title: Maternal obesity, gestational weight gain and childhood cardiac outcomes: role of childhood body mass index.
abstract: Maternal obesity may affect cardiovascular outcomes in the offspring. We examined the associations of maternal prepregnancy body mass index and gestational weight gain with childhood cardiac outcomes and explored whether these associations were explained by parental characteristics, infant characteristics or childhood body mass index.
  
  
  
  In a population-based prospective cohort study among 4852 parents and their children, we obtained maternal weight before pregnancy and in early, mid- and late pregnancy. At age 6 years, we measured aortic root diameter (cm) and left ventricular dimensions. We calculated left ventricular mass (g), left ventricular mass index (g m(-2.7)), relative wall thickness ((2 × left ventricular posterior wall thickness)/left ventricular diameter), fractional shorting (%), eccentric left ventricular hypertrophy and concentric remodeling.
  
  
  
  A one standard deviation score (SDS) higher maternal prepregnancy body mass index was associated with higher left ventricular mass (0.10 SDS (95% confidence interval (CI) 0.08, 0.13)), left ventricular mass index (0.06 SDS (95% CI 0.03, 0.09)) and aortic root diameter (0.09 SDS (95% CI 0.06, 0.12)), but not with relative wall thickness or fractional shortening. A one SDS higher maternal prepregnancy body mass index was associated with an increased risk of eccentric left ventricular hypertrophy (odds ratio 1.21 (95% CI 1.03, 1.41)), but not of concentric remodeling. When analyzing the effects of maternal weight in different periods simultaneously, only maternal prepregnancy weight and early pregnancy weight were associated with left ventricular mass, left ventricular mass index and aortic root diameter (P-values<0.05), independent of weight in other pregnancy periods. All observed associations were independent of parental and infant characteristics, but attenuated to non-significance after adjustment for childhood body mass index.
  
  
  
  Maternal prepregnancy body mass index and weight gain in early pregnancy are both associated with offspring cardiac structure in childhood, but these associations seem to be fully explained by childhood body mass index.
authors.affiliation: Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Toemen
authors.affiliation: Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: O
authors.initials: O
authors.lastname: Gishti
authors.affiliation: Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: van Osch-Gevers
authors.affiliation: Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: E A P
authors.initials: EA
authors.lastname: Steegers
authors.affiliation: Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: W A
authors.initials: WA
authors.lastname: Helbing
authors.affiliation: Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: J F
authors.initials: JF
authors.lastname: Felix
authors.affiliation: Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: I K M
authors.initials: IK
authors.lastname: Reiss
authors.affiliation: Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Duijts
authors.affiliation: Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Gaillard
authors.affiliation: Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: V W V
authors.initials: VW
authors.lastname: Jaddoe
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002648:Child; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D008297:Male; D009035:Mothers; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology*; D011247:Pregnancy; D011264:Pregnancy Trimesters; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000503:physiopathology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D015430:Weight Gain