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Maternal obesity reported to harm offspring

Robin Wulffson MD's picture
pregnancy, obesity, health impact, diabetes, hypertension, preeclampsia

Maternal obesity is known to increase a woman’s risk of complications during pregnancy and is also related to subsequent obesity in her offspring when they reach adulthood. Researchers at Hebrew University, Hadassah Medical Center (Jerusalem, Israel) and the University of Washington (Seattle, Washington) designed a study to evaluate whether excess weight before or during pregnancy was related to other cardio-metabolic risk factors in adulthood. Their study, The Jerusalem Perinatal Family Follow-up Study, was published online ahead of print in the journal Circulation.

The study group was comprised of 1,400 young adults born in Jerusalem; extensive archival data and clinical information was available for these individuals at age 32. The authors focused on whether maternal pre-pregnancy body mass index (mppBMI) and gestational weight gain (GWG) resulted in an increased risk of adiposity and related cardio-metabolic outcomes in their offspring when they reached adulthood.

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The researchers found that an increased mppBMI, independent of GWG and confounders (confusing factors, which could cloud the results), was significantly associated with higher offspring BMI, waist circumference (WC), systolic and diastolic blood pressure, insulin, and triglycerides. In addition, a greater mppBMI was associated with a lower HDL-C (good cholesterol). The increase mppBMI translated to a nearly 5 kg/m2 higher mean BMI, 3.3” greater WC, 0.13 mmol/L (11.4 mg/dL) higher triglycerides, and 0.10 mmol/L (3.8 mg/dL) lower HDL-C among offspring of mothers within the upper mppBMI quartile (BMI greater than 26.4 kg/m2) compared to the lower (BMI less than 21.0 kg/m2). GWG, independent of mppBMI, was positively related to offspring adiposity. Differences of 1.6 kg/m2 in BMI and 2.4cm in waist were observed when offspring of mothers in the upper (GWG greater than 31 lbs) and lower (GWG less than 20 lbs) quartiles of GWG were compared.

The authors concluded that increased maternal weight both before and during pregnancy are associated with cardio-metabolic risk factors in young adult offspring. The associations to the risk factors appeared to be primarily related to offspring adiposity. They noted that further studies are indicated to explore mechanisms underlying the intergenerational cycle of obesity; these studies should attempt to identify potentially new targets for cardio-metabolic risk-reduction interventions.

Take home message:

This study focused on the impact of maternal obesity on offspring; however, obesity also increases the risk of complications during pregnancy. Complications include an increased risk of gestational diabetes, hypertension, and preeclampsia (toxemia). Obese women are at increased risk of requiring a cesarean delivery; furthermore, surgery on an obese woman bears an increased risk of surgical complications, including hemorrhage, prolonged surgery time, wound infections, and uterine infections. Thus, in the interest of her health as well as that of her offspring, an overweight woman should enroll in a weight loss program and successfully complete it before attempting pregnancy.

Reference: Circulation