Increasing maternal prepregnancy body mass index is associated with reduced insulin sensitivity and increased blood pressure in their children.
OBJECTIVE
We aimed to assess the effects of maternal prepregnancy body mass index (BMI) on insulin sensitivity, metabolism and blood pressure in the offspring.


METHODS
We studied 70 prepubertal children aged 8·9 ± 1·9 years (range 4-11 years), born 38-40 weeks of gestation and appropriate-for-gestational-age birthweight. Maternal prepregnancy body mass index (MPP BMI) was calculated from self-reported weight. Children's insulin sensitivity was measured using intravenous glucose tolerance tests and Bergman's minimal model. Other clinical assessments included auxology, fasting lipid and hormonal profiles, DXA-derived body composition and 24-h ambulatory blood pressure monitoring. Data were analysed using random effect mixed models, adjusting for important confounders and a random factor to account for sibling clusters.


RESULTS
Increasing MPP BMI was correlated with increasing BMI standard deviation scores (SDS) (r = 0·30; P = 0·012) and lower insulin sensitivity in their children (r = -0·34; P = 0·004). In multivariate regression models, increasing MPP BMI was associated with lower insulin sensitivity (β = -0·040; P = 0·005), with every 1 kg/m(2) increase in MPP BMI associated with a 4·0% decrease in offspring insulin sensitivity. Greater MPP BMI was associated with higher systolic blood pressure in the daytime (β = 0·794; P = 0·010) and night-time (β = 0·800; P = 0·017), as well as higher 24-h mean arterial pressure (β = 0·508; P = 0·025) in the offspring.


CONCLUSIONS
Greater maternal prepregnancy BMI is associated with lower insulin sensitivity and higher blood pressure in their children, effects that were independent of offspring adiposity. Thus, higher maternal BMI prior to pregnancy (even among women of normal BMI) may contribute to increased risk of type 2 diabetes and other metabolic diseases in the subsequent generation.
Liggins Institute, University of Auckland, Auckland, New Zealand.
José G B
JG
Derraik
Liggins Institute, University of Auckland, Auckland, New Zealand.|Gravida: National Centre for Growth and Development, Auckland, New Zealand.
Ahila
A
Ayyavoo
Liggins Institute, University of Auckland, Auckland, New Zealand.|Gravida: National Centre for Growth and Development, Auckland, New Zealand.
Paul L
PL
Hofman
Liggins Institute, University of Auckland, Auckland, New Zealand.
Janene B
JB
Biggs
Liggins Institute, University of Auckland, Auckland, New Zealand.|Gravida: National Centre for Growth and Development, Auckland, New Zealand.
Wayne S
WS
Cutfield
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008423:Maternal Age; D015999:Multivariate Analysis; D009765:Obesity / Q000503:physiopathology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology; D012044:Regression Analysis; D012307:Risk Factors; D055815:Young Adult