From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children
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Caroline Brand
,
Camila Felin Fochesatto
Abstract
Objectives
To verify the associations between prenatal and perinatal factors with offspring body mass index (BMI) and the moderator role of maternal BMI in this relationship.
Methods
Cross-sectional study developed with 1,562 children and adolescents aged between 6 and 17 years, as well as their mothers, from southern Brazil. The prenatal and perinatal factors, weight, and height for the calculation of maternal BMI were self-reported. For the calculation of BMI, weight and height of the child/adolescent were measured on an anthropometric scale with a coupled stadiometer. Linear regression models were used for the moderation analysis. All analyzes were adjusted for the mother’s and child’s age, sex, sexual maturation, skin color/race, and educational level.
Results
cesarean as type of delivery (β=0.66; 95% CI=0.22 1.04; p=0.002) and pregnancy complications (β=0.60; 95% CI=0.15 1.04; p=0.002) were positively associated with offspring BMI. Schoolchildren who were breastfed for 4–6 months showed −0.56 kg/m2 of BMI (95% CI=−1.06–0.06; p=0.02). Birth weight was also associated with BMI, with low weight being inversely (β=−0.59; 95% CI=−1.03–0.15; p=0.008), while overweight was positively related (β=0.84; 95% CI=0.08 1.60; p=0.02). The moderation analysis indicated a positive interaction between the mother’s BMI and cesarean, pregnancy complications, and smoking with the offspring’s BMI. On the other hand, there was an inverse association between breastfeeding from 7 to 12 months and the offspring BMI, only in mothers with high BMI.
Conclusions
Adequate maternal BMI is essential to prevent a high BMI in their children, especially when considering the influence of prenatal and perinatal risk factors.
Funding source: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Award Identifier / Grant number: 001
Acknowledgments
The authors thank the collaboration of the schools, our research group from Health Research Laboratory (LAPES), as well as all the support of the University of Santa Cruz do Sul – UNISC and Higher Education Personnel Improvement Coordination – Brazil (CAPES).
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Research funding: This manuscript was financed by the support of the Higher Education Personnel Improvement Coordination–Brazil (CAPES) - Financing Code 001.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: This study was approved by the Human Research Ethics Committee of the University of Santa Cruz do Sul (UNISC) (number 1.498.305) and followed the resolution 466/2012 of the National Council of Health in Brazil. The informed consent form for participation in this study was provided by the legal guardian of the participants.
References
1. Ogden, CL, Carroll, MD, Lawman, HG, Fryar, CD, Kruszon-Moran, D, Kit, BK, et al.. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013–2014. JAMA 2016;315:2292. https://doi.org/10.1001/jama.2016.6361.Search in Google Scholar PubMed PubMed Central
2. Wang, LX, Gurka, MJ, Deboer, MD. Metabolic syndrome severity and lifestyle factors among adolescents. Minerva Pediatr 2018;70:467–75. https://doi.org/10.23736/S0026-4946.18.05290-8.Search in Google Scholar PubMed PubMed Central
3. Wang, J, Perona, JS, Schmidt-RioValle, J, Chen, Y, Jing, J, González-Jiménez, E. Metabolic syndrome and its associated early-life factors among Chinese and Spanish adolescents: a pilot study. Nutrients 2019;11:10–5. https://doi.org/10.3390/nu11071568.Search in Google Scholar PubMed PubMed Central
4. Langley-Evans, SC. Developmental programming of health and disease. Proc Nutr Soc 2006;65:97–105. https://doi.org/10.1079/pns2005478.Search in Google Scholar PubMed PubMed Central
