA, independent of BMI.…”

“…The aORs range from 1.42 to 1.73 (31,33,34,95,98,124) 92) reported an association between OSA and depression symptoms (aOR 8.36), especially in those with a history of depression. Biochemically, OSA is associated with higher CRP and decreased HDL-cholesterol (135), decreased MoM level of PAPP-A ( 136), increased ratio of VEGF:PLGF (136), and lower estriol level (137).…”