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Influence of maternal obesity on the association between common pregnancy complications and risk of childhood obesity: an individual participant data meta-analysis

Influence of maternal obesity on the association between common pregnancy complications and risk of childhood obesity: an individual participant data meta-analysis
Influence of maternal obesity on the association between common pregnancy complications and risk of childhood obesity: an individual participant data meta-analysis
Background: gestational diabetes and gestational hypertensive disorders are associated with offspring obesity. The role of maternal adiposity in these associations remains unclear. We aimed to evaluate if these pregnancy complications affect the odds of offspring obesity independently of maternal obesity.

Methods: in this individual participant data meta-analysis of 160757 mother-offspring pairs from 34 prospective European or North-American pregnancy/birth cohorts, we assessed the associations of gestational diabetes, gestational hypertension and pre-eclampsia with childhood BMI and the odds of overweight and obesity throughout childhood. We explored to what extent any association was explained by maternal pre/early-pregnancy BMI.

Findings: gestational diabetes was associated with a higher odds of overweight throughout childhood (Odds Ratio (OR) 1·59 (95% Confidence Intervals (CI) 1·36, 1·86); OR 1·41 (95% CI 1·26, 1·57); OR 1·32 (95% CI 0·99, 1·78) for early-, mid- and late-childhood, respectively) when compared to uncomplicated pregnancies. These associations attenuated towards the null following adjustment for maternal BMI. Likewise, gestational hypertension was associated with a higher odds of overweight throughout childhood, with the strongest association in late-childhood (OR 1·49 (95% CI 1·30, 1·70)), when compared to uncomplicated pregnancies. Additional adjustment for maternal BMI largely explained these associations. Pre-eclampsia was associated with a lower BMI in early-childhood only (difference in BMI-SDS - 0.05 SDS (95% CI - 0·09, - 0·01)), when compared to uncomplicated pregnancies. This association strengthened upon additional adjustment for maternal BMI.

Interpretation: our results suggest that lowering maternal risk of gestational diabetes and hypertensive disorders is unlikely to have a direct impact on childhood obesity. Preventive strategies for reducing childhood obesity should focus on maternal BMI rather than on pregnancy complications.

Funding: this work was supported by the European Union's Horizon 2020 research and innovation programme under grant agreement 733206 (LifeCycle Project).
2352-4650
812-821
Golab, Bernadeta Patro
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Santos, Susana G.
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Voerman, Ellis
49b10c9a-97cf-46c7-92b3-b7d45f7033d7
Lawlor, Debbie A
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Jaddoe, Vincent W. V.
9a192cd2-9c0c-4d34-ad24-c6c4162e7b05
Gaillard, Romy
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Godfrey, Keith
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Maternal Obesity Childhood Outcomes (MOCO) Study Group
Golab, Bernadeta Patro
8fdd19a7-bb30-47f9-8f38-26d9a789c45c
Santos, Susana G.
b9bc0f2b-4cd0-4ee1-8d21-6b07f6260153
Voerman, Ellis
49b10c9a-97cf-46c7-92b3-b7d45f7033d7
Lawlor, Debbie A
220a802a-1560-4433-b4fa-fadbc336b1f4
Jaddoe, Vincent W. V.
9a192cd2-9c0c-4d34-ad24-c6c4162e7b05
Gaillard, Romy
86715fd8-af0e-463e-a980-02a58dd73d0a
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd

Golab, Bernadeta Patro, Santos, Susana G., Voerman, Ellis, Lawlor, Debbie A, Jaddoe, Vincent W. V., Gaillard, Romy and Godfrey, Keith , Maternal Obesity Childhood Outcomes (MOCO) Study Group (2018) Influence of maternal obesity on the association between common pregnancy complications and risk of childhood obesity: an individual participant data meta-analysis. The Lancet Child & Adolescent Health, 2 (11), 812-821.

Record type: Article

Abstract

Background: gestational diabetes and gestational hypertensive disorders are associated with offspring obesity. The role of maternal adiposity in these associations remains unclear. We aimed to evaluate if these pregnancy complications affect the odds of offspring obesity independently of maternal obesity.

Methods: in this individual participant data meta-analysis of 160757 mother-offspring pairs from 34 prospective European or North-American pregnancy/birth cohorts, we assessed the associations of gestational diabetes, gestational hypertension and pre-eclampsia with childhood BMI and the odds of overweight and obesity throughout childhood. We explored to what extent any association was explained by maternal pre/early-pregnancy BMI.

Findings: gestational diabetes was associated with a higher odds of overweight throughout childhood (Odds Ratio (OR) 1·59 (95% Confidence Intervals (CI) 1·36, 1·86); OR 1·41 (95% CI 1·26, 1·57); OR 1·32 (95% CI 0·99, 1·78) for early-, mid- and late-childhood, respectively) when compared to uncomplicated pregnancies. These associations attenuated towards the null following adjustment for maternal BMI. Likewise, gestational hypertension was associated with a higher odds of overweight throughout childhood, with the strongest association in late-childhood (OR 1·49 (95% CI 1·30, 1·70)), when compared to uncomplicated pregnancies. Additional adjustment for maternal BMI largely explained these associations. Pre-eclampsia was associated with a lower BMI in early-childhood only (difference in BMI-SDS - 0.05 SDS (95% CI - 0·09, - 0·01)), when compared to uncomplicated pregnancies. This association strengthened upon additional adjustment for maternal BMI.

Interpretation: our results suggest that lowering maternal risk of gestational diabetes and hypertensive disorders is unlikely to have a direct impact on childhood obesity. Preventive strategies for reducing childhood obesity should focus on maternal BMI rather than on pregnancy complications.

Funding: this work was supported by the European Union's Horizon 2020 research and innovation programme under grant agreement 733206 (LifeCycle Project).

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More information

Accepted/In Press date: 7 August 2018
e-pub ahead of print date: 7 September 2018
Published date: November 2018

Identifiers

Local EPrints ID: 423008
URI: https://eprints.soton.ac.uk/id/eprint/423008
ISSN: 2352-4650
PURE UUID: 88546b93-f562-4738-9fb8-ea9099343fda
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 09 Aug 2018 16:30
Last modified: 11 Dec 2019 05:01

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