scholarly journals Cord Metabolic Profiles in Obese Pregnant Women: Insights Into Offspring Growth and Body Composition

2017 ◽  
Vol 103 (1) ◽  
pp. 346-355 ◽  
Author(s):  
Nashita Patel ◽  
Christian Hellmuth ◽  
Olaf Uhl ◽  
Keith Godfrey ◽  
Annette Briley ◽  
...  
Keyword(s):  
Cord Blood ◽  
Lifestyle Intervention ◽  
Metabolic Profile ◽  
Maternal Obesity ◽  
Physical Activity Intervention ◽  
Controlled Trial ◽  
In Utero ◽  
Obese Women ◽  
Blood Concentrations ◽  
Increased Risk

Abstract Context Offspring exposed in utero to maternal obesity have an increased risk of later obesity; however, the underlying mechanisms remain unknown. Objective To assess the effect of an antenatal lifestyle intervention in obese women on the offspring’s cord blood metabolic profile and to examine associations of the cord blood metabolic profile with maternal clinical characteristics and offspring anthropometry at birth and age 6 months. Design Randomized controlled trial and cohort study. Setting The UK Pregnancies Better Eating and Activity Trial. Participants Three hundred forty-four mother-offspring pairs. Intervention Antenatal behavioral lifestyle (diet and physical activity) intervention. Main Outcome Measures Targeted cord blood metabolic profile, including candidate hormone and metabolomic analyses. Results The lifestyle intervention was not associated with change in the cord blood metabolic profile. Higher maternal glycemia, specifically fasting glucose at 28 weeks gestation, had a linear association with higher cord blood concentrations of lysophosphatidylcholines (LPCs) 16.1 (β = 0.65; 95% confidence interval: 0.03 to 0.10) and 18.1 (0.52; 0.02 to 0.80), independent of the lifestyle intervention. A principal component of cord blood phosphatidylcholines and LPCs was associated with infant z scores of birth weight (0.04; 0.02 to 0.07) and weight at age 6 months (0.05; 0.00 to 0.10). Cord blood insulin growth factor (IGF)-1 and adiponectin concentrations were positively associated with infant weight z score at birth and at 6 months. Conclusions Concentrations of LPCs and IGF-1 in cord blood are related to infant weight. These findings support the hypothesis that susceptibility to childhood obesity may be programmed in utero, but further investigation is required to establish whether these associations are causally related.

scholarly journals Development of a Lifestyle Intervention Program to Support Preconception, Pregnant and Postnatal Women Who are Overweight or Obese: A Qualitative Study

2021 ◽  
Author(s):  
Chee Wai Ku ◽  
Shu Hui Leow ◽  
Lay See Ong ◽  
Christina Erwin ◽  
Isabella Ong ◽  
...  
Keyword(s):  
Lifestyle Intervention ◽  
Goal Setting ◽  
Intervention Program ◽  
Maternal Obesity ◽  
Healthy Lifestyle ◽  
Target Population ◽  
Lifestyle Changes ◽  
Lifestyle Behaviors ◽  
Obese Women ◽  
The Impact

Abstract Background: Poor lifestyle behaviors, including unhealthy diet and physical inactivity, contribute to the global obesity pandemic and result in long-term adverse health effects on mothers and their children. The time period before, during and after pregnancy represents a unique opportunity for interventions to cultivate sustained healthy lifestyle behaviors. Since the success of a lifestyle intervention is heavily dependent on uptake and continued compliance, the intervention components should be acceptable, sustainable, and tailored to the concerns and needs of the target population. This study aims to identify enablers and barriers towards engagement with a lifestyle intervention for improving the metabolic health of prospective mothers and their offspring, among a sample of the target population.Methods: In-depth interviews were conducted with 15 overweight or obese women in the preconception, pregnancy or postpartum periods. Interviews were transcribed verbatim and thematic analysis was undertaken using NVivo. Factors influencing adoption of a novel lifestyle intervention were systematically charted using the integrated–Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, that comprises Recipient, Context, Innovation and Facilitation constructs.Results: Ten enablers and barriers were identified. Barrier factors within the Recipient construct include time constraints as participants juggled multiple roles, and poor baseline knowledge about healthy behaviors and the impact of maternal obesity on maternal and offspring health. Within Context, a family culture of communal meals, convenient access to unhealthy foods in the environment, as well as lack of relevant data sources, were barriers to dietary change. Recipient motivation to be healthy for themselves and their offspring is an enabler, along with family and social support within the Context construct. In the Innovation construct, a holistic delivery platform providing desired information delivered at appropriate times increases engagement. Lastly, in Facilitation, regular feedback, goal setting and nudges would ensure continued engagement and sustainability of lifestyle changes.Conclusions: The features of a successful lifestyle intervention targeting overweight and obese women include (i) a holistic life-course approach to provide education and guidance, (ii) using mobile health platforms to reduce barriers, provide personalized feedback and promote goal-setting, and (iii) health nudges to cultivate sustained lifestyle habits.

