Perinatal risk factors for childhood obesity and metabolic dysregulation
Patrick M Catalano1, Kristen Farrell, Alicia Thomas
1Department of Reproductive Biology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA. pcatalano@metrohealth.org
Insights
Maternal pregravid body mass index (BMI) is the strongest predictor of childhood obesity, regardless of maternal glucose status or birth weight. This finding highlights key perinatal risk factors for pediatric obesity.
Area of Science:
- Reproductive biology and pediatric health.
- Metabolic disorders and obesity research.
Background:
- Childhood obesity rates have risen dramatically in recent decades.
- Identifying perinatal risk factors is crucial for early intervention.
Purpose of the Study:
- To investigate perinatal risk factors associated with the development of childhood obesity.
- To determine the predictive power of maternal characteristics and neonatal factors on long-term child weight status.
Main Methods:
- Prospective study of 89 mother-offspring pairs, evaluating maternal glucose tolerance (normal glucose tolerance or gestational diabetes mellitus) and offspring at birth and childhood.
- Assessed obstetrical data, parental anthropometrics, neonatal body composition, childhood diet, activity levels, and metabolic markers.
- Utilized dual-energy X-ray absorptiometry for body composition and logistic/stepwise regression for predictive modeling.
Main Results:
- Maternal pregravid body mass index (BMI) >30 was the strongest predictor of childhood obesity (upper tertile for weight and body fat).
- Children in the upper tertile for weight showed higher energy intake and leptin levels; those with higher body fat had increased waist circumference, insulin resistance, and triglyceride/leptin levels.
- A significant correlation (r=0.29) was found between body fat at birth and in childhood.
Conclusions:
- Maternal pregravid BMI is the most significant independent predictor of childhood obesity.
- This finding is independent of maternal glucose status and birth weight, emphasizing its critical role.
- Early identification of mothers with high BMI can aid in preventing childhood obesity.
Background:
Childhood obesity has increased significantly in recent decades.
Objective:
The objective was to examine the perinatal risk factors related to childhood obesity.
Design:
In a prospective study, 89 women with normal glucose tolerance (NGT) or gestational diabetes mellitus (GDM) and their offspring were evaluated at birth and at 8.8 +/- 1.8 y. At birth, obstetrical data, parental anthropometric measures, and neonatal body composition were assessed; at follow-up, diet and activity were assessed and laboratory studies were conducted. Weight was classified by using weight for age and sex, and body composition was measured by using dual-energy X-ray absorptiometry. In childhood, data were analyzed as tertiles and prediction models were developed by using logistic and stepwise regression.
Results:
No significant differences in Centers for Disease Control and Prevention weight percentiles, body composition, and most metabolic measures were observed between children of mothers with NGT and GDM at follow-up. Children in the upper tertile for weight had greater energy intake (P = 0.02), skinfold thickness (P = 0.0001), and leptin concentrations (P < 0.0001) than did those in tertiles 1 and 2. Children in the upper tertile for percentage body fat had greater waist circumference (P = 0.0001), insulin resistance (P = 0.002), and triglyceride (P = 0.009) and leptin (P = 0.0001) concentrations than did children in tertiles 1 and 2. The correlation between body fat at birth and follow-up was r = 0.29 (P = 0.02). The strongest perinatal predictor for a child in the upper tertile for weight was maternal pregravid body mass index (BMI; kg/m(2)) >30 (odds ratio: 3.75; 95% CI: 1.39, 10.10; P = 0.009) and for percentage body fat was maternal pregravid BMI >30 (odds ratio: 5.45; 95% CI: 1.62, 18.41; P = 0.006).
Conclusion:
Maternal pregravid BMI, independent of maternal glucose status or birth weight, was the strongest predictor of childhood obesity.
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