Maternal lifestyle characteristics during pregnancy, and the risk of obesity in the offspring: a study of 5,125 children

Stamatis P Mourtakos, Konstantinos D Tambalis, Demosthenes B Panagiotakos, George Antonogeorgos, Giannis Arnaoutis, Konstantinos Karteroliotis, Labros S Sidossis, Stamatis P Mourtakos, Konstantinos D Tambalis, Demosthenes B Panagiotakos, George Antonogeorgos, Giannis Arnaoutis, Konstantinos Karteroliotis, Labros S Sidossis

Abstract

Background: To investigate the association between gestational weight gain, maternal age and lifestyle habits (e.g., physical activity, smoking, and alcohol consumption) during pregnancy, with Body Mass Index of the offspring at the age of 8.

Methods: Α random sample of 5,125 children was extracted from a national database and matched with their mothers. With the use of a standardised questionnaire, telephone interviews were carried out for the collection of information like: maternal age at pregnancy, gestational weight gain (GWG), exercise levels, smoking and alcohol consumption. The Body Mass Index (BMI) status of the offspring at the age of 8 was calculated from data retrieved from the national database (e.g., height and weight).

Results: The odds for being overweight/obese at the age of 8 for 1 kg GWG, for smoking, and for mild exercise during pregnancy compared to sedentary was 1.01 (95%CI: 1.00, 1.02), 1.23 (95%CI: 1.03, 1.47) and 0.77 (95%CI: 0.65, 0.91), respectively. Further analysis revealed that offspring of women who exceeded the Institute of Medicine (IOM) maternal weight gain recommendations were at an increased risk of obesity (OR: 1.45; 95%CI, 1.26, 1.67) compared with offspring of women with GWG within the recommended range. Maternal age and alcohol consumption were not associated with the outcome (p > 0.05).

Conclusion: GWG, physical activity and smoking status during pregnancy were significantly associated with obesity for the offspring at the age of 8. Health care professionals should strongly advise women to not smoke and to perform moderate exercise during pregnancy to prevent obesity in the offspring in later life.