scholarly journals The Effects of a Preconception Lifestyle Intervention on Childhood Cardiometabolic Health—Follow-Up of a Randomized Controlled Trial

Cells ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 41
Author(s):  
Stijn Mintjens ◽  
Mireille N. M. van Poppel ◽  
Henk Groen ◽  
Annemieke Hoek ◽  
Ben Willem Mol ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Lifestyle Intervention ◽  
Maternal Obesity ◽  
Controlled Trial ◽  
Cardiometabolic Health ◽  
Control Group ◽  
Z Score ◽  
Infertile Women ◽  
Z Scores

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.

Obesity and oocyte quality: Significant implications for ART and Emerging mechanistic insights

2021 ◽  
Author(s):  
Macarena B Gonzalez ◽  
Rebecca L Robker ◽  
Ryan D Rose
Keyword(s):  
Pregnancy Complications ◽  
Maternal Obesity ◽  
Ovarian Function ◽  
Polycystic Ovary ◽  
Live Birth Rate ◽  
Oocyte Quality ◽  
Reproductive Age ◽  
Developmental Competence ◽  
Obese Women ◽  
Increased Risk

Abstract The prevalence of obesity in adults worldwide, and specifically in women of reproductive age, is concerning given the risks to fertility posed by the increased risk of type 2 diabetes, metabolic syndrome and other non-communicable diseases. Obesity has a multi-systemic impact in female physiology that is characterized by the presence of oxidative stress, lipotoxicity, and the activation of pro-inflammatory pathways, inducing tissue-specific insulin resistance and ultimately conducive to abnormal ovarian function. A higher body mass is linked to Polycystic Ovary Syndrome, dysregulated menstrual cycles, anovulation, and longer time to pregnancy, even in ovulatory women. In the context of ART, compared to women of normal BMI, obese women have worse outcomes in every step of their journey, resulting in reduced success measured as live birth rate. Even after pregnancy is achieved, obese women have a higher chance of miscarriage, gestational diabetes, pregnancy complications, birth defects, and most worryingly, a higher risk of stillbirth and neonatal death. The potential for compounding effects of ART on pregnancy complications and infant morbidities in obese women has not been studied. There is still much debate in the field on whether these poorer outcomes are mainly driven by defects in oocyte quality, abnormal embryo development or an unaccommodating uterine environment, however the clinical evidence to date suggests a combination of all three are responsible. Animal models of maternal obesity shed light on the mechanisms underlaying the effects of obesity on the peri-conception environment, with recent findings pointing to lipotoxicity in the ovarian environment as a key driver of defects in oocytes that have not only reduced developmental competence but long-lasting effects in offspring health.

Neonatal metabolome of cesarean section and risk of childhood asthma

2021 ◽  
pp. 2102406
Author(s):  
Gözde Gürdeniz ◽  
Madeleine Ernst ◽  
Daniela Rago ◽  
Min Kim ◽  
Julie Courraud ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Cord Blood ◽  
Gut Microbiome ◽  
Childhood Asthma ◽  
Metabolic Profile ◽  
Partial Least Square ◽  
Least Square ◽  
Microbial Colonization ◽  
Increased Risk ◽  
Microbiome Data