5. Hadjkacem, I, Ayadi, H, Turki, M, Yaich, S, Khemekhem, K, Walha, A, et al.. Prenatal, perinatal and postnatal factors associated with autism spectrum disorder. J Pediatr 2016;92:595–601. https://doi.org/10.1016/j.jped.2016.01.012.Search in Google Scholar PubMed
6. Rayfield, S, Plugge, E. Systematic review and meta-analysis of the association between maternal smoking in pregnancy and childhood overweight and obesity. J Epidemiol Community Health 2017;71:162–73. https://doi.org/10.1136/jech-2016-207376.Search in Google Scholar PubMed
7. Li, HT, Zhou, YB, Liu, JM. The impact of cesarean section on offspring overweight and obesity: a systematic review and meta-analysis. Int J Obes 2013;37:893–9. https://doi.org/10.1038/ijo.2012.195.Search in Google Scholar PubMed
8. Byrne, ML, Schwartz, OS, Simmons, JG, Sheeber, L, Whittle, S, Allen, NB. Duration of breastfeeding and subsequent adolescent obesity: effects of maternal behavior and socioeconomic status. J Adolesc Heal 2018;62:471–9. https://doi.org/10.1016/j.jadohealth.2017.10.019.Search in Google Scholar PubMed
9. Timur, BB, Timur, H, Tokmak, A, Isik, H, Gul, E, Eyi, Y, et al.. The influence of maternal obesity on pregnancy complications and neonatal outcomes in diabetic and nondiabetic women. Geburtshilfe Frauenheilkd 2018;78:400–6.10.1055/a-0589-2833Search in Google Scholar PubMed PubMed Central
10. Children’s Hospital of Philadelphia. Small for gestational age. Avaiable at: https://www.chop.edu/conditions-diseases/small-gestational-age [Accessed 22 Nov 2021].Search in Google Scholar
11. Tanaka, T, Ashihara, K, Nakamura, M, Kanda, T, Fujita, D, Yamashita, Y, et al.. Associations between the pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in Japanese women. J Obstet Gynaecol Res 2014;40:1296–303. https://doi.org/10.1111/jog.12353.Search in Google Scholar PubMed
12. Shumer, DE, Norman, PS, Nokooff, NJ. Association between maternal pre-pregnancy obesity and preterm birth according to maternal age and race or ethnicity: a population-based study. Physiol Behav 2017;176:139–48.Search in Google Scholar
13. Liu, HK, Wu, CY, Yang, YN, Wu, PL, He, ZR, Yang, SN, et al.. Association between maternal pre-delivery body mass index and offspring overweight/obesity at 1 and 2 years of age among residents of a suburb in Taiwan. PeerJ 2019;2019:1–15. https://doi.org/10.7717/peerj.6473.Search in Google Scholar
14. Martinez, SR, Maresha, SG, Zhang, L. Mother’s pre-pregnancy BMI is an important determinant of adverse cardiometabolic risk in childhood. Physiol Behav 2016;176:139–48.Search in Google Scholar
15. Ortega, FB, Sui, X, Lavie, CJ, Blair, SN. Body mass index, the most widely used but also widely criticized index: would a gold-standard measure of total body fat be a better predictor of cardiovascular disease mortality? Physiol Behav 2017;176:139–48.Search in Google Scholar
16. Onis, M, Onyando, AW, Borghi, E, Siyam, A, Nishida, C, Siekmann, J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007;85:660–7. https://doi.org/10.2471/blt.07.043497.Search in Google Scholar
17. Tanner, JM. Normal growth and techniques of growth assessment. Clin Endocrinol Metabol 1986;15:411–51. https://doi.org/10.1016/s0300-595x(86)80005-6.Search in Google Scholar
18. World Health Organization. The WHO Child Growth Standardas. Geneva: WHO; 2007.Search in Google Scholar
19. Hayes, AF. Mediation, moderation and conditional process analysis: a regression-based approach. Iorque: Nova; 2013.Search in Google Scholar
20. Boudet-Berquier, J, Salanave, B, Desenclos, J, Castebon, K. Association between maternal prepregnancy obesity and breastfeeding duration: data from a nationwide prospective birth cohort. Matern Child Nutr 2018;14:1–12. https://doi.org/10.1111/mcn.12507.Search in Google Scholar
21. Portela, DS, Vieira, TO, Matos, SMA, de Oliveira, NF, Vieira, GO. Maternal obesity, environmental factors, cesarean delivery and breastfeeding as determinants of overweight and obesity in children: results from a cohort. BMC Pregnancy Childbirth 2015;15:1–10. https://doi.org/10.1186/s12884-015-0518-z.Search in Google Scholar
