Association of pre-pregnancy body mass index with future offspring metabolic profile: findings from three independent European birth cohorts

AbstractBackgroundA high proportion of women start pregnancy overweight/obese. According to the developmental overnutrition hypothesis, this could lead offspring to have metabolic disruption throughout their lives, and, thus perpetuate the obesity epidemic across generations. Concerns about this hypothesis are influencing antenatal care. However, it is unknown whether maternal pregnancy adiposity is associated with long-term risk of adverse metabolic profiles in offspring, and if so, whether this association is causal, via intrauterine mechanisms, or explained by shared familial (genetic, lifestyle, socioeconomic) characteristics. We aimed to determine if associations between maternal body mass index (BMI) with offspring systemic metabolite profile are causal via intrauterine mechanisms or familial factors.Methods and FindingsWe used one and two-stage individual participant data (IPD) metaanalysis, and a negative-control (paternal BMI) to examine the association between maternal prepregnancy BMI and offspring serum metabolome from three European birth cohorts (offspring age at metabolite assessment 16, 17 and 31 years). Circulating metabolites were quantified by high-throughput nuclear magnetic resonance metabolomics. Results from one-stage IPD meta-analysis (N=5327 to 5377 mother-father-offspring trios) showed that increasing maternal and paternal BMI was associated with an adverse cardio-metabolic profile in offspring. We observed strong positive associations with VLDL-lipoproteins, VLDL-C, VLDL-triglycerides, VLDL-diameter, branched/aromatic amino acids, glycoprotein acetyls, and triglycerides, and strong negative associations with HDL-lipoprotein, HDL-diameter, HDL-C, HDL2-C and HDL3-C (all P<0.003). Stronger magnitudes of associations were present for maternal compared with paternal BMI across these associations, however there was no strong statistical evidence for heterogeneity between them (all bootstrap P >0.003, equivalent to 0.05 after accounting for multiple testing). Results were similar in each individual cohort, and in the two-stage analysis. Offspring BMI showed similar patterns of crosssectional association with metabolic profiles as for parental pre-pregnancy BMI associations, but with greater magnitudes. Adjustment of the parent BMI-offspring metabolite associations for offspring BMI suggested the parental associations were largely due to the association of parental BMI measures with offspring BMI.ConclusionOur findings suggest that maternal BMI-offspring metabolome associations are likely to be largely due to shared genetic or familial lifestyle confounding, rather than intrauterine programming mechanisms. They do not support the introduction of measures to reduce maternal BMI in order to prevent adverse offspring cardio-metabolic health.

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Effect of Maternal Body Mass Index and Amniotic Fluid Index on the Accuracy of Sonographic Estimation of Fetal Weight in Late Gestation

American Journal of Perinatology ◽

10.1055/s-0037-1618588 ◽

2018 ◽

Vol 35 (13) ◽

pp. 1235-1240 ◽

Cited By ~ 3

Author(s):

Burton Rochelson ◽

Leah Stork ◽

Stephanie Augustine ◽

Meir Greenberg ◽

Cristina Sison ◽

...

Keyword(s):

Body Mass Index ◽

Amniotic Fluid ◽

Body Mass ◽

Fetal Weight ◽

Maternal Body Mass Index ◽

Amniotic Fluid Index ◽

Maternal Body ◽

Significant Difference ◽

Substantial Error ◽

Maternal Bmi

Objective The objective of this study was to determine the effect, if any, of maternal body mass index (BMI) and amniotic fluid index (AFI) on the accuracy of sonographic estimated fetal weight (EFW) at 40 to 42 weeks' gestation. Methods This was a retrospective cohort study of singleton gestations with ultrasound performed at 40 to 42 weeks from 2010 to 2013. In this study, patients with documented BMI and sonographic EFW and AFI, concurrently, within 7 days of delivery were included. Chronic medical conditions and fetal anomalies were excluded from this study. The primary variable of interest was the rate of substantial error in EFW, defined as absolute percentage error (APE) >10%. Results A total of 1,000 pregnancies were included. Overall, the APE was 6.0 ± 4.5% and the rate of substantial error was 17.4% (n = 174). There was no significant difference in APE or rate of substantial error between BMI groups. In the final multivariable logistic regression model, the rate of substantial error was increased in women with oligohydramnios (OR 1.79; 95% CI: 1.10–2.92). Furthermore, oligohydramnios was significantly more likely to overestimate EFW while polyhydramnios was more likely to underestimate EFW. Maternal BMI did not affect the accuracy of sonographic EFW. Conclusion Sonographic EFW may be affected by extremes of AFI in the postdates period. Maternal BMI does not affect EFW accuracy at 40 to 42 weeks.