BackgroundBirth by cesarean section (CS) is linked to an increased risk of developing asthma, but the underlying mechanisms are unclear.ObjectiveTo elucidate the link between birth by CS and asthma using newborn metabolomic profiles and integrating early life gut microbiome data and cord blood immunology.MethodsWe investigated the influence of CS on liquid chromatography mass spectrometry (LC-MS) metabolomic profiles of dried blood spots from newborns of the two independent Copenhagen Prospective Studies on Asthma in Childhood cohorts, i.e. COPSAC2010 (n=677) and COPSAC2000 (n=387). We assessed the associations between the CS metabolic profile, age one-week gut microbiome data and frequency of cord blood Tregs.ResultsIn COPSAC2010, a partial least square-discriminant analysis (PLS-DA) model showed that children born by CS versus natural delivery had different metabolic profiles (AUC=0.77, p=2.2e-16), which was replicated in COPSAC2000 (AUC=0.66, p=1.2e-5). The metabolic profile of CS was significantly associated with an increased risk of asthma at school-age in both COPSAC2010 (p=0.03) and COPSAC2000 (p=0.005). CS was associated with lower abundance of tryptophan, bile acid and phenylalanine metabolites, indicative of a perturbed gut microbiota. Further, gut bacteria dominating after natural delivery, i.e. Bifidobacterium and Bacteroides were correlated with CS-discriminative microbial metabolites, suggesting maternal microbial transmission during birth regulating the newborn's metabolism. Finally, the CS metabolic profile was associated with frequency of cord blood Tregs.ConclusionsThese findings propose that CS is programming the risk of childhood asthma through perturbed immune responses and gut microbial colonization patterns reflected in the blood metabolome at birth.

scholarly journals Effects of a Lifestyle Intervention in Routine Care on Short- and Long-Term Maternal Weight Retention and Breastfeeding Behavior—12 Months Follow-up of the Cluster-Randomized GeliS Trial

2019 ◽  
Vol 8 (6) ◽  
pp. 876 ◽  
Author(s):  
Julia Hoffmann ◽  
Julia Günther ◽  
Lynne Stecher ◽  
Monika Spies ◽  
Dorothy Meyer ◽  
...  
Keyword(s):  
Lifestyle Intervention ◽  
Exclusive Breastfeeding ◽  
Maternal Obesity ◽  
Routine Care ◽  
Control Group ◽  
Weight Retention ◽  
Maternal Weight ◽  
Increased Risk ◽  
Postpartum Weight ◽  
Cluster Randomized

Postpartum weight retention (PPWR) is associated with an increased risk for maternal obesity and is discussed to be influenced by breastfeeding. The objective was to evaluate the effect of a lifestyle intervention delivered three times during pregnancy and once in the postpartum period on PPWR and on maternal breastfeeding behavior. In total, 1998 participants of the cluster-randomized “healthy living in pregnancy” (GeliS) trial were followed up until the 12th month postpartum (T2pp). Data were collected using maternity records and questionnaires. Data on breastfeeding behavior were collected at T2pp. At T2pp, mean PPWR was lower in women receiving counseling (IV) compared to the control group (C) (−0.2 ± 4.8 kg vs. 0.6 ± 5.2 kg), but there was no significant evidence of between-group differences (adjusted p = 0.123). In the IV, women lost more weight from delivery until T2pp compared to the C (adjusted p = 0.008) and showed a slightly higher rate of exclusive breastfeeding (IV: 87.4%; C: 84.4%; adjusted p < 0.001). In conclusion, we found evidence for slight improvements of maternal postpartum weight characteristics and the rate of exclusive breastfeeding in women receiving a lifestyle intervention embedded in routine care, although the clinical meaning of these findings is unclear.

Maternal obesity influences the endocrine cord blood profile of their offspring

2020 ◽  
Vol 48 (3) ◽  
pp. 242-248 ◽  
Author(s):  
Carolina Carvalho Mocarzel ◽  
Guillermo Coca Velarde ◽  
Roberto de Azevedo Antunes ◽  
Renato Augusto Moreira de Sá ◽  
Asim Kurjak
Keyword(s):  
Cord Blood ◽  
Maternal Obesity ◽  
Density Lipoprotein ◽  
Obese Group ◽  
Lipoprotein Cholesterol ◽  
Control Group ◽  
Healthy Controls ◽  
Obese Women ◽  
Blood Profile ◽  
The Mean

AbstractObjectiveTo compare the endocrine cord blood characteristics of offspring from obese mothers with those of offspring from healthy controls.MethodsCross-sectional case control study. Setting: University medical centers. Patient(s): Offspring from obese mothers (n = 41) and healthy controls (n = 31). Intervention(s): Cord blood withdrawal from neonates. Main outcome measure(s): Cord blood total cholesterol (TC), triglycerides (TGs), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), blood glucose (GL) and insulin (Ins).Result(s)Fetal GL and TGs were reduced in the offspring of obese women when compared to those in the offspring of the controls. The mean cord blood GL level was 47.8 mg/dL standard deviation (SD 33.1) in the offspring of the obese group vs. 57.9 mg/dL (SD 12.5) in the offspring of the control group, and the mean cord blood TG level was 26.5 (SD 33.6) in the offspring of the obese group vs. 34.6 (SD 12.3) in the offspring of the control group. Maternal obesity was also associated with reduced levels of TC and HDL-C in the pregnant women.ConclusionThe observed results suggest that GL and TGs in the cord blood of the offspring of obese mothers were significantly lower than those in the offspring of the control group.

