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Maternal obesity and risk of cardiovascular diseases in offspring: a population-based cohort and sibling-controlled
Neda Razaz1, Eduardo Villamor2, Giulia M Muraca1
1Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Insights
Maternal obesity increases offspring cardiovascular disease risk. Higher maternal body mass index (BMI) correlated with greater risk in children and young adults.
Area of Science:
- Reproductive Health
- Pediatric Cardiology
- Public Health
Background:
- Maternal overweight and obesity are potential risk factors for offspring adiposity and cardiovascular diseases.
- The association between maternal obesity severity and offspring cardiovascular disease (CVD) risk requires further investigation.
Purpose of the Study:
- To examine the association between maternal overweight and obesity severity and the risk of cardiovascular diseases in young offspring.
- To investigate the mediating factors and confirm trends through family-based analyses.
Main Methods:
- A population-based cohort study utilizing data from the Swedish Medical Birth Register (1992-2016).
- Maternal body mass index (BMI) was calculated from early pregnancy measurements.
- Multivariable Cox proportional hazards regression and family case-control analyses were employed.
Main Results:
- Over 2.2 million infants were included; 1741 (0.08%) developed cardiovascular disease between ages 1-25.
- Offspring of mothers with obesity grade II (BMI 35.0-39.9) had 1.84 times the risk (HR 1.84; 95% CI 1.36-2.49) compared to normal BMI.
- Offspring of mothers with obesity grade III (BMI ≥40.0) had 2.51 times the risk (HR 2.51; 95% CI 1.60-3.92).
- Increased risk of cerebrovascular diseases was linked to maternal obesity severity, partly mediated by neonatal complications.
Conclusions:
- Maternal obesity is a significant risk factor for cardiovascular diseases in offspring during childhood and early adulthood.
- Further research is needed to replicate these findings and elucidate underlying mechanisms.
Background:
Maternal overweight and obesity might increase risks of adiposity and cardiovascular and metabolic diseases in offspring. We examined associations between maternal overweight and obesity severity and risk of cardiovascular diseases in young offspring.
Methods:
In this population-based cohort study, we used data from live singleton births recorded in the Swedish Medical Birth Register. We calculated maternal BMI in early pregnancy from self-reported height and weight measurements at the first prenatal visit. We used multivariable Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% CIs. We calculated the proportion of the associations mediated through known consequences of obesity that also predicted cardiovascular diseases and did family case-control analyses.
Findings:
We identified 2 230 115 live singleton infants (without congenital malformations) in Sweden registered between Jan 1, 1992, and Dec 31, 2016. Overall, 1741 (0·08%) offspring were diagnosed with a cardiovascular disease between ages 1 and 25 years. Cardiovascular disease rates by maternal BMI categories were 0·57 per 10 000 child-years (BMI 18·5-24·9 kg/m2; normal weight), 0·61 per 10 000 child-years (25·0-29·9 kg/m2; overweight), 0·67 per 10 000 child-years (30·0-34·9 kg/m2; obesity grade I), 1·02 per 10 000 child-years (35·0-39·9 kg/m2; obesity grade II), and 1·38 per 10 000 child-years (≥40·0 kg/m2; obesity grade III). Compared with offspring of mothers with normal BMI, HRs of cardiovascular diseases were 1·10 (95% CI 0·97-1·25) for overweight, 1·16 (0·95-1·43) for obesity grade I, 1·84 (1·36-2·49) for obesity grade II, and 2·51 (1·60-3·92) for obesity grade III. Risks of cerebrovascular diseases increased with maternal obesity severity and were partly mediated through asphyxia-related neonatal complications. The sibling-cohort analysis also indicated a positive trend between maternal BMI and cardiovascular disease rates.
Interpretations:
Our findings indicate that maternal obesity might be a risk factor for cardiovascular diseases in childhood and early adulthood. These results need to be replicated and possible underlying mechanisms identified.
Funding:
Swedish Research Council for Health, Working Life and Welfare.
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