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Exploratory Study of the Relationship Between Maternal Body Mass Index and Spontaneous Fetal Movements

Inquiry@Queen's Undergraduate Research Conference Proceedings ◽

10.24908/iqurcp.8769 ◽

2016 ◽

Author(s):

Wei Ning (Will) Jiang

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Interrater Reliability ◽

Well Being ◽

Normal Weight ◽

Maternal Body Mass Index ◽

Body Movements ◽

Maternal Body ◽

Fetal Movements ◽

Maternal Bmi

Maternal body mass index (BMI) has been reported to be associated with the number of fetal body movements and the duration of fetal breathing movements in hypertensive pregnant women (Brown et al., 2008). However, whether a relationship exists in pregnancies classified as overweight or normal weight but not complicated by hypertension is unknown and the focus of this study. Forty-five maternal-fetal pairs (normotensive, normal weight=15; normotensive, overweight=15; hypertensive=15) who had participated in a study of fetal behavior which included a 20 min real-time ultrasound scan observation of fetal movements were randomly selected from the laboratory archival database. Gestational age at testing ranged from 33-39 weeks [M(SD)= 36.2 (1.4) weeks]. All infants were delivered healthy at term. Video-recordings of the ultrasound scans were scored for the number of fetal body movements (interrater reliability r=.97) and the cumulative duration of breathing (interrater reliability r=.94) movements. The number of fetal body movements differed between groups, F(2,38)=3.19, p=0.05, with fetuses of overweight mothers moving less frequently than those of normal weight mothers (M=9.7 vs 15.5, respectively). Maternal BMI prior to pregnancy, r=-0.43, p<0.01, and at time of observation, r=-0.44, p<0.01, was associated with the number of fetal body movements, but not with duration of breathing movements. As BMI increased, the number of fetal body movements decreased. It was concluded that maternal BMI may affect the number of spontaneous fetal movements. A prospective study is necessary to determine whether BMI should be considered when using body movement counts to assess well-being and/or neurodevelopment.

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Exploring the role of genetic confounding in the association between maternal and offspring body mass index: evidence from three birth cohorts

International Journal of Epidemiology ◽

10.1093/ije/dyz095 ◽

2019 ◽

Vol 49 (1) ◽

pp. 233-243 ◽

Cited By ~ 4

Author(s):

Tom A Bond ◽

Ville Karhunen ◽

Matthias Wielscher ◽

Juha Auvinen ◽

Minna Männikkö ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Sensitivity Analyses ◽

Nucleotide Polymorphisms ◽

Birth Cohorts ◽

Single Nucleotide ◽

Individual Participant ◽

Offspring Genotype ◽

Maternal Bmi

Abstract Background Maternal pre-pregnancy body mass index (BMI) is positively associated with offspring birth weight (BW) and BMI in childhood and adulthood. Each of these associations could be due to causal intrauterine effects, or confounding (genetic or environmental), or some combination of these. Here we estimate the extent to which the association between maternal BMI and offspring body size is explained by offspring genotype, as a first step towards establishing the importance of genetic confounding. Methods We examined the associations of maternal pre-pregnancy BMI with offspring BW and BMI at 1, 5, 10 and 15 years, in three European birth cohorts (n ≤11 498). Bivariate Genomic-relatedness-based Restricted Maximum Likelihood implemented in the GCTA software (GCTA-GREML) was used to estimate the extent to which phenotypic covariance was explained by offspring genotype as captured by common imputed single nucleotide polymorphisms (SNPs). We merged individual participant data from all cohorts, enabling calculation of pooled estimates. Results Phenotypic covariance (equivalent here to Pearson’s correlation coefficient) between maternal BMI and offspring phenotype was 0.15 [95% confidence interval (CI): 0.13, 0.17] for offspring BW, increasing to 0.29 (95% CI: 0.26, 0.31) for offspring 15 year BMI. Covariance explained by offspring genotype was negligible for BW [–0.04 (95% CI: –0.09, 0.01)], but increased to 0.12 (95% CI: 0.04, 0.21) at 15 years, which is equivalent to 43% (95% CI: 15%, 72%) of the phenotypic covariance. Sensitivity analyses using weight, BMI and ponderal index as the offspring phenotype at all ages showed similar results. Conclusions Offspring genotype explains a substantial fraction of the covariance between maternal BMI and offspring adolescent BMI. This is consistent with a potentially important role for genetic confounding as a driver of the maternal BMI–offspring BMI association.

