Anthropometrics and Body Composition by Dual Energy X-Ray in Children of Obese Women: A Follow-Up of a Randomized Controlled Trial (the Lifestyle in Pregnancy and Offspring [LiPO] Study)

Abstract

ObjectiveIn obese women, 1) to assess whether lower gestational weight gain (GWG) during pregnancy in the lifestyle intervention group of a randomized controlled trial (RCT) resulted in differences in offspring anthropometrics and body composition, and 2) to compare offspring outcomes to a reference group of children born to women with a normal Body Mass Index (BMI).Research design and methodsThe LiPO (Lifestyle in Pregnancy and Offspring) study was an offspring follow-up of a RCT with 360 obese pregnant women with a lifestyle intervention during pregnancy including dietary advice, coaching and exercise. The trial was completed by 301 women who were eligible for follow-up. In addition, to the children from the RCT, a group of children born to women with a normal BMI were included as a reference group. At 2.8 (range 2.5–3.2) years, anthropometrics were measured in 157 children of the RCT mothers and in 97 reference group children with Body Mass Index (BMI) Z-score as a primary outcome. Body composition was estimated by Dual Energy X-ray (DEXA) in 123 successful scans out of 147 (84%).ResultsNo differences between randomized groups were seen in mean (95% C.I.) BMI Z-score (intervention group 0.06 [−0.17; 0.29] vs. controls −0.18 [−0.43; 0.05]), in the percentage of overweight or obese children (10.9% vs. 6.7%), in other anthropometrics, or in body composition values by DEXA. Outcomes between children from the RCT and the reference group children were not significantly different.ConclusionsThe RCT with lifestyle intervention in obese pregnant women did not result in any detectable effect on offspring anthropometrics or body composition by DEXA at 2.8 years of age. This may reflect the limited difference in GWG between intervention and control groups. Offspring of obese mothers from the RCT were comparable to offspring of mothers with a normal BMI.Trial registrationclinicaltrials.gov NCT00530439, NCT01918319 and NCT01918423. URL: NCT00530439?term = NCT00530439&rank = 1, NCT01918319?term = NCT00530439&rank = 2 and NCT01918423?term = NCT00530439&rank = 3.

Maternal obesity and offspring body composition by indirect methods: a systematic review and meta-analysis

“…Ten studies were conducted in the United States 5,6,29,30,32,33,34,35,36,37 , two in the United Kingdom 28,38 , two in Denmark 32,39 , one in Australia 27 , one in Brazil 31 , and one in Portugal 40 ( Table 1). The number of participants in the cohorts ranged from 78 34 to 3,263 38 .…”

“…Eight studies measured body composition in newborns 5,6,27,29,32,33,37,40 , whilst all other studies measured body composition in childhood (2-11 years of age). The methods for the assessment of body composition included DEXA in eight studies 28,30,32,34,35,36,38,39 , ADP in seven 5,6,27,31,33,37,38 and TOBEC in one 29 (Table 2). …”

“…13 reported fat mass 5,6,29,30,31,32,33,34,35,37,38,39,40 and two FMI 28,31 as the primary outcome. In nine studies 5,28,29,31,32,33,34,35,38 univariate analyses showed a statistically significant positive association between maternal pre-pregnancy BMI and fat mass in offspring.…”

“…pre-pregnancy BMI and body fat mass in children was assessed in 13 studies 5,6,27,29,31,32,33,34,35,36,37,39,40 and a positive association was reported only following univariate analyses in six studies 5,29,31,32,33,34 . Eight studies included in the meta-analysis 5,6,27,29,31,32,33,39 assessed body fat percent and fat mass in infants in the first months of life to six years of age.…”

Association between Prepregnancy Body Mass Index and Gestational Weight Gain with Size, Tempo, and Velocity of Infant Growth: Analysis of the Newborn Epigenetic Study Cohort

“…32 Observational studies that follow children born of mothers who were participants in lifestyle interventions targeting gestational weight gain or gestational diabetes have not found a ''spillover'' effect on childhood obesity or metabolic profile. [32][33][34] Grounding interventions in life course theoretical models and developing solution-focused intervention strategies that cover both prenatal and early postnatal behavioral changes may be needed to advance the evidence base in this area. 1 In short, comprehensive and effective childhood obesity prevention will require targeting factors at different developmental windows in order to meaningful affect the prevalence of obesity in the population.…”