CHICAGO, Illinois — The children born to women who gain an appropriate or adequate amount of weight during pregnancy are significantly more likely to have healthier markers of metabolic risk at 10 years of age than children born to women who gain an excessive amount of weight, research shows .
Researchers also report that higher prepregnancy body-mass index (BMI) was associated with worsened markers of metabolic risk in offspring, but this relationship was attenuated if women stayed within the Institute of Medicine (IOM) recommendations for weight gain during pregnancy.
“These data from a small longitudinal observational study that suggest weight control during pregnancy might reduce the harmful effects of maternal obesity on childhood cardiometabolic risk factors,” senior investigator Dr Dana Dabelea (University of Colorado, Denver) told heartwire .
Dr Jill Landsbaugh (University of Denver, CO) presented the results of the Exploring Perinatal Outcomes Among Children (EPOCH) study today at the American Diabetes Association 2013 Scientific Sessions. During the presentation, Landsbaugh explained that exposure to maternal diabetes/obesity in utero has been shown to be associated with an increased risk of obesity later in life and more rapid increases in body-mass index (BMI) during childhood. To heartwire , Dabelea said it is not fully known what proportion of the weight gain is the result of inheriting a genetic susceptibility to obesity and what proportion is the result of the maternal weight gain during pregnancy.
“Studies like this can help address that question, because if gestational weight gain during pregnancy has the potential to modify the relationship between prepregnancy BMI and childhood obesity, it means that at least part of that association is due to specific intrauterine affects,” said Dabelea.
Role of Gestational Weight Gain on Future Risk
The retrospective cohort study included 393 mother-child pairs with children aged between six and 13 years old. The women were stratified into two cohorts: 211 women with a prepregnancy BMI <25 and 181 women with a prepregnancy BMI >25. Women who were normal weight gained 14.1 kg during pregnancy compared with 12.4 kg gained for women who were considered overweight/obese prior to becoming pregnant.
Despite this, 34.9% of normal-weight women exceeded the 2009 IOM recommended amount of weight gain during their pregnancy compared with 61.3% of overweight/obese women. The overweight/obese women were significantly more likely to have children (assessed at an average age of 10 years old) who had higher BMI, larger waist circumferences, and significantly more visceral and subcutaneous adipose tissue. The children of overweight/obese mothers also had lower HDL-cholesterol levels and higher triglyceride levels and were more likely to be insulin resistant.
However, as the investigators noted, the effects of maternal BMI on metabolic parameters were modified by gestational weight gain. For example, for every one-unit increase in maternal prepregnancy BMI among women who gained excessive weight, there was a subsequent increase in childhood BMI of 0.29 units, explained Landsbaugh. For women who gained an appropriate amount of weight, each one-unit increase in maternal BMI was associated with an increase in childhood BMI of 0.24 units. Appropriate weight gain also attenuated the effect on childhood HDL levels and homeostasis model assessment (HOMA) insulin resistance.
“For the women who are currently overweight or obese, it’s a very positive message,” Landsbaugh told heartwire . “If they gain an adequate amount of weight, it can attenuate the effect on childhood metabolic risk. Yes, the mothers might be overweight or obese, but they can do something for their child. They can monitor their weight gain and gain the adequate amount based on their weight category prior to pregnancy and then they could have better outcomes with their child.”
To heartwire , Dabelea said that women often don’t receive appropriate counseling on weight gain during pregnancy. For those who do, the message is hardly standardized, she added. Obstetricians and gynecologists are more concerned with the opposite problem, that women gain enough weight so that the baby is healthy during gestation.
— Michael O’Riordan0