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

Content Provider	Europe PMC
Author	Tam, Claudia H. T. Ma, Ronald C. W. Yuen, Lai Yuk Ozaki, Risa Li, Albert Martin Hou, Yong Chan, Michael H. M. Ho, Chung Shun Yang, Xilin Chan, Juliana C. N. Tam, Wing Hung
Abstract	Aims/hypothesisAccumulating 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.MethodsWe 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.ResultsIndependent 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/interpretationBoth 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.Electronic supplementary materialThe online version of this article (10.1007/s00125-018-4724-x) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
ISSN	0012186X
Journal	Diabetologia
Volume Number	61
PubMed Central reference number	PMC6223878
Issue Number	12
PubMed reference number	30225524
e-ISSN	14320428
DOI	10.1007/s00125-018-4724-x
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2018-09-17
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. © The Author(s) 2018
Subject Keyword	Adiposity Cardiometabolic risk factors Chinese children Gestational weight gain Hypertension Insulin resistance Maternal pre-pregnancy BMI
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism Internal Medicine