References

    1. Dugan SA. Exercise for preventing childhood obesity. Phys Med Rehabil Clin N Am. 2008;19(2):205–16. doi: 10.1016/j.pmr.2007.11.001.
    1. Kosti RI, Panagiotakos DB. The epidemic of obesity in children and adolescents in the world. Cent Eur J Public Health. 2006;14(4):151–9.
    1. Lee CF, Hwang FM, Liou YM, Chien LY. A preliminary study on the pattern of weight change from pregnancy to 6 months postpartum: a latent growth model approach. Int J Obes (Lond) 2011;35(8):1079–86. doi: 10.1038/ijo.2010.225.
    1. Villamor E, Cnattingius S. Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study. Lancet. 2006;368(9542):1164–70. doi: 10.1016/S0140-6736(06)69473-7.
    1. Walsh JM, Murphy DJ. Weight and pregnancy. BMJ. 2007;335(7612):169. doi: 10.1136/bmj.39267.518808.80.
    1. Park S, Sappenfield WM, Bish C, Salihu H, Goodman D, Bensyl DM. Assessment of the Institute of Medicine recommendations for weight gain during pregnancy: Florida, 2004–2007. Matern Child Health J. 2011;15(3):289–301. doi: 10.1007/s10995-010-0596-5.
    1. Rooney BL, Mathiason MA, Schauberger CW. Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort. Matern Child Health J. 2011;15(8):1166–75. doi: 10.1007/s10995-010-0689-1.
    1. Mamun AA, Callaway LK, O’Callaghan MJ, Williams GM, Najman JM, Alati R, et al. Associations of maternal pre-pregnancy obesity and excess pregnancy weight gains with adverse pregnancy outcomes and length of hospital stay. BMC Pregnancy Childbirth. 2011;11:62. doi: 10.1186/1471-2393-11-62.
    1. Schack-Nielsen L, Michaelsen KF, Gamborg M, Mortensen EL, Sørensen TI. Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood. Int J Obes. 2010;34(1):67–74. doi: 10.1038/ijo.2009.206.
    1. Gaskins RB, LaGasse LL, Liu J, Shankaran S, Lester BM, Bada HS, et al. Small for gestational age and higher birth weight predict childhood obesity in preterm infants. Am J Perinatol. 2010;27(9):721–30. doi: 10.1055/s-0030-1253555.
    1. Arenz S, Von Kries R. Protective effect of breast-feeding against obesity in childhood (2009): can a meta-analysis of published observational studies help to validate the hypothesis? Adv Exp Med Biol. 2009;639:145–52. doi: 10.1007/978-1-4020-8749-3_12.
    1. James WPT. The epidemiology of obesity: the size of the problem. J Intern Med. 2008;263:336–52. doi: 10.1111/j.1365-2796.2008.01922.x.
    1. Martorell R, Kettel Khan L, Hughes ML, Grummer-Strawn LM. Overweight and obesity in preschool children from developing countries. Int J Obes Relat Metab Disord. 2000;24:959–67. doi: 10.1038/sj.ijo.0801264.
    1. Tambalis KD, Panagiotakos DB, Kavouras SA, Kallistratos AA, Moraiti IP, Douvis SJ, et al. Eleven-year prevalence trends of obesity in Greek children: first evidence that prevalence of obesity is levelling off. Obesity (Silver Spring) 2010;18(1):161–6. doi: 10.1038/oby.2009.188.
    1. Tambalis KD, Panagiotakos DB, Psarra G, Sidossis LS. Inverse, but independent trends in obesity and fitness levels among Greek children: a time-series analysis from 1997 to 2007. Obes Facts. 2011;4(2):165–74. doi: 10.1159/000327994.
    1. Tambalis KD, Panagiotakos DB, Sidossis LS. Greek children living in rural areas are heavier but fitter compared to their urban counterparts. A comparative, time-series analysis (1997–2008) J Rural Health. 2011;27(3):270–7. doi: 10.1111/j.1748-0361.2010.00346.x.
    1. Chalkias C, Papadopoulos AG, Benekos G, Tambalis K, Psarra G, Sidossis L. Spatial variability of childhood obesity in response to socioeconomic heterogeneity. The case of Athens Metropolitan area, Greece. Proceedings of the 17th European Colloquium on Quantitative and Theoretical Geography (ECQTG2011), ed. S. Kalogirou, ISBN: 978-960-87751-1-4, 2011. p. 605–61.
    1. Wrotniak BH, Shults J, Butts S, Stettler N. Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort study. Am J Clin Nutr. 2008;87(6):1818–24.
    1. Seneviratne SN, Parry GK, McCowan LM, Ekeroma A, Jiang Y, Gusso S, et al. Antenatal exercise in overweight and obese women and its effects on offspring and maternal health: design and rationale of the IMPROVE (Improving Maternal and Progeny Obesity Via Exercise) randomised controlled trial. BMC Pregnancy Childbirth. 2014;14:148. doi: 10.1186/1471-2393-14-148.
    1. Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. Br Med J. 2007;335(7612):194. doi: 10.1136/bmj.39238.399444.55.
