Associations of maternal prepregnancy body mass index and gestational weight gain with cardio‐metabolic risk factors in adolescent offspring: a prospective cohort study

<jats:sec><jats:title>Objective</jats:title><jats:p>To assess the associations of maternal prepregnancy body mass index (<jats:styled-content style="fixed-case">BMI</jats:styled-content>) and rates of early‐pregnancy, mid‐pregnancy and total gestational weight gain with adolescent body fat distribution and cardio‐metabolic outcomes.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Population‐based prospective cohort study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Western Australia.</jats:p></jats:sec><jats:sec><jats:title>Population</jats:title><jats:p>Thousand three hundred and ninety‐two mothers and their children.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Maternal prepregnancy weight was assessed by questionnaire. Maternal weights at a mean of 16.5 ± 2.2 <jats:styled-content style="fixed-case">SD</jats:styled-content> and 34.1 ± 1.5 <jats:styled-content style="fixed-case">SD</jats:styled-content> weeks of gestation were obtained from medical records. Offspring adiposity and cardio‐metabolic outcomes were assessed at a median age 17.0 years [95% confidence interval (<jats:styled-content style="fixed-case">CI</jats:styled-content>) range: 16.7, 17.7].</jats:p></jats:sec><jats:sec><jats:title>Main outcome measures</jats:title><jats:p>Adolescent <jats:styled-content style="fixed-case">BMI</jats:styled-content>, waist circumference (<jats:styled-content style="fixed-case">WC</jats:styled-content>), waist‐to‐hip ratio (<jats:styled-content style="fixed-case">WHR</jats:styled-content>), blood pressure, total and <jats:styled-content style="fixed-case">HDL</jats:styled-content>‐cholesterol, triglycerides, insulin, glucose and <jats:styled-content style="fixed-case">HOMA</jats:styled-content>‐<jats:styled-content style="fixed-case">IR</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Higher prepregnancy <jats:styled-content style="fixed-case">BMI</jats:styled-content> was associated with higher adolescent <jats:styled-content style="fixed-case">BMI</jats:styled-content>,<jats:styled-content style="fixed-case"> WC</jats:styled-content>,<jats:styled-content style="fixed-case"> WHR</jats:styled-content>, systolic blood pressure, insulin, glucose and <jats:styled-content style="fixed-case">HOMA</jats:styled-content>‐<jats:styled-content style="fixed-case">IR</jats:styled-content> levels (<jats:italic>P</jats:italic>‐values <0.05). Adjustment for adolescent current <jats:styled-content style="fixed-case">BMI</jats:styled-content> attenuated the associations of prepregnancy <jats:styled-content style="fixed-case">BMI</jats:styled-content> with adolescent cardio‐metabolic outcomes. Higher weight gain in early‐pregnancy, but not mid‐pregnancy, was associated with higher adolescent <jats:styled-content style="fixed-case">BMI</jats:styled-content>,<jats:styled-content style="fixed-case"> WC</jats:styled-content> and <jats:styled-content style="fixed-case">WHR</jats:styled-content> (<jats:italic>P</jats:italic>‐values <0.05), but not with other cardio‐metabolic risk factors. Total gestational weight gain was associated with adolescent <jats:styled-content style="fixed-case">BMI</jats:styled-content> and <jats:styled-content style="fixed-case">WC</jats:styled-content> (<jats:italic>P</jats:italic>‐values <0.05). Higher prepregnancy <jats:styled-content style="fixed-case">BMI</jats:styled-content> and early‐pregnancy weight gain were associated with increased risks of the high‐metabolic risk cluster in adolescents (<jats:styled-content style="fixed-case">OR</jats:styled-content> 1.57, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 1.33, 1.85 and <jats:styled-content style="fixed-case">OR</jats:styled-content> 1.23, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 1.03, 1.47 per <jats:styled-content style="fixed-case">SD</jats:styled-content> increase in prepregnancy <jats:styled-content style="fixed-case">BMI</jats:styled-content> and early‐pregnancy weight gain, respectively).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Higher maternal prepregnancy <jats:styled-content style="fixed-case">BMI</jats:styled-content> and early‐pregnancy weight gain rate are associated with an adverse adolescent cardio‐metabolic profile. These associations are largely mediated by adolescent <jats:styled-content style="fixed-case">BMI</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Tweetable abstract</jats:title><jats:p>Prepregnancy <jats:styled-content style="fixed-case">BMI</jats:styled-content> and early‐pregnancy <jats:styled-content style="fixed-case">WG</jats:styled-content> rate are associated with adverse adolescent cardio‐metabolic profile.</jats:p></jats:sec>