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The impact of maternal gestational weight gain on cardiometabolic risk factors in children
Claudia H T Tam1, Ronald C W Ma2,3,4, Lai Yuk Yuen5
19/F, Lui Che Woo Clinical Science Building, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong Special Administrative Region, Hong Kong.
Insights
Gestational weight gain (GWG) outside recommendations impacts child health. Both excessive and inadequate GWG are linked to increased childhood adiposity, hypertension, and insulin resistance, highlighting the importance of appropriate weight gain during pregnancy.
Area of Science:
- Reproductive Medicine and Perinatal Health
- Pediatric Endocrinology and Metabolic Health
- Public Health and Epidemiology
Background:
- Gestational weight gain (GWG) is recognized for its impact on pregnancy outcomes.
- Long-term cardiometabolic health implications for offspring following varying GWG have not been extensively studied.
- Understanding the relationship between maternal GWG and offspring's future health is crucial for preventative strategies.
Purpose of the Study:
- To investigate the association between gestational weight gain (GWG) and cardiometabolic risk factors in offspring at 7 years of age.
- To determine if deviations from Institute of Medicine (IOM) guidelines for GWG influence offspring's adiposity, hypertension, and insulin resistance.
- To explore potential quadratic relationships between standardized GWG and cardiometabolic parameters.
Main Methods:
- Analysis of 905 mother-child pairs from the Hyperglycemia and Adverse Pregnancy Outcome study in Hong Kong.
- Classification of maternal GWG into categories: below, within, or exceeding 2009 IOM guidelines, adjusted for pre-pregnancy BMI.
- Assessment of offspring's body size, adiposity, hypertension, and insulin resistance markers at age 7, with adjustments for confounders.
Main Results:
- Offspring of mothers with excessive GWG showed larger body size, increased adiposity, hypertension, and insulin resistance compared to those within guidelines.
- Offspring of mothers with inadequate GWG also exhibited higher risks of hypertension and insulin resistance versus those within recommended ranges.
- Significant quadratic relationships were observed for diastolic blood pressure, insulin AUC, pancreatic beta cell function, and insulin sensitivity index with standardized GWG.
Conclusions:
- Both excessive and inadequate gestational weight gain independently and significantly increase the risk of childhood adiposity, hypertension, and insulin resistance.
- These findings underscore the critical role of appropriate GWG in mitigating long-term cardiometabolic risks for offspring.
- Adverse intrauterine exposures related to GWG appear to have lasting effects on offspring's cardiometabolic health.
Aims/Hypothesis:
Accumulating evidence suggests an impact of gestational weight gain (GWG) on pregnancy outcomes; however, data on cardiometabolic risk factors later in life have not been comprehensively studied. This study aimed to evaluate the relationship between GWG and cardiometabolic risk in offspring aged 7 years.
Methods:
We included a total of 905 mother-child pairs who enrolled in the follow-up visit of the multicentre Hyperglycemia and Adverse Pregnancy Outcome study, at the Hong Kong Centre. Women were classified as having gained weight below, within or exceeding the 2009 Institute of Medicine (IOM) guidelines. A standardised GWG according to pre-pregnancy BMI categories was calculated to explore for any quadratic relationship.
Results:
Independent of pre-pregnancy BMI, gestational hyperglycaemia and other confounders, women who gained more weight than the IOM recommendations had offspring with a larger body size and increased odds of adiposity, hypertension and insulin resistance (range of p values of all the traits: 4.6 × 10-9 < p < 0.0390) than women who were within the recommended range of weight gain during pregnancy. Meanwhile, women who gained less weight than outlined in the recommendations had offspring with increased risks of hypertension and insulin resistance, compared with those who gained weight within the recommended range (7.9 × 10-3 < p < 0.0477). Quadratic relationships for diastolic blood pressure, AUC for insulin, pancreatic beta cell function and insulin sensitivity index were confirmed in the analysis of standardised GWG (1.4 × 10-3 < pquadratic < 0.0282). Further adjustment for current BMI noticeably attenuated the observed associations.
Conclusions/Interpretation:
Both excessive and inadequate GWG have independent and significant impacts on childhood adiposity, hypertension and insulin resistance. Our findings support the notion that adverse intrauterine exposures are associated with persistent cardiometabolic risk in the offspring.
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