title: Associations of maternal prepregnancy body mass index and gestational weight gain with cardio-metabolic risk factors in adolescent offspring: a prospective cohort study.
abstract: OBJECTIVE
  To assess the associations of maternal prepregnancy body mass index (BMI) and rates of early-pregnancy, mid-pregnancy and total gestational weight gain with adolescent body fat distribution and cardio-metabolic outcomes.
  
  
  METHODS
  Population-based prospective cohort study.
  
  
  METHODS
  Western Australia.
  
  
  METHODS
  Thousand three hundred and ninety-two mothers and their children.
  
  
  METHODS
  Maternal prepregnancy weight was assessed by questionnaire. Maternal weights at a mean of 16.5 ± 2.2 SD and 34.1 ± 1.5 SD weeks of gestation were obtained from medical records. Offspring adiposity and cardio-metabolic outcomes were assessed at a median age 17.0 years [95% confidence interval (CI) range: 16.7, 17.7].
  
  
  METHODS
  Adolescent BMI, waist circumference (WC), waist-to-hip ratio (WHR), blood pressure, total and HDL-cholesterol, triglycerides, insulin, glucose and HOMA-IR.
  
  
  RESULTS
  Higher prepregnancy BMI was associated with higher adolescent BMI, WC, WHR, systolic blood pressure, insulin, glucose and HOMA-IR levels (P-values <0.05). Adjustment for adolescent current BMI attenuated the associations of prepregnancy BMI with adolescent cardio-metabolic outcomes. Higher weight gain in early-pregnancy, but not mid-pregnancy, was associated with higher adolescent BMI, WC and WHR (P-values <0.05), but not with other cardio-metabolic risk factors. Total gestational weight gain was associated with adolescent BMI and WC (P-values <0.05). Higher prepregnancy BMI and early-pregnancy weight gain were associated with increased risks of the high-metabolic risk cluster in adolescents (OR 1.57, 95% CI 1.33, 1.85 and OR 1.23, 95% CI 1.03, 1.47 per SD increase in prepregnancy BMI and early-pregnancy weight gain, respectively).
  
  
  CONCLUSIONS
  Higher maternal prepregnancy BMI and early-pregnancy weight gain rate are associated with an adverse adolescent cardio-metabolic profile. These associations are largely mediated by adolescent BMI.
authors.affiliation: Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Gaillard
authors.affiliation: Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Welten
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
authors.forename: W H
authors.initials: WH
authors.lastname: Oddy
authors.affiliation: School of Medicine and Pharmacology, UWA, Perth, WA, Australia.
authors.forename: L J
authors.initials: LJ
authors.lastname: Beilin
authors.affiliation: School of Medicine and Pharmacology, UWA, Perth, WA, Australia.
authors.forename: T A
authors.initials: TA
authors.lastname: Mori
authors.affiliation: Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: V W V
authors.initials: VW
authors.lastname: Jaddoe
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
authors.forename: R-C
authors.initials: RC
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D015430:Weight Gain; D014904:Western Australia / Q000453:epidemiology
keywords: Adiposity; adolescence; blood pressure; cohort study; gestational weight gain; insulin/glucose; lipids; maternal body mass index; pregnancy