Association of maternal cardiovascular health in early-to-mid pregnancy with offspring cardiovascular phenotypes in early childhood: a prospective birth cohort study.
Maternal CVH during early-to-mid pregnancy is associated with offspring blood pressure, cardiac structure and function at age 4, indicating the potential value of multifactorial prenatal health assessment for identifying early-life cardiovascular risk, extending existing DOHaD and CVH literature.
Background: Early-life growth is associated with individual cardiometabolic risk factors, but its relationship with overall cardiovascular health (CVH) in low- and middle-income countries (LMICs) is unclear. We examined associations of maternal, household, and child growth factors with young-adult CVH across four LMIC birth cohorts. Methods: We analyzed harmonized data from the Consortium of Health-Oriented Research in Transitioning Societies (COHORTS), including 4,582 participants ages 18-30 years from Brazil, Guatemala, the Philippines, and South Africa. CHV was assessed using a modified American Heart Association Life's Simple 7 score based on body mass index (BMI), blood pressure (BP), fasting blood glucose (FBG), and smoking. Site-specific multivariable ordinal logistic regression models evaluated associations between early-life factors and CVH. Results: Men had poorer CVH than women across most sites, largely because of less favorable BP and smoking profiles. Higher birthweight was associated with lower odds of better CVH in Brazil (AOR=0.81; 95% CI: 0.71-0.94) and the Philippines (AOR=0.63; 95% CI: 0.45-0.87). Greater conditional relative weight at 2 years was also inversely associated with CVH in both sites. Birthweight, conditional height and conditional relative weight at 2 years were strongly associated with adult BMI, whereas associations with BP and FBG were weaker. Attained schooling was associated with CVH in Brazil (AOR = 1.13 per year; 95% CI: 1.10-1.16), and the Philippines (AOR = 1.17; 95% CI: 1.10-1.24). Conclusions: Early-life growth patterns and educational attainment are associated with cardiovascular health in young adulthood across diverse LMIC settings, supporting life-course strategies to promote cardiovascular health.
S. Qabazard, L. Ware, B. Horta et al.· medRxiv· 0 citations
Background Obesity is increasingly common among women of childbearing age worldwide. Maternal obesity during pregnancy may have long-term implications for offspring health, but its association with offspring mortality remains not well understood. In this nationwide cohort study, we examined the associations of maternal body mass index (BMI) in early pregnancy with all-cause and cause-specific mortality in offspring. Methods and findings We included 2,606,684 live births in Sweden during 1982–2014 (except for 1990 and 1991) and followed them from birth until death, emigration from Sweden, or December 31, 2023, whichever came first. Information on maternal BMI during early pregnancy was obtained from the Medical Birth Register and was categorized as: underweight (BMI <18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), obesity grade I (30.0–34.9 kg/m2), obesity grade II (35.0–39.9 kg/m2), and obesity grade III (≥40.0 kg/m2). Data on all-cause and cause-specific mortality in offsprings were obtained from the Cause of Death Register. Cox proportional hazard models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) for offspring mortality according to maternal BMI (both as a continuous and as a categorical variable), adjusting for maternal characteristics (age, education, and income at the childbirth, marital status, country of birth, smoking status in early pregnancy, psychiatric disorders and cardiovascular diseases before the childbirth). We used cousin comparison analysis to explore the potential influence of familial confounding factors. During a median follow-up of 22.4 years (interquartile range 14.9–30.7 years), 21,981 (0.8%) offspring died. Maternal BMI was positively associated with all-cause mortality in offspring: HR 1.03 (95% CI [1.02, 1.03]; p < 0.001) per 1 unit increase in BMI. Offspring of mothers with overweight or obesity (regardless of grade) during early pregnancy had higher risks of all-cause mortality than their counterparts with normal maternal BMI at the reference category; the corresponding HRs were HR 1.11 (95% CI [1.07, 1.15]; p < 0.001) for overweight, HR 1.27 (95% CI [1.20, 1.35]; p < 0.001) for obesity grade I, HR 1.68 (95% CI [1.52, 1.86]; p < 0.001) for obesity grade II, and HR 1.92 (95% CI [1.59, 2.33]; p < 0.001) for obesity grade III, respectively. The associations were similar for several of the most common underlying causes of death in young age, i.e., respiratory diseases, cardiovascular diseases, and congenital anomalies. The associations were attenuated but remained in the cousin comparison analysis. The main limitation was the potential for residual confounding; the observed associations should not be interpreted as evidence of a causal effect of maternal BMI in early pregnancy on offspring mortality. Conclusions Offspring born to mothers with overweight or obesity during early pregnancy had an increased risk of premature mortality up to early adulthood. Given the rising obesity rate in women of childbearing age, our findings underscore the need to better understand the underlying mechanisms for this association. If confirmed by further studies, these results highlight the importance of achieving a healthy maternal BMI prior to conception as a potential strategy to improve child health.
