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Maternal overnutrition elevates offspring's blood pressure-A systematic review and meta-analysis
Szimonetta Eitmann1, Péter Mátrai1, Dávid Németh1
1Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
Insights
Maternal overnutrition increases offspring blood pressure (BP). Higher maternal prepregnancy body mass index (ppBMI) is linked to increased offspring BP, independent of offspring obesity. Gestational weight gain (GWG) impacts offspring BP primarily through offspring obesity.
Area of Science:
- Cardiovascular Health
- Pediatric Endocrinology
- Maternal-Fetal Medicine
Background:
- Maternal overnutrition during pregnancy is a known risk factor for cardiometabolic diseases in offspring.
- Understanding the specific impact of maternal nutritional status on offspring blood pressure is crucial for preventative strategies.
Purpose of the Study:
- To systematically review and meta-analyze the association between maternal overnutrition and offspring blood pressure (BP).
- To investigate the mediating role of offspring obesity in the relationship between maternal overnutrition and offspring BP.
Main Methods:
- A systematic review and meta-analysis of human observational studies published before October 2021.
- Data from 17 studies including 140,517 mother-offspring pairs were analyzed using a random-effect model.
- Quantitative estimates of association between maternal prepregnancy BMI, gestational weight gain, and offspring BP were extracted.
Main Results:
- Increased maternal prepregnancy body mass index (ppBMI) correlated positively with offspring systolic and diastolic BP.
- A 5 kg/m² increase in maternal ppBMI was associated with a 1.9 mmHg rise in offspring systolic BP and a 0.5 mmHg rise in diastolic BP.
- Gestational weight gain (GWG) correlated with offspring systolic BP, but this association was mediated by offspring obesity.
Conclusions:
- Higher maternal prepregnancy BMI independently increases the risk of hypertension in offspring.
- The association between gestational weight gain and offspring systolic BP is indirect, mediated by offspring obesity.
- Reducing maternal obesity and addressing childhood obesity are vital for preventing hypertension in offspring.
Background:
Maternal overnutrition during pregnancy predisposes the offspring to cardiometabolic diseases.
Objectives:
This systematic review and meta-analysis aimed to investigate the association between maternal overnutrition and offspring's blood pressure (BP) and the effect of offspring's obesity on this association.
Data Sources:
PubMed, EMBASE, Clinicaltrials.gov, CENTRAL.
Study Selection And Data Extraction:
Human studies published in English before October 2021 were identified that presented quantitative estimates of association between maternal overnutrition just before or during pregnancy and the offspring's BP.
Synthesis:
Random-effect model with the DerSimonian and Laird weighting method was used to analyse regression coefficients or mean differences.
Results:
After selection, 17 observational studies (140,517 mother-offspring pairs) were included. Prepregnancy body mass index (ppBMI) showed positive correlation with BP in offspring (regression coefficient for systolic: 0.38 mmHg per kg/m2 , 95% confidence interval (CI) 0.17, 0.58; diastolic: 0.10 mmHg per kg/m2 , 95% CI 0.05, 0.14). These indicate 1.9 mmHg increase in systolic and 0.5 mmHg increase in diastolic BP of offspring with every 5 kg/m2 gain in maternal ppBMI. Results on coefficients adjusted for offspring's BMI also showed association (systolic: 0.08 mmHg per kg/m2 , 95% CI 0.04, 0.11; diastolic: 0.03 mmHg per kg/m2 , 95% CI 0.01, 0.04). Independent from ppBMI, gestational weight gain (GWG) showed positive correlation with systolic BP (systolic BP: 0.05 mmHg per kg, 95% CI 0.01, 0.09), but not after adjustment for offspring's BMI. Mean systolic BP was higher in children of mothers with excessive GWG than in those of mothers with optimal GWG (difference: 0.65 mmHg, 95% CI 0.25, 1.05).
Conclusions:
Independent from offspring's BMI, higher prepregnancy BMI may increase the risk for hypertension in offspring. The positive association between GWG and offspring's systolic BP is indirect via offspring's obesity. Reduction in maternal obesity and treatment of obesity in children of obese mothers are needed to prevent hypertension.
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