High and low gestational weight gain increase cardiometabolic risk in children
medwireNews: Both excessive and inadequate weight gain during pregnancy are associated with significantly increased cardiometabolic risk factors among the children at age 7 years, researchers from Hong Kong report.
The findings were independent of maternal BMI prior to pregnancy, glucose levels during pregnancy, family history of diabetes, and several other environmental factors during the pre- and postnatal periods.
Wing Hung Tam (The Chinese University of Hong Kong, Shatin) and colleagues therefore say that their study has “important implications for prevention and treatment” of cardiometabolic risk in children.
They write in Diabetologia: “Pregnancy may be a potential window of opportunity for intervention through modifiable behaviours, including maternal nutrition and physical activity.”
The results are based on an analysis of 905 mother–child pairs from the HAPO study who were followed up when the children were 7 years of age.
The women were classified as having gained weight below (17.2%), within (41.8%), or above (41.0%) the 2009 Institute of Medicine guidelines.
After adjustment for potential confounders, the researchers found that women who exceeded the recommended level of gestational weight gain had children with a significantly larger body size (greater height and weight) than did women who gained the recommended amount of weight.
The children of women with excessive weight gain were also significantly more likely to have increased adiposity (BMI, waist circumference, and hip circumference), higher diastolic blood pressure, increased insulin sensitivity, and decreased beta-cell function than those of women with normal weight gain.
Women who gained less weight than recommended had decreased beta-cell function, compared with those who gained weight within the advised range.
Further analysis, in which gestational weight gain was standardized according to pre-pregnancy BMI, confirmed that weight gain during pregnancy had an independent U-shaped relationship with a number of childhood cardiometabolic risk factors.
Specifically, both inadequate and excessive weight gain were associated with significantly increased risk for diastolic blood pressure, a greater area under the curve for insulin during the oral glucose tolerance test, increased pancreatic beta cell function, and decreased Matsuda insulin sensitivity index in the children, when compared with the recommended level of weight gain.
Of note, nearly all of these associations were attenuated to nonsignificant levels when current childhood BMI was taken into account.
Tam et al conclude: “Our findings support the notion that adverse intrauterine exposures are associated with persistent cardiometabolic risk in the offspring.”
They add that “long-term follow-up of these children is necessary to evaluate the effect of maternal [gestational weight gain] on cardiometabolic risk in adolescence and adulthood.”
By Laura Cowen
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