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Maternal body mass index in pregnancy and mental disorders in adult offspring: a record linkage study in Aberdeen, Scotland

Scientific Reports ◽

10.1038/s41598-021-94511-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Marius Lahti-Pulkkinen ◽

Katri Räikkönen ◽

Sohinee Bhattacharya ◽

Rebecca M. Reynolds

Keyword(s):

Body Mass Index ◽

Mental Disorders ◽

Body Mass ◽

Maternal Obesity ◽

Severe Obesity ◽

Maternal Body Mass Index ◽

Adult Offspring ◽

Maternal Body ◽

Maternal Bmi ◽

In Pregnancy

AbstractMaternal obesity in pregnancy predicts offspring psychopathology risk in childhood but it remains unclear whether maternal obesity or underweight associate with adult offspring mental disorders. We examined longitudinally whether maternal body mass index (BMI) in pregnancy predicted mental disorders in her offspring and whether the associations differed by offspring birth year among 68,571 mother–child dyads of Aberdeen Maternity and Neonatal Databank, Scotland. The offspring were born 1950–1999. Maternal BMI was measured at a mean 15.7 gestational weeks and classified into underweight, normal weight, overweight, moderate obesity and severe obesity. Mental disorders were identified from nationwide registers carrying diagnoses of all hospitalizations and deaths in Scotland in 1996–2017. We found that maternal BMI in pregnancy was associated with offspring mental disorders in a time-dependent manner: In offspring born 1950–1974, maternal underweight predicted an increased hazard of mental disorders [Hazard Ratio (HR) = 1.74; 95% Confidence Interval (CI) = 1.01–3.00)]. In offspring born 1975–1999, maternal severe obesity predicted increased hazards of any mental (HR 1.60; 95% CI 1.08–2.38) substance use (HR 1.91; 95% CI 1.03–3.57) and schizophrenia spectrum (HR 2.80; 95% CI 1.40–5.63) disorders. Our findings of time-specific associations between maternal prenatal BMI and adult offspring mental disorders may carry important public health implications by underlining possible lifelong effects of maternal BMI on offspring psychopathology.

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Maternal Body Mass Index and Risk of Congenital Heart Defects in Infants: A Dose-Response Meta-Analysis

BioMed Research International ◽

10.1155/2019/1315796 ◽

2019 ◽

Vol 2019 ◽

pp. 1-14 ◽

Cited By ~ 2

Author(s):

Xuezhen Liu ◽

Guoyong Ding ◽

Weili Yang ◽

Xia Feng ◽

Yuejin Li ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Congenital Heart Defects ◽

Dose Response ◽

Congenital Heart ◽

Heart Defects ◽

Meta Analysis ◽

Maternal Body Mass Index ◽

Increased Risk ◽

Maternal Bmi

Objective. The exact shape of the dose-response relationship between maternal body mass index (BMI) and the risk of congenital heart defects (CHDs) in infants has not been clearly defined yet. This study aims to further clarify the relationship between maternal obesity and the risk of CHDs in infants by an overall and dose-response meta-analysis. Methods. PubMed, Embase, and Web of Science databases were searched to identify all related studies. The studies were limited to human cohort or case-control studies in English language. Random-effect models and dose-response meta-analysis were used to synthesize the results. Heterogeneity, subgroup analysis, sensitivity analysis, and publication bias were also assessed. Results. Nineteen studies with 2,416,546 participants were included in our meta-analysis. Compared with the mothers with normal weight, the pooled relative risks (RRs) of infants with CHDs were 1.08 (95% CI=1.03-1.13) in overweight and 1.23 (95% CI=1.17-1.29) in obese mothers. According to the findings from the linear meta-analysis, we observed an increased risk of infants with CHDs (RR=1.07, 95% CI=1.06-1.08) for each 5 kg/m2 increase in maternal BMI. A nonlinear relationship between maternal BMI and risk of infants with CHDs was also found (p=0.012). Conclusion. The results from our meta-analysis indicate that increased maternal BMI is related to increased risk of CHDs in infants.

