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Title: Mother's pre-pregnancy BMI is an important determinant of adverse cardiometabolic risk in childhood

Author
item TAN, HONG - Children'S Nutrition Research Center (CNRC)
item ROBERTS, JAMES - University Of Pittsburgh
item CATOV, JANET - University Of Pittsburgh
item KRISHNAMURTHY, RAMKUMAR - Texas Children'S Hospital
item SHYPAILO, ROMAN - Children'S Nutrition Research Center (CNRC)
item BACHA, FIDA - Children'S Nutrition Research Center (CNRC)

Submitted to: Pediatric Diabetes
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/18/2015
Publication Date: 9/1/2015
Citation: Tan, H.C., Roberts, J., Catov, J., Krishnamurthy, R., Shypailo, R., Bacha, F. 2015. Mother's pre-pregnancy BMI is an important determinant of adverse cardiometabolic risk in childhood. Pediatric Diabetes. 16(6):419-426.

Interpretive Summary: Previous studies suggest an impact of maternal health and the in-utero exposure, on the body weight and later risk of diabetes and cardiovascular disease in the offspring. Our study aimed to evaluate the relationship of maternal pre-pregnancy body mass index (BMI) to the BMI, body composition and cardiometabolic characteristics of the offspring in childhood. We hypothesized that children of pre-pregnancy overweight or obese mothers would have a higher BMI, fat mass, and more adverse cardiometabolic traits compared with children of mothers were normal weight during the pre-pregnancy period. Our study shows that children of mothers who were overweight or obese at the time of conception have a greater tendency to be overweight/obese with increased total body fat and abdominal fat compared to children born to normal weight mother. They also showed evidence of insulin resistance, a risk factor for diabetes and cardiovascular disease. These findings highlight the importance of maternal over nutrition during conception as a contributing factor for excess adiposity and cardiometabolic disease risk in the offspring during later childhood. The contribution of environmental/societal factors vs. epigenetics factors to these findings need to be evaluated in future studies.

Technical Abstract: Maternal adiposity is associated with poor offspring cardiometabolic health. We aimed to evaluate the relationship of maternal pre-pregnancy body mass index (BMI) on the BMI, body composition and cardiometabolic characteristics of the offspring. Forty offspring of overweight/obese mothers (O-OW) and 28 offspring of normal weight mothers (O-NW) underwent evaluation of body composition, abdominal fat distribution, blood pressure measurement, fasting lipids and an oral glucose tolerance test. The anthropometric and cardiometabolic characteristics of O-OW were compared with those of O-NW, and the relationship to maternal BMI was evaluated. Results Subjects (mean age: 12.6 +/- 0.4, female: 52.9%) had similar gestational age, birth weight, age, gender, and Tanner stage. However, O-OW had a significantly higher BMI (24.4 +/- 1.2 vs. 19.7 +/- 0.8 kg/m**2, p=0.001), % body fat (31.7 +/- 1.6 vs. 24.6 +/- 1.1%, p<0.001), visceral fat (41.9 +/- 4.7 vs. 26.1 +/- 3.9 cm2, p=0.012) with no difference in lean body mass compared with O-NW. O-OW had lower whole body insulin sensitivity index (WBISI) with an adverse cardiovascular disease risk profile [higher blood pressure (BP), triglycerides to high-density lipoprotein (HDL) ratio, hs-C-reactive protein (CRP) and lower HDL]. In addition to offspring’s %body fat (beta = -0.60, p < 0.001), maternal pre-pregnancy BMI (beta = -0.19, p = 0.046) contributed significantly and independently to the offspring’s WBISI (R**2 = 0.55, p < 0.001). High pre-pregnancy BMI is an important contributor to excess adiposity, insulin resistance, and cardiometabolic disease risk in the offspring during childhood.