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Associations of maternal prepregnancy body mass index and gestational weight gain with cardio-metabolic

Prepregnancy body mass index (BMI) and early-pregnancy weight gain rate are associated with adverse adolescent cardio-metabolic profile.

Authors:
Gaillard R, Welten M, Oddy WH, Beilin LJ, Mori TA, Jaddoe VWV, Huang RC.

Authors notes:
BJOG Int J Obstet Gynaecol. 2015;123(2):207-16.

Keywords:
Adiposity, Adolescence, Blood pressure, Cohort study, Gestational weight gain, Insulin/glucose, Lipids, Maternal body mass index, Pregnancy

Abstract:
Objective: To assess the associations of maternal prepregnancy body mass index (BMI) and rates of early-pregnancy, mid-pregnancy and total gestational weight gain with adolescent body fat distribution and cardio-metabolic outcomes.

Design: Population-based prospective cohort study. Setting: Western Australia.
Population: Thousand three hundred and ninety-two mothers and their children.

Methods: Maternal prepregnancy weight was assessed by questionnaire.
Maternal weights at a mean of 16 and 34 weeks of gestation were obtained from medical records.
Offspring adiposity and cardio-metabolic outcomes were assessed at a median age 17 years.

Main outcome measures: Adolescent BMI, waist circumference (WC), waist-to-hip ratio (WHR), blood pressure, total and HDL-cholesterol, triglycerides, insulin, glucose and HOMA-IR.

Results: Higher prepregnancy BMI was associated with higher adolescent BMI, WC, WHR, systolic blood pressure, insulin, glucose and HOMA-IR levels.

Adjustment for adolescent current BMI attenuated the associations of prepregnancy BMI with adolescent cardio-metabolic outcomes.

Higher weight gain in early-pregnancy, but not mid-pregnancy, was associated with higher adolescent BMI, WC and WHR, but not with other cardio-metabolic risk factors.

Total gestational weight gain was associated with adolescent BMI and WC.

Higher prepregnancy BMI and early-pregnancy weight gain were associated with increased risks of the high-metabolic risk cluster in adolescents.

Conclusions: Higher maternal prepregnancy BMI and early-pregnancy weight gain rate are associated with an adverse adolescent cardio-metabolic profile.

These associations are largely mediated by adolescent BMI.