scholarly journals Lifestyle Intervention in Pregnant Women With Obesity Impacts Cord Blood DNA Methylation Which Associates With Body Composition in the Offspring

2021 ◽  
Author(s):  
Josefine Jönsson ◽  
Kristina M. Renault ◽  
Sonia García-Calzón ◽  
Alexander Perfilyev ◽  
Angela C. Estampador ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Body Composition ◽  
Cord Blood ◽  
Pregnant Women ◽  
Lifestyle Intervention ◽  
Lean Mass ◽  
Maternal Obesity ◽  
Standard Of Care ◽  
Dietary Advice ◽  
Lifestyle Interventions

Maternal obesity may lead to epigenetic alterations in the offspring and might thereby contribute to disease later in life. We investigated whether a lifestyle intervention in pregnant women with obesity is associated with epigenetic variation in cord blood and body composition in the offspring.<b> </b>Genome-wide DNA methylation was analyzed in cord blood from 208 offspring from the TOP-study, which includes pregnant women with obesity randomized to lifestyle interventions comprised of physical activity with or without dietary advice versus controls (standard of care). DNA methylation was altered at 379 sites, annotated to 370 genes, in cord blood from offspring of mothers following a lifestyle intervention versus controls (<i>FDR</i><5%) when using the Houseman reference-free method to correct for cell composition and three of these sites were significant based on Bonferroni correction. These 370 genes are overrepresented in gene ontology terms including response to fatty acids and adipose tissue development. Offspring of mothers included in a lifestyle intervention were born with more lean mass compared to controls. Methylation at 17 sites, annotated to e.g. <i>DISC1</i>, <i>GBX2</i>, <i>HERC2</i> and <i>HUWE1</i>, partially mediates the effect of the lifestyle intervention on lean mass in the offspring (FDR<5%). Moreover, 22 methylation sites were associated with offspring BMI z-scores during the first 3 years of life (<i>p</i><0.05). Overall,<b> </b>lifestyle interventions in pregnant women with obesity are associated with epigenetic changes in offspring, potentially influencing the offspring’s lean mass and early growth.

scholarly journals The impact of gestational diabetes and maternal obesity on the mother and her offspring

2010 ◽  
Vol 1 (4) ◽  
pp. 208-215 ◽  
Author(s):  
P. M. Catalano
Keyword(s):  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Glucose Intolerance ◽  
Maternal Obesity ◽  
Insulin Response ◽  
Obese Women ◽  
Increased Risk ◽  
Short And Long Term ◽  
The Impact

Thein uteromaternal metabolic environment is important relative to both short and long term development of the offspring. Although poor fetal growth remains a significant factor relative to long-term outcome, fetal overgrowth is assuming greater importance because of the increase in obesity in the world’s populations. Maternal obesity and gestational diabetes are the most common metabolic complications of pregnancy related to fetal overgrowth and more specifically adiposity.Women with gestational diabetes have increased insulin resistance and inadequate insulin response compared with weight-matched controls. Gestational diabetes increases the risk of maternal hypertensive disease (preeclampsia) as well as cesarean delivery. At birth the neonate has increased adiposity and is at risk for birth injury. Multiple studies have reported that children of women with gestational diabetes have a greater prevalence childhood obesity and glucose intolerance; even at glucose concentrations less than currently used to define gestational diabetes, compared with normoglycemic women.Obese women also have increased insulin resistance, insulin response and inflammatory cytokines compared with average weight women both before and during pregnancy. They too are at increased risk for the metabolic syndrome-like disorders during pregnancy that is hypertension, hyperlipidemia, glucose intolerance and coagulation disorders. Analogous to women with gestational diabetes, neonates of obese women are heavier at delivery because of increased fat and not lean body mass. Similarly, these children have an increased risk of childhood adiposity and metabolic dysregulation. Hence, the preconceptional and perinatal period offers a unique opportunity to modify both short and long term risks for both the woman and her offspring.

