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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Maternal prepregnancy BMI, offspring's early postnatal growth, and metabolic profile at age 5-6 years: the ABCD Study
Adriëtte J J M Oostvogels1, Karien Stronks, Tessa J Roseboom
1Departments of Public Health (A.J.J.M.O., K.S., T.G.M.V.), Clinical Epidemiology, Biostatistics, and Bioinformatics (T.J.R.), and Gynecology and Obstetrics (T.J.R., J.A.M.v.d.P.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; and Department of Epidemiology and Health Promotion (M.v.E.), Public Health Service, 1018 WT Amsterdam, The Netherlands.
Insights
Maternal prepregnancy body mass index (pBMI) and accelerated infant growth are linked to poor cardiometabolic health in children. Their combined effect amplifies risks, highlighting the importance of monitoring both factors for early intervention.
Area of Science:
- Pediatric Health
- Cardiometabolic Health
- Maternal-Child Health
Background:
- Maternal prepregnancy body mass index (pBMI) is linked to adverse cardiometabolic outcomes in offspring.
- Accelerated postnatal growth in infants also poses risks to later cardiometabolic health.
- The interaction between maternal pBMI and offspring's postnatal growth requires further investigation.
Purpose of the Study:
- To examine the association between maternal pBMI and offspring's metabolic profile at 5-6 years of age.
- To determine if offspring's postnatal growth mediates or moderates this association.
- To investigate the combined impact of maternal pBMI and postnatal growth on child metabolic health.
Main Methods:
- Analysis of 1459 mother-child pairs from the prospective ABCD study.
- Assessment of maternal pBMI and offspring's postnatal growth (weight and weight-for-length gain) from 1-3 months.
- Evaluation of offspring's metabolic components at 5-6 years, including WHtR, blood pressure, glucose, triglycerides, and HDL-C.
Main Results:
- Maternal pBMI was associated with increased offspring WHtR, SBP, DBP, and metabolic score.
- Postnatal weight gain and weight-for-length gain were independently linked to higher WHtR, glucose, and metabolic scores.
- Interactions between maternal pBMI and postnatal growth were observed for SBP, triglycerides, and metabolic score.
Conclusions:
- Both high maternal pBMI and accelerated postnatal growth are independently associated with adverse metabolic profiles in early childhood.
- Postnatal growth does not appear to mediate the effects of maternal pBMI on offspring's metabolic health.
- The combination of high maternal pBMI and accelerated postnatal growth amplifies adverse metabolic effects in children.
Context:
Maternal prepregnancy body mass index (pBMI) and offspring's accelerated postnatal growth have adverse consequences for later cardiometabolic health, but it is unknown how these two factors interact.
Objective:
To assess the association between maternal pBMI and offspring's metabolic profile at age 5-6 years and determine the role (independent/mediating/moderating) of offspring's postnatal growth in this association.
Design/Participants:
In total, 1459 mother-child pairs from the prospective ABCD study with known maternal pBMI, offspring postnatal growth (weight and weight-for-length gain) between age 1-3 months (Δ SD score).
Main Outcome Measures:
We analyzed metabolic components of offspring at age 5-6 years, including waist-to-height-ratio (WHtR), systolic/diastolic blood pressure (SBP/DBP), fasting glucose, triglycerides, and high-density lipoprotein-cholesterol values, both individually (Z-scores) and combined (sum Z-scores; metabolic score).
Results:
Maternal pBMI was positively associated with offspring's WHtR (β = 0.025; 95% confidence interval [CI], 0.010-0.039), SBP (β = 0.020; 95% CI, 0.005-0.0035), DBP (β = 0.016; 95% CI, 0.000-0.031), and metabolic score (β = 0.078; 95% CI, 0.039-0.118) after adjusting. Adding postnatal growth had no relevant impact on these effect sizes. Postnatal weight gain was independently associated with WHtR (β = 0.199; 95% CI, 0.097-0.300), fasting glucose values (β = 0.117; 95% CI, 0.008-0.227), metabolic score (β = 0.405; 95% CI, 0.128-0.682). Postnatal weight-for-length gain was independently associated with WHtR (β = 0.145; 95% CI, 0.080-0.211), and metabolic score (β = 0.301; 95% CI, 0.125-0.477). An interaction between maternal pBMI and postnatal weight gain was present in the association with SBP (P = .021) and metabolic score (P = .047), and between maternal pBMI and postnatal weight-for-length gain in the association with triglycerides (P = .022) and metabolic score (P = .042).
Conclusions:
Both high maternal pBMI and postnatal accelerated growth are associated with adverse metabolic components in early childhood. No evidence was found for a mediating role of postnatal growth. The combination of high maternal pBMI and postnatal accelerated growth amplified individual effects.
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