22. World Health Organization. Appropriate technology for birth. Lancet 1985;326:436–7.10.1016/S0140-6736(85)92750-3Search in Google Scholar
23. Gondwe, T, Betha, K, Kusneniwar, GN, Bunker, CH, Gong, T, Simhan, H, et al.. Maternal factors associated with mode of delivery in a population with a high cesarean section rate. J Epidemiol Glob Health 2019;9:252–8. https://doi.org/10.2991/jegh.k.191017.001.Search in Google Scholar
24. Guendelman, S, Gemmill, A, Thornton, D, Walker, D, Harvey, M, Walsh, J, et al.. Prevalence, disparities, and determinants of primary cesarean births among first-time mothers in Mexico. Health Aff 2017;36:714–22. https://doi.org/10.1377/hlthaff.2016.1084.Search in Google Scholar
25. Chavarro, JE, Martín-Calvo, N, Yuan, C, Arvizu, M, Rich-Edwards, JW, Michels, KB, et al.. Association of birth by cesarean delivery with obesity and type 2 diabetes among adult women. JAMA Netw Open 2020;3:e202605. https://doi.org/10.1001/jamanetworkopen.2020.2605.Search in Google Scholar
26. Labbok, M, Taylor, E. Achieving exclusive breastfeeding in the United States: findings and recommendations. Washigton: United States Breastfeeding Committee; 2008:1–55 pp.Search in Google Scholar
27. Victora, CG, Bahl, R, Barros, AJD, França, GVA, Horton, S, Krasevec, J, et al.. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016;387:475–90. https://doi.org/10.1016/s0140-6736(15)01024-7.Search in Google Scholar
28. Brasil. Ministério da Saúde. Ministério da saúde da criança: Nutrição Infantil. Brasil: Ministério da Saúde; 2009:112 p.Search in Google Scholar
29. Pearce, J, Langley-Evans, SC. The types of food introduced during complementary feeding and risk of childhood obesity: a systematic review. Int J Obes 2013;37:477–85. https://doi.org/10.1038/ijo.2013.8.Search in Google Scholar PubMed
30. Rito, AI, Buoncristiano, M, Spinelli, A, Salanave, B, Kunešová, M, Hejgaard, T, et al.. Association between characteristics at birth, breastfeeding and obesity in 22 countries: the WHO European childhood obesity surveillance initiative - COSI 2015/2017. Obes Facts 2019;12:226–43. https://doi.org/10.1159/000500425.Search in Google Scholar PubMed PubMed Central
31. Chu, SY, Kim, SY, Schmid, CH, Dietz, PM, Callaghan, WM, Lau, J, et al.. Maternal obesity and risk of cesarean delivery: a meta-analysis. Obes Rev 2007;8:385–94. https://doi.org/10.1111/j.1467-789x.2007.00397.x.Search in Google Scholar
32. Li, S, Zhu, Y, Yeung, E, Chavarro, JE, Yuan, C, Field, AE, et al.. Offspring risk of obesity in childhood, adolescence and adulthood in relation to gestational diabetes mellitus: a sex-specific association. Int J Epidemiol 2017;46:1533–41. https://doi.org/10.1093/ije/dyx151.Search in Google Scholar PubMed PubMed Central
33. Kitsiou-Tzeli, S, Tzetis, M. Maternal epigenetics and fetal and neonatal growth. Curr Opin Endocrinol Diabetes Obes 2017;24:43–6. https://doi.org/10.1097/MED.0000000000000305.Search in Google Scholar PubMed
34. Gluckman, PD, Hanson, MA, Mitchell, MD. Developmental origins of health and disease: reducing the burden of chronic disease in the next generation. Genome Med 2010;2. https://doi.org/10.1186/gm135.Search in Google Scholar PubMed PubMed Central
35. Lee, EY, Yoon, K. Epidemic obesity in children and adolescents : risk factors and prevention. Front Med 2018;12:658–66. https://doi.org/10.1007/s11684-018-0640-1.Search in Google Scholar PubMed
© 2022 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review Article
- Effects of vitamin D supplementation on glycemic control of children and adolescents with type 1 diabetes mellitus: a systematic review
- Original Articles
- A preliminary study on the relationship between environmental endocrine disruptors and precocious puberty in girls
- Tissue concentration of aldosterone in fetal adrenals of intrauterine death cases