Maternal Obesity and Risk for Birth Defects

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_1) ◽  
pp. 1152-1158 ◽  
Author(s):  
Margaret L. Watkins ◽  
Sonja A. Rasmussen ◽  
Margaret A. Honein ◽  
Lorenzo D. Botto ◽  
Cynthia A. Moore
Keyword(s):  
Spina Bifida ◽  
Birth Defects ◽  
Maternal Obesity ◽  
Heart Defects ◽  
Average Weight ◽  
Maternal Body Mass Index ◽  
Healthy Weight ◽  
Obese Women ◽  
Overweight Women ◽  
Increased Risk

Objective. Several studies have shown an increased risk for neural tube defects associated with prepregnancy maternal obesity. Because few recent studies have examined the relation between maternal prepregnancy obesity and overweight and other birth defects, we explored the relation for several birth defects and compared our findings with those of previous studies. Methods. We conducted a population-based case-control study of several selected major birth defects using data from the Atlanta Birth Defects Risk Factor Surveillance Study. Mothers who delivered an infant with and without selected birth defects in a 5-county metropolitan Atlanta area between January 1993 and August 1997 were interviewed. Maternal body mass index (BMI) was calculated from self-reported maternal prepregnancy weight and height. Women with known preexisting diabetes were excluded. The risks for obese women (BMI ≥30) and overweight women (BMI 25.0–29.9) were compared with those for average-weight women (BMI 18.5–24.9). Results. Obese women were more likely than average-weight women to have an infant with spina bifida (unadjusted odds ratio [OR]: 3.5; 95% confidence interval [CI]: 1.2–10.3), omphalocele (OR: 3.3; 95% CI: 1.0–10.3), heart defects (OR: 2.0; 95% CI: 1.2–3.4), and multiple anomalies (OR: 2.0; 95% CI: 1.0–3.8). Overweight women were more likely than average-weight women to have infants with heart defects (OR: 2.0; 95% CI: 1.2–3.1) and multiple anomalies (OR: 1.9; 95% CI: 1.1–3.4). Conclusions. Our study confirmed the previously established association between spina bifida and prepregnancy maternal obesity and found an association for omphalocele, heart defects, and multiple anomalies among infants of obese women. We also found an association between heart defects and multiple anomalies and being overweight before pregnancy. A higher risk for some birth defects is yet another adverse pregnancy outcome associated with maternal obesity. Obesity prevention efforts are needed to increase the number of women who are of healthy weight before pregnancy.

The impact of parity and maternal obesity on the fetal outcomes of a non-selected Lower Saxony population

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lars Brodowski ◽  
Niels Rochow ◽  
Efrah I. Yousuf ◽  
Fabian Kohls ◽  
Constantin S. von Kaisenberg ◽  
...  
Keyword(s):  
Maternal Obesity ◽  
Fetal Distress ◽  
Maternal Body Mass Index ◽  
Obese Women ◽  
Lower Saxony ◽  
Fetal Outcomes ◽  
Increased Risk ◽  
Longitudinal Position ◽  
The Impact ◽  
Maternal Bmi

Abstract Objectives Maternal obesity during pregnancy is associated with adverse intrauterine events and fetal outcomes and may increase the risk of obesity and metabolic disease development in offspring. Higher parity, regardless of socioeconomic status, is associated with increased maternal body mass index (BMI). In this study, we examined the relationship between parity, maternal obesity, and fetal outcomes in a large sample of mother-neonate pairs from Lower Saxony, Germany. Methods This retrospective cohort study examined pseudonymized data of a non-selected singleton cohort from Lower Saxony’s statewide quality assurance initiative. 448,963 cases were included. Newborn outcomes were assessed in relation to maternal BMI and parity. Results Maternal obesity was associated with an increased risk of placental insufficiency, chorioamnionitis, and fetal distress while giving birth. This effect was present across all parity groups. Fetal presentation did not differ between BMI groups, except for the increased risk of high longitudinal position and shoulder dystocia in obese women. Maternal obesity was also associated with an increased risk of premature birth, low arterial cord blood pH and low 5-min APGAR scores. Conclusions Maternal obesity increases the risk of adverse neonatal outcomes. There is a positive correlation between parity and increased maternal BMI. Weight-dependent fetal risk factors increase with parity, while parity-dependent outcomes occur less frequently in multipara. Prevention and intervention programs for women planning to become pregnant can be promising measures to reduce pregnancy and birth complications.

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