BackgroundThe association of gestational hypertension (GH) and preeclampsia (PE) with offspring adiposity outcomes had controversial results in different studies.ObjectiveWe conducted a systematic review and meta-analysis to evaluate the relationship between maternal GH/PE and offspring adiposity outcomes.Search strategyStudies were identified in PubMed, Embase, and Cochrane databases, with keywords including “gestational hypertension”, “preeclampsia”, “offspring”, “weight”, “cohort study”, etc., without year restriction. This study was registered with PROSPERO, CRD42022292084.Selection criteriaWe set the selection criteria for six aspects: population, outcome, time frame, study design, and availability. For the studies included in the meta-analysis, we required the potential confounders in these studies have been adjusted.Data collection and analysisTwo reviewers independently evaluated the data from the included studies. The meta-analyses included mean differences, regression coefficients, and corresponding 95% confidence intervals. Results were performed using RevMan software (version 5.4; Cochrane Collaboration). Heterogeneity among the included studies was assessed using the I2 statistic.Main resultsA total of 16 studies were included in our review, 15 of which were evaluated as high quality. In all offspring, during the early life (28 days-36 months), GH/PE exposure was found to be not or inversely associated with offspring obesity, then become positively associated at larger ages (3-19 years old). In offspring with adverse birth outcomes, the maternal GH/PE-exposed group had a lower weight in the short term (28 days to 18 months), but there was a trend of rapid weight gain as they grew older, compared with the non-exposed group. The meta-analysis showed that the BMI of the female offspring in the maternal PE-exposed group was significantly higher than that of the non-exposed offspring (MD=1.04, 95% CI: 0.67~1.42, P < 0.05).ConclusionsThe systematic review suggested that maternal exposure to de novo hypertension disorders of pregnancy (HDP) was associated with obesity in offspring, extending from early childhood to adolescence. The meta-analysis showed that PE was associated with higher BMI in female offspring. More studies are needed to conduct stratified analyses by PE/GH, the severity of HDP, or gender.Systematic review registrationPROSPERO, identifier CRD42022292084.
What is already known about this topic? Elevated gestational weight gain (GWG) during pregnancy among women diagnosed with gestational diabetes mellitus (GDM) is correlated with an increased instance of large for gestational age (LGA) and macrosomia. However, it remains uncertain whether managing weekly GWG following a GDM diagnosis positively impacts fetal birth weight. What is added by this report? Our study found that GWG following GDM diagnosis correlates positively with the risk of LGA and macrosomia among all body mass index (BMI) subgroups, especially for overweight and obese women. What are the implications for public health practice? The results of this research highlight the importance of enforcing a more stringent regulation on GWG on a weekly basis for overweight and obese women diagnosed with GDM, particularly when considering neonatal growth.
What is already known about this topic?Joint effects of gestational weight gain (GWG) and hyperglycemia on adverse pregnancy outcomes suggest that lower optimal GWG is optimal for women with gestational diabetes mellitus (GDM). However, there is still a lack of guidelines. What is added by this report?Optimal weekly GWG range after diagnosis of GDM for underweight, normal-weight, overweight, and obese women was 0.37-0.56 kg/week, 0.26-0.48 kg/week, 0.19-0.32 kg/week, and 0.12-0.23 kg/week, respectively. What are the implications for public health practice?The findings may be used to inform prenatal counseling regarding optimal gestational weight gain for women with gestational diabetes mellitus, and suggest the need for weight gain management.
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