Hui Wang, Hua Chen, J. Möller et al.· PLoS Medicine· 0 citations
Abstract Objective To assess the mechanisms by which intrauterine exposure to maternal obesity and/or gestational diabetes mellitus (GDM) contribute to offspring adiposity and dysmetabolism. Study Design Prospective cohort study at two U.S. centers that enrolled pregnant individuals carrying non-anomalous, singletons at 36 to 40 weeks who met criteria for three groups: (1) normal BMI without GDM, (2) obesity without GDM, and (3) GDM. We collected fasting maternal blood at enrollment; neonatal anthropometrics, air displacement plethysmography, and umbilical cord blood at delivery; and infant body composition at 3 months. Biomarkers and outcomes were compared between maternal exposure groups. Multivariable regression with backward selection identified predictors of offspring outcomes. Results Of 283 participants enrolled, 278 were included in the final analysis: 95 (34.2%) had normal BMI, 104 (37.4%) had obesity without GDM, and 79 (28.4%) had GDM. Maternal biomarkers differed between groups with highest HbA1c, insulin, glucose, triglycerides, and free fatty acids in GDM. Leptin, IL-6, and CRP were highest with obesity, and adiponectin was highest with normal BMI. Neonates born to participants with GDM had higher birthweight, head and abdominal circumferences, and higher C-peptide and leptin levels. No differences were observed between fat free mass, fat mass, percent fat or body mass. By 3 months, only head circumference remained different between groups. Maternal triglycerides was a predictor of multiple neonatal outcomes including birthweight, head and abdominal circumference and leptin. Marital status and delivery gestational age were also associated with multiple outcomes whereas maternal age, gestational weight gain, HbA1c, and cholesterol were only associated with one outcome. Chronic hypertension, income, and IL-6 were not associated with any outcomes. Conclusion Maternal obesity and GDM are associated with neonatal overgrowth, and hypertriglyceridemia may be an important contributor. These findings underscore the importance of metabolic optimization (weight loss, glycemic control, lipid management) before conception to mitigate intergenerational transmission of obesity and metabolic disease. Key Points Metabolic biomarkers vary by obesity and GDM. Neonatal size and biomarkers differ by obesity and GDM. Maternal triglyceridemia may contribute to adverse outcomes.
A. Battarbee, C. Blanchard, P. Chandler-Laney et al.· American Journal of Perinato...· 0 citations
It is suggested that acute maternal stress during pregnancy is associated with cardiovascular risk factors in offspring in adolescence and is modulated by the timing of the exposure.
Moshe Shay Ben-Haim, S. Israel, I. Youssim et al.· International Journal of Epi...· 0 citations
Little evidence that maternal smoking initiation affected WHR is found, and little evidence that maternal smoking heaviness affected the remaining cardiometabolic risk factors; paternal smoking showed no clear effect on any outcome.
G. Power, T. Bond, L. Bhatta et al.· BMC Medicine· 0 citations
BACKGROUND AND AIM
Impacts of maternal exposures on infant metabolic profiles, particularly tracked up to school age, are poorly known. The aim was to investigate associations of maternal obesity, gestational weight gain (GWG) and gestational diabetes mellitus (GDM) with children's serum metabolites.
METHODS
Serum metabolites were analyzed using nuclear magnetic resonance metabolomics at 6 months (n=257) and 1 (n=256), 2 (n=238), and 5-6 years of age (n=139). Associations between maternal exposures and offspring metabolites were examined using multivariable regression models adjusted for confounders and correction for multiple comparisons.
RESULTS
Maternal pre-pregnancy body mass index (pBMI) associated positively with the ratio of n-6 fatty acids to n-3 fatty acids and the particle sizes of very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), and inversely with n-3 fatty acids, docosahexaenoic acid and ratio of phospholipids to total lipids in large LDL-particles at 6 months (false discovery rate < 0.05). Accordingly, maternal obesity showed positive associations with ratio of n-6 fatty acids to n-3 fatty acids and inverse associations with n-3 fatty acids. GDM was negatively associated with the phospholipid-to-total lipids ratio in small VLDL-particles in 2 years old children (false discovery rate < 0.05). No associations of child metabolites were seen with pBMI, obesity at 1-year, 2-years, and 5-6 years, or at any age with GWG after correcting for multiple comparisons.
CONCLUSIONS
These findings suggest that maternal obesity and GDM, shape the offspring's metabolic profile; these may be of significance for later health.
Chunpeng Zhang, V. Houttu, Dattatray Mongad et al.· Clinical Nutrition ESPEN· 0 citations
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