    1. Kendrick JS, Williamson DF, Caspersen CJ. Re: “A meta-analysis of physical activity in the prevention of coronary heart disease”. Am J Epidemiol. 1991;134(2):232–4.
    1. Evenson KR, Chasan-Taber L, Symons Downs D, Pearce EE. Review of self-reported physical activity assessments for pregnancy: summary of the evidence for validity and reliability. Paediatr Perinat Epidemiol. 2012;26(5):479–94. doi: 10.1111/j.1365-3016.2012.01311.x.
    1. American College of Sports Medicine . ACSM’s Guidelines for Exercise Testing and Prescription. 6. Philadelphia: Lippincot, Williams and Wilkins; 2000.
    1. ACSM American College of Sports Medicine Position Stand and American Heart Association. Recommendations for cardiovascular screening, staffing, and emergency policies at health/fitness facilities. Med Sci Sports Exerc. 1998;30(6):1009–18. doi: 10.1097/00005768-199806000-00034.
    1. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 1998;43(7):1334–59. doi: 10.1249/MSS.0b013e318213fefb.
    1. Evenson KR, Wen F. Measuring physical activity among pregnant women using a structured one-week recall questionnaire: evidence for validity and reliability. Int J Behav Nutr Phys Act. 2010;7:21. doi: 10.1186/1479-5868-7-21.
    1. Stevenson L. Exercise in pregnancy. Part 2: Recommendations for individuals. Can Fam Physician. 1997;43:107–111.
    1. Artal R, Posner M. Fetal responses to maternal exercise (1991) In: Artal R, Wiswell RS, Drinkwater B, editors. Exercise in Pregnancy. 2. Baltimore, Md: Williams & Wilkins; 1991. pp. 213–24.
    1. Saftlas AF, Logsden-Sackett N, Wang W, Woolson R, Bracken MB. Work, leisure-time activity, and risk of preeclampsia and gestational hypertension. Am J Epidemiol. 2004;160:758–65. doi: 10.1093/aje/kwh277.
    1. Sorensen TK, Williams MA, Lee I, Dashow EE, Thompson ML, Luthy DA. Recreational physical activity during pregnancy and risk of preeclampsia. Hypertension. 2003;41:1273–80. doi: 10.1161/01.HYP.0000072270.82815.91.
    1. Dye TD, Knox KL, Artal R, Aubry RH, Wojtowycz MA. Physical activity, obesity, and diabetes in pregnancy. Am J Epidemiol. 1997;146(11):961–5. doi: 10.1093/oxfordjournals.aje.a009223.
    1. American College of Obstetricians and Gynecologists Exercise during pregnancy and the postpartum period ACOG Committee Opinion No. 267. Obstet Gynecol. 2002;99:171–3. doi: 10.1016/S0029-7844(01)01749-5.
    1. American College of Sports Medicine Impact of physical activity during pregnancy and postpartum on chronic disease risk: Roundtable consensus statement. Med Sci Sports Exerc. 2006;38:989–1006. doi: 10.1249/01.mss.0000218147.51025.8a.
    1. Dempsey JC, Sorensen TK, Williams MA, Lee IM, Miller RS, Dashow EE, et al. Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol. 2004;159(7):663–70. doi: 10.1093/aje/kwh091.
    1. Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines for Americans. US Dept of Health and Human Services; 2008.
    1. American College of Sports Medicine . Exercise prescription for healthy populations and special considerations. In: Thompson WR, editor. Guidelines for Exercise Testing and Prescription. 8. Philadelphia: Wolters Kluwer, Lippincott Williams & Wilkins; 2010. pp. 183–7.
    1. Davies GA, Wolfe LA, Mottola MF, MacKinnon C, Arsenault MY, Bartellas E, et al. Exercise in pregnancy and the postpartum period. J Obstet Gynaecol Can. 2003;25(6):516–29.
    1. Denmark National Board of Health . Physical activity- a handbook on prevention and treatment. Copenhagen, Denmark: National Board of Health; 2003.
    1. National Collaborating Centre for Women’s and Children’s Health (UK) (2008) Antenatal care: routine care for the healthy pregnant woman. London: RCOG Press; 2008.
    1. Directorate for Health and Social Affairs . Guidelines for Antenatal Care. Oslo, Norway: Directorate for Health and Social Affairs; 2005.
    1. Sports Medicine Australia. Exercise in pregnancy. .
    1. Neovius K, Rasmussen F, Sundstro MJ, Neovius M. Forecast of future premature mortality as a result of trends in obesity and smoking: nationwide cohort simulation study. Eur J Epidemiol. 2010;10:703–9. doi: 10.1007/s10654-010-9485-x.
    1. Cnattingius S. The epidemiology of smoking during pregnancy: smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine Tob Res. 2004;6:125–40. doi: 10.1080/14622200410001669187.
    1. Andres RL. Perinatal complications associated with maternal smoking. Semin Neonatol. 2005;5:231–41. doi: 10.1053/siny.2000.0025.
