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Maternal obesity, gestational weight gain and childhood cardiac outcomes: role of childhood body mass index

International Journal of Obesity volume 40, pages 1070–1078 (2016)Cite this article

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Abstract

Background:

Maternal obesity may affect cardiovascular outcomes in the offspring. We examined the associations of maternal prepregnancy body mass index and gestational weight gain with childhood cardiac outcomes and explored whether these associations were explained by parental characteristics, infant characteristics or childhood body mass index.

Methods:

In a population-based prospective cohort study among 4852 parents and their children, we obtained maternal weight before pregnancy and in early, mid- and late pregnancy. At age 6 years, we measured aortic root diameter (cm) and left ventricular dimensions. We calculated left ventricular mass (g), left ventricular mass index (g m−2.7), relative wall thickness ((2 × left ventricular posterior wall thickness)/left ventricular diameter), fractional shorting (%), eccentric left ventricular hypertrophy and concentric remodeling.

Results:

A one standard deviation score (SDS) higher maternal prepregnancy body mass index was associated with higher left ventricular mass (0.10 SDS (95% confidence interval (CI) 0.08, 0.13)), left ventricular mass index (0.06 SDS (95% CI 0.03, 0.09)) and aortic root diameter (0.09 SDS (95% CI 0.06, 0.12)), but not with relative wall thickness or fractional shortening. A one SDS higher maternal prepregnancy body mass index was associated with an increased risk of eccentric left ventricular hypertrophy (odds ratio 1.21 (95% CI 1.03, 1.41)), but not of concentric remodeling. When analyzing the effects of maternal weight in different periods simultaneously, only maternal prepregnancy weight and early pregnancy weight were associated with left ventricular mass, left ventricular mass index and aortic root diameter (P-values<0.05), independent of weight in other pregnancy periods. All observed associations were independent of parental and infant characteristics, but attenuated to non-significance after adjustment for childhood body mass index.

Conclusion:

Maternal prepregnancy body mass index and weight gain in early pregnancy are both associated with offspring cardiac structure in childhood, but these associations seem to be fully explained by childhood body mass index.

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Acknowledgements

We gratefully acknowledge the contribution of the participating children, their mothers, general practitioners, hospitals, midwives and pharmacies in Rotterdam. The Generation R Study is conducted by the Erasmus Medical Center in close collaboration with the School of Law and Faculty of Social Sciences of the Erasmus University Rotterdam, the Municipal Health Service Rotterdam area, Rotterdam, the Rotterdam Homecare Foundation, Rotterdam and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond (STAR), Rotterdam. The general design of Generation R Study is made possible by financial support from the Erasmus MC, University Medical Center, Rotterdam, the Netherlands Organization for Health Research and Development (ZonMw), the Netherlands Organisation for Scientific Research (NWO), zthe Ministry of Health, Welfare and Sport and the Ministry of Youth and Families. VWVJ received an additional grant from the Netherlands Organization for Health Research and Development (VIDI 016. 136. 361) and a European Research Council Consolidator Grant (ERC-2014-CoG-648916). This research was partly funded by the European Commision’s Horizon 2020 Programme: EU H2020-PHC-2014—grant no. 633595: DynaHEALTH—understanding the dynamic determinants of glucose homeostasis and social capability to promote healthy and active aging and by the European Union's Seventh Framework Programme (FP7/2007-2013), project EarlyNutrition under grant agreement no. 289346.

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Authors and Affiliations

  1. Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

    L Toemen, O Gishti, J F Felix, L Duijts, R Gaillard & V W V Jaddoe

  2. Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

    L Toemen, O Gishti, J F Felix, L Duijts, R Gaillard & V W V Jaddoe

  3. Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

    L Toemen, O Gishti, L van Osch-Gevers, W A Helbing, J F Felix, I K M Reiss, L Duijts, R Gaillard & V W V Jaddoe

  4. Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

    E A P Steegers

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  1. L Toemen
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Toemen, L., Gishti, O., van Osch-Gevers, L. et al. Maternal obesity, gestational weight gain and childhood cardiac outcomes: role of childhood body mass index. Int J Obes 40, 1070–1078 (2016). https://doi.org/10.1038/ijo.2016.86

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