The Joint Associations of Maternal BMI and Glycemia with Childhood Adiposity
Open Access
- 30 June 2020
- journal article
- research article
- Published by The Endocrine Society in Journal of Clinical Endocrinology & Metabolism
- Vol. 105 (7), 2177-2188
- https://doi.org/10.1210/clinem/dgaa180
Abstract
Context: An obesogenic perinatal environment contributes to adverse offspring metabolic health. Previous studies have been limited by lack of direct adiposity measurements and failure to account for potential confounders. Objective: Examine the joint associations of maternal midpregnancy body mass index (BMI) and glycemia with direct adiposity measures in 10-14 year old offspring. Design and Setting: International, epidemiological study: Hyperglycemia and Adverse Pregnancy Outcome (HAPO) and HAPO Follow-up Study, conducted between 2000-2006 and 2013-2016, respectively. Participants and Main Outcome Measures: In 4832 children, adiposity measures for body mass index (BMI), body fat with air displacement plethysmography, skinfold thickness, and waist circumference were obtained at mean age 11.4 years. Results: Maternal BMI and glucose, as continuous and categorical variables, were the primary predictors. In fully adjusted models controlling for child age, sex, field center, and maternal characteristics, maternal BMI had significant, positive associations with all childhood adiposity outcomes, while maternal glycemia had significant, positive associations with childhood adiposity outcomes except BMI. In joint analyses, and compared with a nonobese, nongestational diabetes mellitus (GDM) reference group, maternal obesity and GDM were associated with higher odds (maternal obesity odds ratio; OR [95% confidence interval; CI], GDM OR [95% CI]; combined OR [95% CI]) of childhood overweight/obese BMI (3.00 [2.42-3.74], 1.39 [1.14-1.71], 3.55 [2.49-5.05]), obese BMI (3.54 [2.70-4.64], 1.73 [1.29-2.30], 6.10 [4.14-8.99]), percent body fat >85th percentile (2.15 [1.68-2.75], 1.33 [1.03-1.72], 3.88 [2.72-5.55]), sum of skinfolds >85th percentile (2.35 [1.83-3.00], 1.75 [1.37-2.24], 3.66 [2.55-5.27]), and waist circumference >85th percentile (2.52 [1.99-3.21], 1.39 [1.07-1.80], 4.18 [2.93-5.96]). Conclusions: Midpregnancy maternal BMI and glycemia are independently and additively associated with direct adiposity measures in 10-14 year old children. The combination of maternal obesity and GDM is associated with the highest odds of childhood adiposity.Keywords
Funding Information
- National Institute of Diabetes and Digestive and Kidney Diseases (R01-HD-34242, R01-HD-34243)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (1U01-DK-094830)
This publication has 32 references indexed in Scilit:
- Extended international (IOTF) body mass index cut‐offs for thinness, overweight and obesityPediatric Obesity, 2012
- The Hyperglycemia and Adverse Pregnancy Outcome StudyDiabetes Care, 2012
- Associations of Gestational Diabetes, Existing Diabetes, and Glycosuria With Offspring Obesity and Cardiometabolic OutcomesDiabetes Care, 2011
- National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participantsThe Lancet, 2011
- Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study: associations with maternal body mass indexBJOG: An International Journal of Obstetrics and Gynaecology, 2010
- International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in PregnancyDiabetes Care, 2010
- Relationship between body mass index and adiposity in prepubertal children: ethnic and geographic comparisons between New York City and Jinan City (China)Journal of Applied Physiology, 2009
- Childhood Obesity and Metabolic ImprintingDiabetes Care, 2007
- A Modified Least-Squares Regression Approach to the Estimation of Risk DifferenceAmerican Journal of Epidemiology, 2007
- Birth Cohort Effect on the Obesity Epidemic in DenmarkEpidemiology, 2006