Fengxiu Ouyang1, Margaret G Parker2, Zhong-Cheng Luo1,3, Xia Wang1, Hui-Juan Zhang4,5, Fan Jiang1,6, Xiaobin Wang7,8, Matthew W Gillman9, Jun Zhang1. 1. MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 2. Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA. 3. Department of Obstetrics and Gynecology, Sainte-Justine Hospital, University of Montreal, Montreal, Quebec, Canada. 4. Department of Pathology, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China. 5. Department of Bio-Bank, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China. 6. Department of Developmental and Behavioral Pediatrics, Shanghai Pediatric Transitional Institution, Shanghai Children's Medical Center Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. 7. Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 8. Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA. 9. Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Abstract
OBJECTIVE: High prepregnancy body mass index (BMI), excessive gestational weight gain (GWG), and gestational diabetes mellitus (GDM) are associated with the risk of childhood obesity. This study aims to examine the extent to which these effects may be mediated through the placenta. METHODS: Data included 33,893 mothers and their singleton infants from birth to 7 years old (total 154,590 visits) in the Collaborative Perinatal Project, a U.S. multicenter prospective cohort study from 1959 to 1976. The placentas were weighed after removing cord and membranes. We performed sequential generalized estimating equation-linear models excluding and including placental weight to evaluate its mediation effect. RESULTS: In this population, 21.7% of mothers had overweight or obesity, 17.3% had excessive GWG, and 350 (1%) had diagnosed GDM; in addition, 7.2% children had obesity. After adjustment for prepregnancy BMI and other covariates, childhood BMI was 0.23 (95% CI: 0.05, 0.40) kg/m(2) higher for children born to mothers with GDM versus those without GDM. Inclusion of placental weight in the model attenuated the association by 52% to 0.11 (95% CI: -0.06, 0.28) and similarly attenuated the associations with childhood BMI for GWG by 25% and maternal prepregnancy BMI by 17%. CONCLUSIONS: Placental weight partly mediates the effects of prepregnancy BMI, excessive GWG, and GDM on childhood BMI.
OBJECTIVE: High prepregnancy body mass index (BMI), excessive gestational weight gain (GWG), and gestational diabetes mellitus (GDM) are associated with the risk of childhood obesity. This study aims to examine the extent to which these effects may be mediated through the placenta. METHODS: Data included 33,893 mothers and their singleton infants from birth to 7 years old (total 154,590 visits) in the Collaborative Perinatal Project, a U.S. multicenter prospective cohort study from 1959 to 1976. The placentas were weighed after removing cord and membranes. We performed sequential generalized estimating equation-linear models excluding and including placental weight to evaluate its mediation effect. RESULTS: In this population, 21.7% of mothers had overweight or obesity, 17.3% had excessive GWG, and 350 (1%) had diagnosed GDM; in addition, 7.2% children had obesity. After adjustment for prepregnancy BMI and other covariates, childhood BMI was 0.23 (95% CI: 0.05, 0.40) kg/m(2) higher for children born to mothers with GDM versus those without GDM. Inclusion of placental weight in the model attenuated the association by 52% to 0.11 (95% CI: -0.06, 0.28) and similarly attenuated the associations with childhood BMI for GWG by 25% and maternal prepregnancy BMI by 17%. CONCLUSIONS: Placental weight partly mediates the effects of prepregnancy BMI, excessive GWG, and GDM on childhood BMI.
Authors: Bernadeta Patro Golab; Susana Santos; Ellis Voerman; Debbie A Lawlor; Vincent W V Jaddoe; Romy Gaillard Journal: Lancet Child Adolesc Health Date: 2018-09-07
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Authors: Raffael Ott; Jens H Stupin; Andrea Loui; Elisabeth Eilers; Kerstin Melchior; Rebecca C Rancourt; Karen Schellong; Thomas Ziska; Joachim W Dudenhausen; Wolfgang Henrich; Andreas Plagemann Journal: BMC Pregnancy Childbirth Date: 2018-06-20 Impact factor: 3.007