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Diabetologia. 2018 Dec;61(12):2539-2548. doi: 10.1007/s00125-018-4724-x. Epub 2018 Sep 17.

The impact of maternal gestational weight gain on cardiometabolic risk factors in children.

Author information

1
9/F, Lui Che Woo Clinical Science Building, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong Special Administrative Region, Hong Kong.
2
9/F, Lui Che Woo Clinical Science Building, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong Special Administrative Region, Hong Kong. rcwma@cuhk.edu.hk.
3
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, Hong Kong. rcwma@cuhk.edu.hk.
4
Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, Hong Kong. rcwma@cuhk.edu.hk.
5
1/F, Special Block (Block E), Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong Special Administrative Region, Hong Kong.
6
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, Hong Kong.
7
Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, Hong Kong.
8
Department of Chemical Pathology, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, Hong Kong.
9
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
10
Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, Hong Kong.
11
1/F, Special Block (Block E), Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong Special Administrative Region, Hong Kong. tamwh@cuhk.edu.hk.

Abstract

AIMS/HYPOTHESIS:

Accumulating evidence suggests an impact of gestational weight gain (GWG) on pregnancy outcomes; however, data on cardiometabolic risk factors later in life have not been comprehensively studied. This study aimed to evaluate the relationship between GWG and cardiometabolic risk in offspring aged 7 years.

METHODS:

We included a total of 905 mother-child pairs who enrolled in the follow-up visit of the multicentre Hyperglycemia and Adverse Pregnancy Outcome study, at the Hong Kong Centre. Women were classified as having gained weight below, within or exceeding the 2009 Institute of Medicine (IOM) guidelines. A standardised GWG according to pre-pregnancy BMI categories was calculated to explore for any quadratic relationship.

RESULTS:

Independent of pre-pregnancy BMI, gestational hyperglycaemia and other confounders, women who gained more weight than the IOM recommendations had offspring with a larger body size and increased odds of adiposity, hypertension and insulin resistance (range of p values of all the traits: 4.6 × 10-9 < p < 0.0390) than women who were within the recommended range of weight gain during pregnancy. Meanwhile, women who gained less weight than outlined in the recommendations had offspring with increased risks of hypertension and insulin resistance, compared with those who gained weight within the recommended range (7.9 × 10-3 < p < 0.0477). Quadratic relationships for diastolic blood pressure, AUC for insulin, pancreatic beta cell function and insulin sensitivity index were confirmed in the analysis of standardised GWG (1.4 × 10-3 < pquadratic < 0.0282). Further adjustment for current BMI noticeably attenuated the observed associations.

CONCLUSIONS/INTERPRETATION:

Both excessive and inadequate GWG have independent and significant impacts on childhood adiposity, hypertension and insulin resistance. Our findings support the notion that adverse intrauterine exposures are associated with persistent cardiometabolic risk in the offspring.

KEYWORDS:

Adiposity; Cardiometabolic risk factors; Chinese children; Gestational weight gain; Hypertension; Insulin resistance; Maternal pre-pregnancy BMI

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