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The Effects of a Preconception Lifestyle Intervention on Childhood Cardiometabolic Health-Follow-Up of a Randomized
Stijn Mintjens1,2,3, Mireille N M van Poppel4,5, Henk Groen6
1Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands.
Insights
A lifestyle intervention before pregnancy did not significantly improve offspring cardiometabolic health in obese women. Low follow-up rates and potential biases limited the study
Area of Science:
- Reproductive Health
- Pediatric Health
- Metabolic Health
Background:
- Maternal obesity is linked to adverse offspring metabolic outcomes, including obesity and poor cardiometabolic health.
- Preconception interventions aim to mitigate these risks, but their long-term effects on offspring health require investigation.
Purpose of the Study:
- To determine if a preconception lifestyle intervention in obese women improves their offspring's cardiometabolic health.
- To assess the impact on children's Body Mass Index (BMI) Z scores, blood pressure, and metabolic markers.
Main Methods:
- Randomized controlled trial involving 577 infertile women with obesity.
- Intervention group received a 6-month lifestyle program; control group received prompt infertility management.
- Follow-up assessed cardiometabolic parameters in 3- to 6-year-old children (17 intervention, 29 control).
Main Results:
- No significant differences were found in offspring BMI Z scores or blood pressure Z scores between groups.
- Other cardiometabolic outcomes, including body fat percentage and serum lipids, also showed no significant differences.
- Offspring in both groups exhibited elevated BMI and blood pressure Z scores compared to population norms.
Conclusions:
- The preconception lifestyle intervention did not demonstrate a detectable effect on the cardiometabolic health of offspring in this study.
- Low follow-up rates and potential selection bias may have limited the ability to detect intervention effects.
- Further research with improved follow-up and bias mitigation is needed to confirm potential benefits.
Abstract:
Maternal obesity is associated with adverse metabolic outcomes in her offspring, from the earliest stages of development leading to obesity and poorer cardiometabolic health in her offspring. We investigated whether an effective preconception lifestyle intervention in obese women affected cardiometabolic health of their offspring. We randomly allocated 577 infertile women with obesity to a 6-month lifestyle intervention, or to prompt infertility management. Of the 305 eligible children, despite intensive efforts, 17 in the intervention and 29 in the control group were available for follow-up at age 3-6 years. We compared the child's Body Mass Index (BMI) Z score, waist and hip circumference, body-fat percentage, blood pressure Z scores, pulse wave velocity and serum lipids, glucose and insulin concentrations. Between the intervention and control groups, the mean (±SD) offspring BMI Z score (0.69 (±1.17) vs. 0.62 (±1.04)) and systolic and diastolic blood pressure Z scores (0.45 (±0.65) vs. 0.54 (±0.57); 0.91 (±0.66) vs. 0.96 (±0.57)) were similar, although elevated compared to the norm population. We also did not detect any differences between the groups in the other outcomes. In this study, we could not detect effects of a preconception lifestyle intervention in obese infertile women on the cardiometabolic health of their offspring. Low follow-up rates, perhaps due to the children's age or the subject matter, combined with selection bias abating contrast in periconceptional weight between participating mothers, hampered the detection of potential effects. Future studies that account for these factors are needed to confirm whether a preconception lifestyle intervention may improve the cardiometabolic health of children of obese mothers.
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