Adriëtte J J M Oostvogels1, Karien Stronks, Tessa J Roseboom, Joris A M van der Post, Manon van Eijsden, Tanja G M Vrijkotte. 1. Departments of Public Health (A.J.J.M.O., K.S., T.G.M.V.), Clinical Epidemiology, Biostatistics, and Bioinformatics (T.J.R.), and Gynecology and Obstetrics (T.J.R., J.A.M.v.d.P.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands; and Department of Epidemiology and Health Promotion (M.v.E.), Public Health Service, 1018 WT Amsterdam, The Netherlands.
Abstract
CONTEXT: Maternal prepregnancy body mass index (pBMI) and offspring's accelerated postnatal growth have adverse consequences for later cardiometabolic health, but it is unknown how these two factors interact. OBJECTIVE: To assess the association between maternal pBMI and offspring's metabolic profile at age 5-6 years and determine the role (independent/mediating/moderating) of offspring's postnatal growth in this association. DESIGN/PARTICIPANTS: In total, 1459 mother-child pairs from the prospective ABCD study with known maternal pBMI, offspring postnatal growth (weight and weight-for-length gain) between age 1-3 months (Δ SD score). MAIN OUTCOME MEASURES: We analyzed metabolic components of offspring at age 5-6 years, including waist-to-height-ratio (WHtR), systolic/diastolic blood pressure (SBP/DBP), fasting glucose, triglycerides, and high-density lipoprotein-cholesterol values, both individually (Z-scores) and combined (sum Z-scores; metabolic score). RESULTS: Maternal pBMI was positively associated with offspring's WHtR (β = 0.025; 95% confidence interval [CI], 0.010-0.039), SBP (β = 0.020; 95% CI, 0.005-0.0035), DBP (β = 0.016; 95% CI, 0.000-0.031), and metabolic score (β = 0.078; 95% CI, 0.039-0.118) after adjusting. Adding postnatal growth had no relevant impact on these effect sizes. Postnatal weight gain was independently associated with WHtR (β = 0.199; 95% CI, 0.097-0.300), fasting glucose values (β = 0.117; 95% CI, 0.008-0.227), metabolic score (β = 0.405; 95% CI, 0.128-0.682). Postnatal weight-for-length gain was independently associated with WHtR (β = 0.145; 95% CI, 0.080-0.211), and metabolic score (β = 0.301; 95% CI, 0.125-0.477). An interaction between maternal pBMI and postnatal weight gain was present in the association with SBP (P = .021) and metabolic score (P = .047), and between maternal pBMI and postnatal weight-for-length gain in the association with triglycerides (P = .022) and metabolic score (P = .042). CONCLUSIONS: Both high maternal pBMI and postnatal accelerated growth are associated with adverse metabolic components in early childhood. No evidence was found for a mediating role of postnatal growth. The combination of high maternal pBMI and postnatal accelerated growth amplified individual effects.
CONTEXT: Maternal prepregnancy body mass index (pBMI) and offspring's accelerated postnatal growth have adverse consequences for later cardiometabolic health, but it is unknown how these two factors interact. OBJECTIVE: To assess the association between maternal pBMI and offspring's metabolic profile at age 5-6 years and determine the role (independent/mediating/moderating) of offspring's postnatal growth in this association. DESIGN/PARTICIPANTS: In total, 1459 mother-child pairs from the prospective ABCD study with known maternal pBMI, offspring postnatal growth (weight and weight-for-length gain) between age 1-3 months (Δ SD score). MAIN OUTCOME MEASURES: We analyzed metabolic components of offspring at age 5-6 years, including waist-to-height-ratio (WHtR), systolic/diastolic blood pressure (SBP/DBP), fasting glucose, triglycerides, and high-density lipoprotein-cholesterol values, both individually (Z-scores) and combined (sum Z-scores; metabolic score). RESULTS: Maternal pBMI was positively associated with offspring's WHtR (β = 0.025; 95% confidence interval [CI], 0.010-0.039), SBP (β = 0.020; 95% CI, 0.005-0.0035), DBP (β = 0.016; 95% CI, 0.000-0.031), and metabolic score (β = 0.078; 95% CI, 0.039-0.118) after adjusting. Adding postnatal growth had no relevant impact on these effect sizes. Postnatal weight gain was independently associated with WHtR (β = 0.199; 95% CI, 0.097-0.300), fasting glucose values (β = 0.117; 95% CI, 0.008-0.227), metabolic score (β = 0.405; 95% CI, 0.128-0.682). Postnatal weight-for-length gain was independently associated with WHtR (β = 0.145; 95% CI, 0.080-0.211), and metabolic score (β = 0.301; 95% CI, 0.125-0.477). An interaction between maternal pBMI and postnatal weight gain was present in the association with SBP (P = .021) and metabolic score (P = .047), and between maternal pBMI and postnatal weight-for-length gain in the association with triglycerides (P = .022) and metabolic score (P = .042). CONCLUSIONS: Both high maternal pBMI and postnatal accelerated growth are associated with adverse metabolic components in early childhood. No evidence was found for a mediating role of postnatal growth. The combination of high maternal pBMI and postnatal accelerated growth amplified individual effects.
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