- Complications of orthopedic treatment in patients diagnosed with X-linked hypophosphatemic rickets
- Comparison of insulin sensitivity indices for detection of double diabetes in Indian adolescents with type 1 diabetes
- Evaluation of the growth and nutritional status of preschool children: a pilot study in the cold area of China
- Arterial hypertension is associated with an increased risk of metabolic complications in pediatric patient with obesity
- From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children
- Screening of non-syndromic early-onset child and adolescent obese patients in terms of LEP, LEPR, MC4R and POMC gene variants by next-generation sequencing
- The association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness in children with obesity: a cross-sectional study
- Comprehensive assessment of cardiovascular disease risk in children with short stature due to isolated growth hormone deficiency: a case-control study
- Visceral adiposity is related to insulin sensitivity and inflammation in adolescents with obesity and mild sleep disordered breathing
- Recurrent hypoglycemic seizure as a presenting symptom of post-TBI hypopituitarism in children: a case report, review and proposed protocol
- Evaluation of the etiological and clinical characteristics of pediatric central diabetes insipidus
- Case Reports
- Clinical and radiologic evaluation of a Turkish family with hypochondroplasia and a rare FGFR3 variant
- Rituximab therapy in ROHHAD(NET) syndrome
- Ectopic parathyroid hormone as a rare aetiology of hypercalcemia with rhabdomyosarcoma: a new treatment strategy with zoledronic acid and Denosumab
- A 2-bp deletion mutation in SMPD1 gene leading to lysosomal acid sphingomyelinase deficiency in a Chinese consanguineous pedigree
Articles in the same Issue
- Frontmatter
- Review Article
- Effects of vitamin D supplementation on glycemic control of children and adolescents with type 1 diabetes mellitus: a systematic review
- Original Articles
- A preliminary study on the relationship between environmental endocrine disruptors and precocious puberty in girls
- Tissue concentration of aldosterone in fetal adrenals of intrauterine death cases
- Complications of orthopedic treatment in patients diagnosed with X-linked hypophosphatemic rickets
- Comparison of insulin sensitivity indices for detection of double diabetes in Indian adolescents with type 1 diabetes
- Evaluation of the growth and nutritional status of preschool children: a pilot study in the cold area of China
- Arterial hypertension is associated with an increased risk of metabolic complications in pediatric patient with obesity
- From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children
- Screening of non-syndromic early-onset child and adolescent obese patients in terms of LEP, LEPR, MC4R and POMC gene variants by next-generation sequencing
- The association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness in children with obesity: a cross-sectional study
- Comprehensive assessment of cardiovascular disease risk in children with short stature due to isolated growth hormone deficiency: a case-control study
- Visceral adiposity is related to insulin sensitivity and inflammation in adolescents with obesity and mild sleep disordered breathing
- Recurrent hypoglycemic seizure as a presenting symptom of post-TBI hypopituitarism in children: a case report, review and proposed protocol
- Evaluation of the etiological and clinical characteristics of pediatric central diabetes insipidus
- Case Reports
- Clinical and radiologic evaluation of a Turkish family with hypochondroplasia and a rare FGFR3 variant
- Rituximab therapy in ROHHAD(NET) syndrome
- Ectopic parathyroid hormone as a rare aetiology of hypercalcemia with rhabdomyosarcoma: a new treatment strategy with zoledronic acid and Denosumab
- A 2-bp deletion mutation in SMPD1 gene leading to lysosomal acid sphingomyelinase deficiency in a Chinese consanguineous pedigree
