Change in modifiable maternal characteristics and behaviours between consecutive pregnancies and offspring adiposity:...

Area of Science:

• Reproductive Health
• Pediatric Obesity
• Maternal-Fetal Medicine

Background:

• Modifiable maternal exposures during the periconceptional period are causally linked to offspring obesity.
• The interconception period presents a critical window for interventions to mitigate these risks.
• Understanding changes in maternal exposures between pregnancies is key to preventing subsequent child adiposity.

Purpose of the Study:

• To systematically identify and synthesize evidence on the impact of changes in modifiable maternal exposures between pregnancies on offspring adiposity.
• To explore the role of the interpregnancy interval in influencing subsequent child adiposity.
• To inform the development of targeted interventions for mothers before a subsequent pregnancy.

Main Methods:

• Systematic review of longitudinal studies published between 1990 and 2019.
• Inclusion criteria: measurements on at least two occasions from 1 year pre-first conception to second birth, and offspring adiposity measures in second or higher-order siblings.
• Focused on modifiable maternal factors, excluding age, ethnicity, and genetics.

Main Results:

• Eleven studies met the inclusion criteria.
• Higher interpregnancy weight changes (gain or loss), maternal smoking initiation, smoking during the first pregnancy with subsequent cessation, increased smoking quantity, and longer interpregnancy intervals were associated with increased offspring adiposity.
• Vaginal birth after cesarean delivery demonstrated a protective effect against offspring adiposity.

Conclusions:

• Changes in maternal exposures during the interconception period significantly influence adiposity risk in subsequent children.
• Further research is required to determine if first pregnancy exposures permanently fix adiposity risk or if interconception changes can modify it.
• Interconception interventions targeting modifiable maternal risk factors hold potential for preventing childhood obesity in subsequent pregnancies.