title: Childhood cardiometabolic outcomes of maternal obesity during pregnancy: the Generation R Study.
abstract: Maternal prepregnancy obesity is associated with impaired cardiometabolic health in offspring. Whether these associations reflect direct intrauterine causal mechanisms remains unclear. In a population-based prospective cohort study among 4871 mothers, fathers, and their children, we examined the associations of both maternal and paternal prepregnancy body mass index (BMI) with childhood body fat distribution and cardiometabolic outcomes and explored whether any association was explained by pregnancy, birth, and childhood factors. We measured childhood BMI, total body and abdominal fat distribution, blood pressure, and blood levels of lipids, insulin, and C-peptide at the age of 6 years. We observed that higher maternal and paternal prepregnancy BMI were associated with higher childhood BMI, total body and abdominal fat mass measures, systolic blood pressure, and insulin levels and lower high-density lipoprotein cholesterol levels (P<0.05). Stronger associations were present for maternal than paternal BMI, with statistical support for heterogeneity between these associations. The associations for childhood fat mass and cardiometabolic outcomes attenuated after adjustment for childhood current BMI. Compared with children from normal-weight mothers, those from obese mothers had increased risks of childhood overweight (odds ratio, 3.84 [95% confidence interval, 3.01-4.90]) and clustering of cardiometabolic risk factors (odds ratio, 3.00 [95% confidence interval, 2.09-4.34]). Smaller effect estimates for these outcomes were observed for paternal obesity. In conclusion, higher maternal and paternal prepregnancy BMI were associated with an adverse cardiometabolic profile in offspring, with stronger associations present for maternal prepregnancy BMI. These findings suggest that maternal prepregnancy BMI may influence the cardiometabolic health of offspring through direct intrauterine mechanisms.
authors.affiliation: The Generation R Study Group (Na29-15), Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. v.jaddoe@erasmusmc.nl.
authors.forename: Romy
authors.initials: R
authors.lastname: Gaillard
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Duijts
authors.forename: Janine F
authors.initials: JF
authors.lastname: Felix
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D050218:Body Fat Distribution; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D009426:Netherlands; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D002784:Cholesterol
keywords: blood pressure; body mass index; cohort studies; lipids; pediatric obesity; pregnancy