ESPE Abstracts (2018) 89 P-P1-115

Greater Maternal BMI Early in Pregnancy and Excessive Gestational Weight Gain are Independently Associated with Adverse Health Outcomes in the Offspring at Age 7 Years

José G B Derraika,b,c, Valentina Chiavarolia, Sarah A Hopkinsa, Janene B Biggsa, Raquel O Rodriguesa, Sumudu N Seneviratnea,d, Lesley M E McCowane, Wayne S Cutfielda,b & Paul L Hofmana

aLiggins Institute, University of Auckland, Auckland, New Zealand; bA Better Start – National Science Challenge, University of Auckland, Auckland, New Zealand; cDepartment of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden; dDepartment of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; eDepartment of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

Background: Maternal overweight/obesity during pregnancy and excessive gestational weight gain (GWtG) have been recognized as important early-life risk factors for childhood obesity. We aimed to examine whether maternal BMI at 20 weeks of gestation and excessive GWtG were associated with alterations in body composition and metabolism in childhood in the offspring of primiparous mothers who participated in a randomised controlled trial of exercise regimen during pregnancy.

Methods: Of the initial 84 women and their offspring who participated in the trial, follow-up data were available on 52 mothers and their children. Children underwent clinical assessments at approximately 7.6 years, including body composition by DXA and fasting blood tests (i.e. glucose, insulin, and lipid profile), while their nutritional intake was estimated from food diaries. Multivariable models were run with maternal BMI (as a continuous variable) and GWtG (excessive or not), while adjusting for other important confounders.

Results: Twenty-five mothers (48%) were overweight/obese early in pregnancy and 35 (67%) had excessive GWtG as per IOM guidelines. Greater maternal BMI at trial recruitment was associated with increased weight SDS (β=0.09; P=0.001), BMI SDS (β=0.08; P=0.005), and percentage body fat (β=0.44; P=0.031) in the offspring in childhood. Maternal BMI early in pregnancy was not associated with any fasting metabolic parameters in their children. Independently of maternal BMI, children born to mothers with excessive GWtG had increased abdominal adiposity (android to gynoid fat ratio 0.64 vs 0.55; P=0.043), as well as a less favourable lipid profile with lower HDL (1.57 vs 1.77 mmol/L; P=0.010), higher triglycerides (0.87 vs 0.63 mmol/L; P=0.003), and higher total cholesterol to HDL ratio (3.13 vs 2.55 mmol/L; P=0.024), even though macronutrient intake was similar in both groups.

Conclusions: Greater maternal BMI early in pregnancy is associated with increased adiposity in the offspring at age 7.6 years. Importantly, irrespective of maternal BMI early in pregnancy, excessive GWtG is also associated with adverse effects in the offspring.