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Effect of Maternal Body Mass Index on Intrapartum and Neonatal Outcome in Nulliparous Women in North Karnataka: A Prospective Cohort Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/50002.15278 ◽

2021 ◽

Author(s):

Krutika Sainath Andola ◽

Hema Sinhasane ◽

Ravikumar Subhash Kurle ◽

Umadevi Sainath Andola ◽

Shruthi Sainath Andola

Keyword(s):

Body Mass Index ◽

Birth Weight ◽

Body Mass ◽

Pregnancy Complications ◽

Neonatal Outcome ◽

World Health ◽

Maternal Body Mass Index ◽

Increased Risk ◽

Modifiable Factors ◽

Maternal Bmi

Introduction: Nutrient intake and weight gain are the two main modifiable factors during pregnancy that influence maternal and infant outcome. Body Mass Index (BMI) derived from weight and height is a marker of metabolic and endocrinal status and is used to classify people from underweight to obese. Pregnancy complications related to maternal BMI is a growing problem. Both lean and obese mothers carry an increased risk of adverse perinatal outcome. Aim: To assess the effect of maternal BMI on labour and mode of delivery, neonatal outcome and to detect the obstetric complications in relation to different BMI’s. Materials and Methods: A prospective study was conducted in Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India, from August 2014 to July 2016 in which total of 200 primigravidas with singleton pregnancy; in labour after 28 weeks of gestation were included. BMI was calculated using the formula by Quetelet. The women were categorised into underweight, normal, overweight and obese according to World Health Organisation (WHO). Results: Out of 200 cases, 111 (55.5%) were of normal BMI, 61 (30.5%) overweight, 16 (8.0%) obese and 12 (6.0%) underweight. Pre-eclampsia, oligohydramnios, Intrauterine Growth Restriction (IUGR), anaemia, foetal birth weight <2.5 kg, increased incidence of Neonatal Intensive Care Unit (NICU) admissions and early neonatal complications were commonly seen in underweight which was statistically significant (p<0.01). Gestational hypertension (n=5), increased incidence of caesarean sections (n=13), foetal birth weight >3.5 kg (n=5), failed spinal anaesthesia (n=2), postpartum haemorrhage (n=4), post Lower Segment Caesarean Section (LSCS) wound gape (n=2) and prolonged hospital stay (n=3) were the complications seen in obese individuals. Conclusion: Maternal BMI showed a strong association between pregnancy complications and outcomes. Therefore, all the pregnant women need to be advised to maintain normal BMI in order to achieve a healthy outcome as both underweight and obese women carry risk for adverse pregnancy outcome.

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The Association between Maternal Height, Body Mass Index, and Perinatal Outcomes

American Journal of Perinatology ◽

10.1055/s-0038-1673395 ◽

2018 ◽

Vol 36 (06) ◽

pp. 632-640 ◽

Cited By ~ 4

Author(s):

Nicole Marshall ◽

Frances Biel ◽

Janne Boone-Heinonen ◽

Dmitry Dukhovny ◽

Aaron Caughey ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Regression Models ◽

Perinatal Outcomes ◽

Maternal Body Mass Index ◽

Maternal Height ◽

Logistic Regression Models ◽

Adverse Perinatal Outcomes ◽

Multivariable Adjustment ◽

Maternal Bmi

Objective To test the hypothesis that maternal height is associated with adverse perinatal outcomes, controlling for and stratified by maternal body mass index (BMI). Study Design This was a retrospective cohort study of all births in California between 2007 and 2010 (n = 1,775,984). Maternal height was categorized into quintiles, with lowest quintile (≤20%) representing shorter stature and the uppermost quintile (≥80%) representing taller stature. Outcomes included gestational diabetes mellitus (GDM), preeclampsia, cesarean, preterm birth (PTB), macrosomia, and low birth weight (LBW). We calculated height/outcome associations among BMI categories, and BMI/outcome associations among height categories, using various multivariable logistic regression models. Results Taller women were less likely to have GDM, nulliparous cesarean, PTB, and LBW; these associations were similar across maternal BMI categories and persisted after multivariable adjustment. In contrast, when stratified by maternal height, the associations between maternal BMI and birth outcomes varied by specific outcomes, for example, the association between morbid obesity (compared with normal or overweight) and the risk of GDM was weaker among shorter women (adjusted odds ratio [aOR], 95% confidence interval [CI]: 3.48, 3.28–3.69) than taller women (aOR, 95% CI: 4.42, 4.19–4.66). Conclusion Maternal height is strongly associated with altered perinatal risk even after accounting for variations in complications by BMI.

