학술논문

Associations of maternal prepregnancy body mass index and gestational weight gain with cardio-metabolic risk factors in adolescent offspring: a prospective cohort study.
Document Type
Journal Article
Source
BJOG: An International Journal of Obstetrics & Gynaecology. Jan2016, Vol. 123 Issue 2, p207-216. 10p.
Subject
*PREGNANCY complications
*WEIGHT gain
*COHORT analysis
*BODY mass index
*METABOLISM
*CARDIOVASCULAR disease prevention
*PREVENTION of obesity
*OBESITY complications
*BLOOD pressure
*CARDIOVASCULAR diseases
*LONGITUDINAL method
*OBESITY
*RESEARCH funding
*DISEASE prevalence
*METABOLIC syndrome
*WAIST-hip ratio
*WAIST circumference
*PRENATAL exposure delayed effects
*PREVENTION
Language
ISSN
1470-0328
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 16.5 ± 2.2 SD and 34.1 ± 1.5 SD weeks of gestation were obtained from medical records. Offspring adiposity and cardio-metabolic outcomes were assessed at a median age 17.0 years [95% confidence interval (CI) range: 16.7, 17.7].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 (P-values <0.05). 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 (P-values <0.05), but not with other cardio-metabolic risk factors. Total gestational weight gain was associated with adolescent BMI and WC (P-values <0.05). Higher prepregnancy BMI and early-pregnancy weight gain were associated with increased risks of the high-metabolic risk cluster in adolescents (OR 1.57, 95% CI 1.33, 1.85 and OR 1.23, 95% CI 1.03, 1.47 per SD increase in prepregnancy BMI and early-pregnancy weight gain, respectively).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. [ABSTRACT FROM AUTHOR]