    1. Von Kries R, Toschke AM, Koletzko B, Slikker W., Jr Maternal smoking during pregnancy and childhood obesity. Am J Epidemiol. 2002;156:954–61. doi: 10.1093/aje/kwf128.
    1. Ino T. Maternal smoking during pregnancy and offspring obesity: meta-analysis. Pediatr Int. 2010;52:94–9. doi: 10.1111/j.1442-200X.2009.02883.x.
    1. Oken E, Levitan EB, Gillman MW. Maternal smoking during pregnancy and child overweight: systematic review and metaanalysis. Int J Obes. 2008;32:201–10. doi: 10.1038/sj.ijo.0803760.
    1. Suzuki K, Ando D, Sato M, Tanaka T, Kondo N, Yamagata Z. The association between maternal smoking during pregnancy and childhood obesity persists to the age of 9–10 years. J Epidemiol. 2009;3:136–42. doi: 10.2188/jea.JE20081012.
    1. Mamun AA, Lawlor DA, Alati R, O’Callaghan MJ, Williams GM, Najman JM. Does maternal smoking during pregnancy have a direct effect on future offspring obesity? Evidence from a prospective birth cohort study. Am J Epidemiol. 2006;164:317–25. doi: 10.1093/aje/kwj209.
    1. Power C, Jefferis BJ. Fetal environment and subsequent obesity: a study of maternal smoking. Int J Epidemiol. 2002;31:413–9. doi: 10.1093/ije/31.2.413.
    1. Toschke AM, Montgomery SM, Pfeiffer U, von Kries R. Early intrauterine exposure to tobaccoinhaled products and obesity. Am J Epidemiol. 2003;158:1068–74. doi: 10.1093/aje/kwg258.
    1. Slotkin TA. Fetal nicotine or cocaine exposure: which one is worse? J Pharmacol Exp Ther. 1998;285:931–45.
    1. Verhulst SL, Nelen V, Hond ED, Kiippen G, Beunckens C, Vael C, et al. Intrauterine exposure to environmental pollutants and body mass index during the first 3 yearsof life. Environ Health Perspect. 2009;117:122–6. doi: 10.1289/ehp.0800003.
    1. Smink A, Ribas-Fito N, Garcia R, Torrent M, Mendez MA, Grimalt JO, et al. Exposure to hexachlorobenzene during pregnancy increases the risk of overweight in children aged 6 years. Acta Paediatr. 2008;97:1465–9. doi: 10.1111/j.1651-2227.2008.00937.x.
    1. Chen A, Pennell M, Klebanoff M, et al. Maternal smoking during pregnancy in relation to child overweight: follow-up to age 8 years. Int J Epidemiol. 2006;35:121–30. doi: 10.1093/ije/dyi218.
    1. Syme C, Abrahamowicz M, Mahboubi A, Leonard GT, Perron M, Richer L, et al. Prenatal exposure to maternal cigarette smoking and accumulation of intra-abdominal fat during adolescence. Obesity. 2009;18(5):1021–5. doi: 10.1038/oby.2009.354.
    1. Buka SL, Goldstein JM, Spartos E, Tsuang MT. The retrospective measurement of prenatal and perinatal events: accuracy of maternal recall. Schizophr Res. 2004;71(2–3):417–26. doi: 10.1016/j.schres.2004.04.004.
    1. Githens PB, Glass CA, Sloan FA, Entman SS. Maternal recall and medical records: an examination of events during pregnancy, childbirth, and early infancy. Birth. 1993;20(3):136–41. doi: 10.1111/j.1523-536X.1993.tb00438.x.
    1. Yawn BP, Suman VJ, Jacobsen SJ. Maternal recall of distant pregnancy events. J Clin Epidemiol. 1998;51:399–405. doi: 10.1016/S0895-4356(97)00304-1.
    1. Villar J, Dorgan J, Menendez R, Bolaños L, Pareja G, Kestler E. Perinatal data reliability in a large teaching obstetric unit. Br J Obstet Gynaecol. 1998;95(9):841–8. doi: 10.1111/j.1471-0528.1988.tb06567.x.
    1. Krassas GE, Kelestimur F, Micic D, Tzotzas T, Konstandinidis T, Bougoulia M, et al. Self-reported prevalence of obesity among 20,329 adults from large territories of Greece, Serbia and Turkey. Hormones (Athens) 2003;2(1):49–54. doi: 10.14310/horm.2002.1182.
    1. Manios Y. Design and descriptive results of the ‘Growth, Exercise and Nutrition Epidemiological Study In preSchoolers’: the GENESIS study. BMC Public Health. 2006;6:32. doi: 10.1186/1471-2458-6-32.
    1. Villanueva EV. The validity of self-reported weight in US adults: a population based cross-sectional study. BMC Public Health. 2001;1:11. doi: 10.1186/1471-2458-1-11.
    1. Manios Y, Grammatikaki E, Kondaki K, Ioannou E, Anastasiadou A, Birbilis M. The effect of maternal obesity on initiation and duration of breast-feeding in Greece: the GENESIS study. Public Health Nutr. 2009;12(04):517–24. doi: 10.1017/S1368980008002838.
    1. Brawarsky P, Stotland NE, Jackson RA, Fuentes-Afflick E, Escobar GJ, Rubashkin N, et al. Pre-pregnancy and pregnancy-related factors and the risk of excessive or inadequate gestational weight gain. Int J Gynaecol Obstet. 2005;91:125–31. doi: 10.1016/j.ijgo.2005.08.008.

Source: PubMed

3
S'abonner