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Maternal body mass index in early pregnancy and severe asphyxia-related complications in preterm infants

International Journal of Epidemiology ◽

10.1093/ije/dyaa088 ◽

2020 ◽

Vol 49 (5) ◽

pp. 1647-1660

Author(s):

Ayoub Mitha ◽

Ruoqing Chen ◽

Stefan Johansson ◽

Neda Razaz ◽

Sven Cnattingius

Keyword(s):

Body Mass Index ◽

Preterm Infants ◽

Body Mass ◽

Early Pregnancy ◽

Gestational Age ◽

Maternal Body Mass Index ◽

Neonatal Seizures ◽

Maternal Body ◽

Apgar Scores ◽

Maternal Bmi

Abstract Background Little is known about the associations between maternal body mass index (BMI) and asphyxia-related morbidity in preterm infants (<37 weeks). We aimed to investigate associations between maternal BMI in early pregnancy and severe asphyxia-related neonatal complications in preterm infants (<37 weeks) and to examine whether possible associations were mediated by overweight- or obesity-related complications. Methods In this Swedish population-based cohort of 62 499 singleton non-malformed preterm infants born from 1997 to 2011, risks of low Apgar scores (0–3) at 5 and 10 minutes, neonatal seizures and intraventricular haemorrhage (IVH) were estimated through two analytical approaches. In the conventional approach, the denominator for risk was all live births at a given gestational age. In the fetuses-at-risk (FAR) approach, the denominator for risk was ongoing pregnancies at a given gestational age. Results Using the conventional approach, adjusted risk ratios per 10-unit BMI increase were 1.32 [95% confidence interval (CI) 1.13–1.54] and 1.37 (95% CI 1.12–1.67) for low Apgar scores at 5 and 10 minutes, respectively; 1.28 (95% CI 1.00–1.65) for neonatal seizures; and 1.18 (95% CI 1.01–1.37) for IVH. Using the FAR approach, corresponding risks were higher. These associations varied by gestational age (<32 and 32–36 weeks). Associations between maternal BMI and asphyxia-related outcomes were partly mediated through lower gestational age. Conclusions Increasing maternal BMI in early pregnancy is associated with increased risks of severe asphyxia-related complications in preterm infants. Our findings add to the evidence to support interventions to reduce obesity in woman of reproductive age.

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Maternal Body Mass Index during Pregnancy and Offspring Neurocognitive Development

Obstetric Medicine ◽

10.1177/1753495x12472643 ◽

2013 ◽

Vol 6 (1) ◽

pp. 20-25 ◽

Cited By ~ 23

Author(s):

Wendy Y Craig ◽

Glenn E Palomaki ◽

Louis M Neveux ◽

James E Haddow

Keyword(s):

Body Mass Index ◽

Regression Analysis ◽

Body Mass ◽

Inverse Relationship ◽

Maternal Obesity ◽

Maternal Body Mass Index ◽

Second Trimester ◽

Maternal Body ◽

Neurocognitive Development ◽

Maternal Bmi

Background: This hypothesis generating study explores second trimester maternal body mass index (BMI) during pregnancy and offspring neurocognitive development. Methods: Mothers and offspring served as controls in two earlier studies: 101 children at age two years and 118 children at age eight years. Results Frequency of maternal BMI ≥30 kg/m 2 increased from 10% in 1987-1990 to 30% in 2004-2006 ( P < 0.001); the socioeconomic gradient became more pronounced. At age two, one or more BSID-III (Bayley Scales of Infant Development, 3rd Edition) scores <85 were more frequent with higher maternal BMI ( P = 0.029); regression analysis suggested an inverse relationship between language scores and BMI ( P = 0.054). Among eight-year-olds, one or more WISC-III (Wechsler Intelligence Scale for Children, 3rd edition) scores <85 increased with maternal BMI ( P = 0.017); regression analysis showed an inverse relationship between performance subscale IQ score and BMI ( P = 0.023). Conclusion: Second trimester maternal obesity may be an independent risk factor for some aspects of children's neurocognitive development. Further study is indicated.

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