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Adiposity and cardiovascular outcomes in three-year-old children of participants in UPBEAT, an RCT of a complex intervention in pregnant women with obesity

Adiposity and cardiovascular outcomes in three-year-old children of participants in UPBEAT, an RCT of a complex intervention in pregnant women with obesity
Adiposity and cardiovascular outcomes in three-year-old children of participants in UPBEAT, an RCT of a complex intervention in pregnant women with obesity
Background: maternal obesity is associated with offspring cardiometabolic risk. UPBEAT was a randomised controlled trial of an antenatal diet and physical activity intervention in 1,555 women with obesity. The intervention was associated with lower gestational weight gain, healthier diet and metabolic profile in pregnancy, and reduced infant adiposity at six months.

Objective: we have investigated whether the UPBEAT intervention influenced childhood cardiometabolic outcomes or was associated with sustained improvements in maternal lifestyle 3-years after delivery.

Methods: in UPBEAT mother-child dyads at the 3-year follow-up, we assessed childhood blood pressure, resting pulse rate, and adiposity (body mass index, skinfold thicknesses, body fat, waist and arm circumferences) and maternal diet, physical activity, and anthropometry.

Results: 514 three-year-old children attended the appointment (49% intervention, 51% standard care). There was no difference in the main outcome of interest, subscapular skinfold thickness, between the trial arms (-0.30mm, 95% confidence interval: -0.92, 0.31). However, the intervention was associated with a lower resting pulse rate (-5bpm (-8.41, -1.07)). There was also a non-significant lower odds of overweight/obesity (OR 0.73; 0.50, 1.08). Maternal dietary improvements observed in the UPBEAT trial, including glycaemic load and saturated fat were maintained 3-years postpartum.

Conclusion: this study has demonstrated that an antenatal dietary and physical activity intervention in women with obesity is associated with lower offspring pulse rate and sustained improvement in maternal diet. Whilst larger than previous cohorts, there remains potential for bias from attrition and these findings require validation in future cohorts.
2047-6302
1-11
Dalrymple, Kathryn
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Tydeman, Florence A S
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Taylor, Paul D.
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Flynn, Angela
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O’Keeffe, Majella
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Briley, Annette
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Santosh, Paramala
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Hayes, Louise
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Robson, Stephen C.
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Nelson, Scott M.
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Sattar, Naveed
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Whitworth, Melissa K
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Mills, Harriet L.
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Singh, Claire
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Seed, Paul T.
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White, Sara L.
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Lawlor, Deborah A.
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Godfrey, Keith
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Poston, Lucilla
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UPBEAT Consortium
Dalrymple, Kathryn
d1e42b67-297a-473d-b3c1-cb275cf4cf64
Tydeman, Florence A S
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Taylor, Paul D.
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Flynn, Angela
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O’Keeffe, Majella
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Briley, Annette
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Santosh, Paramala
c1ac98e0-83b9-4583-a3ce-ca82085ffde4
Hayes, Louise
529063f9-0f7c-487b-83c3-b026debf6120
Robson, Stephen C.
a8c77714-2b9b-4e47-a98d-b37f993f73b0
Nelson, Scott M.
9dfe7220-67c4-490d-8aa7-3f593bf0b409
Sattar, Naveed
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Whitworth, Melissa K
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Mills, Harriet L.
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Singh, Claire
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Seed, Paul T.
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White, Sara L.
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Lawlor, Deborah A.
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Godfrey, Keith
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Poston, Lucilla
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Dalrymple, Kathryn, Tydeman, Florence A S, Taylor, Paul D., Flynn, Angela, O’Keeffe, Majella, Briley, Annette, Santosh, Paramala, Hayes, Louise, Robson, Stephen C., Nelson, Scott M., Sattar, Naveed, Whitworth, Melissa K, Mills, Harriet L., Singh, Claire, Seed, Paul T., White, Sara L., Lawlor, Deborah A., Godfrey, Keith and Poston, Lucilla , UPBEAT Consortium (2020) Adiposity and cardiovascular outcomes in three-year-old children of participants in UPBEAT, an RCT of a complex intervention in pregnant women with obesity. Pediatric Obesity, 16 (3), 1-11, [e12725]. (doi:10.1111/ijpo.12725).

Record type: Article

Abstract

Background: maternal obesity is associated with offspring cardiometabolic risk. UPBEAT was a randomised controlled trial of an antenatal diet and physical activity intervention in 1,555 women with obesity. The intervention was associated with lower gestational weight gain, healthier diet and metabolic profile in pregnancy, and reduced infant adiposity at six months.

Objective: we have investigated whether the UPBEAT intervention influenced childhood cardiometabolic outcomes or was associated with sustained improvements in maternal lifestyle 3-years after delivery.

Methods: in UPBEAT mother-child dyads at the 3-year follow-up, we assessed childhood blood pressure, resting pulse rate, and adiposity (body mass index, skinfold thicknesses, body fat, waist and arm circumferences) and maternal diet, physical activity, and anthropometry.

Results: 514 three-year-old children attended the appointment (49% intervention, 51% standard care). There was no difference in the main outcome of interest, subscapular skinfold thickness, between the trial arms (-0.30mm, 95% confidence interval: -0.92, 0.31). However, the intervention was associated with a lower resting pulse rate (-5bpm (-8.41, -1.07)). There was also a non-significant lower odds of overweight/obesity (OR 0.73; 0.50, 1.08). Maternal dietary improvements observed in the UPBEAT trial, including glycaemic load and saturated fat were maintained 3-years postpartum.

Conclusion: this study has demonstrated that an antenatal dietary and physical activity intervention in women with obesity is associated with lower offspring pulse rate and sustained improvement in maternal diet. Whilst larger than previous cohorts, there remains potential for bias from attrition and these findings require validation in future cohorts.

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Accepted/In Press date: 7 August 2020
e-pub ahead of print date: 11 September 2020

Identifiers

Local EPrints ID: 443561
URI: http://eprints.soton.ac.uk/id/eprint/443561
ISSN: 2047-6302
PURE UUID: 57e11f7c-f72a-45ef-8668-c2510a8271af
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 01 Sep 2020 16:32
Last modified: 24 Sep 2021 04:01

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Contributors

Author: Kathryn Dalrymple
Author: Florence A S Tydeman
Author: Paul D. Taylor
Author: Angela Flynn
Author: Majella O’Keeffe
Author: Annette Briley
Author: Paramala Santosh
Author: Louise Hayes
Author: Stephen C. Robson
Author: Scott M. Nelson
Author: Naveed Sattar
Author: Melissa K Whitworth
Author: Harriet L. Mills
Author: Claire Singh
Author: Paul T. Seed
Author: Sara L. White
Author: Deborah A. Lawlor
Author: Keith Godfrey ORCID iD
Author: Lucilla Poston
Corporate Author: UPBEAT Consortium

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