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Maternal Factors in Pregnancy and Ethnicity Influence Childhood Adiposity, Cardiac Structure, and Function
Sophia Khan1, Andrew Whatmore1, Reena Perchard1
1Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
Insights
South Asian children have higher adiposity and impaired diastolic function compared to White European children. Maternal glucose levels uniquely impact cardiac function in South Asian children.
Area of Science:
- Pediatric Cardiology
- Metabolic Health
- Ethnic Disparities in Health
Background:
- Maternal and offspring adiposity and metabolic status are linked.
- Limited evidence exists on combined ethnic background, maternal factors, and childhood cardiac outcomes.
Purpose of the Study:
- To investigate the influence of ethnicity, maternal adiposity, maternal glycemic status, and child adiposity on cardiac structure and function in children.
Main Methods:
- Prospective, single-center mother-child cohort study.
- Included 101 healthy pre-pubertal children (56 White Europeans, 45 South Asians).
- Assessed anthropometry, echocardiography, maternal BMI, and glucose levels.
Main Results:
- South Asian children had higher body fat and greater weight/height changes from birth than White Europeans.
- Maternal BMI correlated with child adiposity; maternal glucose linked to child body fat.
- South Asian children showed lower diastolic function (E/A, E'/A') and unique correlations between maternal glycemia and cardiac function.
Conclusions:
- Ethnic differences in adiposity and diastolic function are evident by age 9.1 years.
- Novel associations between maternal glycemia, child adiposity, and cardiac function were found specifically in South Asian children.
Importance:
The links between maternal and offspring adiposity and metabolic status are well established. There is much less evidence for the impact of these relationships combined with ethnic background on cardiac structure and function in childhood.
Objective:
To test the hypothesis that ethnicity, maternal adiposity and glycemic status, and child adiposity affect cardiac structure and function.
Design:
A prospective cohort study.
Setting:
A single-center mother-child cohort study. The cohort is a subset of the international multi-center Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study.
Participants:
This study included 101 healthy pre-pubertal British-born children [56 White Europeans (WEs) and 45 South Asians (SAs)] with a median age of 9.1 years, range 6.0-12.2 years, at the time of the investigation.
Main Outcomes And Measures:
Anthropometric and echocardiographic measurements were made on the cohort. Maternal pregnancy and birth data were available. Relationships between maternal parameters (BMI and glucose status), child adiposity, and echo measures were assessed.
Results:
Despite no ethnic difference in BMI SDS at a median age of 9.1 years, SA children exhibited higher levels of body fat than WE children (whole body, right arm, and truncal fat all p < 0.001). SA children also exhibited greater changes in weight and height SDS but not BMI SDS from birth than WE children. As expected, maternal BMI correlated with child BMI (r = 0.28; p = 0.006), and body fat measures (e.g., whole body fat r = 0.25; p = 0.03). Maternal fasting glucose levels were associated with child body fat measures (r = 0.22-0.28; p = 0.02-0.05). Left ventricular (LV) indices were not different between SA and WE children, but E/A and E'/A' (measures of diastolic function) were lower in SA when compared with WE children. LV indices correlated positively to BMI SDS and body fat markers only in SA children. Maternal fasting and 2-h glucose were negatively correlated with E'/A' in SA children (r = -0.53, p = 0.015, and r = -0.49, p = 0.023, respectively) but not in WE children.
Conclusion And Relevance:
SA and WE children exhibit differences in adiposity and diastolic function at a median age of 9.1 years. Novel relationships between maternal glycemia, child adiposity, and cardiac structure and function, present only in SA children, were identified.
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