Growth from birth to 6 months of infants with and without intrauterine preeclampsia exposure

Gow, Megan L.; Roberts, Lynne M.; Henry, Amanda; Davis, Gregory K.; Mangos, George; Pettit, Franziska; Khouri, J.; Došen, Ana; Brown, Mark; Craig, Maria E.

doi:10.1017/s2040174421000167

Cited by 5 publications

(21 citation statements)

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“…This study forms part of the larger P4 study investigating the long term impacts of HDP. The main findings to date have been (a) in mothers, women six months after HP versus NP show more markers of cardiovascular and metabolic disease susceptibility including; higher blood pressure, higher fat mass, more tendency to insulin resistance, and higher rates of micronutrient insufficiency (b) in infants, more infants were born small for gestational age (SGA) after HP, and SGA infants, regardless of hypertensive pregnancy status, were more likely to experience rapid weight gain 0-6 months (rapid catch-up growth being itself associated with future cardiovascular disease) (Brown Mark et al, 2020;Gow et al, 2021;McLennan et al, 2021). One potential mechanism for these observations could be microbiota related.…”

Section: Discussionmentioning

confidence: 99%

The P4 Study: Postpartum Maternal and Infant Faecal Microbiome 6 Months After Hypertensive Versus Normotensive Pregnancy

Susic

Wang

Roberts

et al. 2022

Front. Cell. Infect. Microbiol.

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Objective/HypothesisTo explore potential differences in faecal microbiome between women, and their infants, who had normotensive pregnancies (NP) and those who had a hypertensive pregnancy (HP), either gestational hypertension (GH) or preeclampsia (PE).MethodsThis is a sub study of P4 (Postpartum Physiology, Psychology, and Paediatrics Study) and includes 18 mother-infant pairs: 10 NP and 8 HP (HP as defined by blood pressure > 140/90mmHg; of which 6 had PE, and 2 GH), six months postpartum. The participating mothers collected stool samples from themselves and their infants. 16S rRNA V3-V4 amplicons were used to study the faecal microbiome.ResultsThe sample of women and their infants were mostly primiparous (n =16) with vaginal birth (n = 14). At the time of faecal sampling 8 women were using hormonal contraception, and one HP woman remained on an antihypertensive. All women had blood pressure < 130/80mmHg, and 10 had high BMI (> 30). All infants had started solids, 8 were exclusively breastfed, 1 exclusively formula fed and 9 both. Three infants had been exposed to a course of antibiotics. Six months postpartum, there were no significant differences in alpha or beta diversity between the gut microbiota of HP and NP women (P > 0.05). However, a statistically significant difference was detected in alpha diversity between infants following HP and NP, with lower diversity levels in HP infants (P < 0.05). It was also found that at a genus and species level, the gut microbiota of HP women was enriched with Bifidobacterium and Bifididobacterium sp. and depleted in Barnisiella and Barnesiella intestinihominis when compared to NP women (P < 0.05). Similarly, the gut microbiota of infants born from HP was enriched in Streptococcus infantis and depleted in Sutterella, Sutterella sp., Bacteroides sp. and Clostridium aldenense compared to infants born from NP (P < 0.05).DiscussionWhile our findings are at best preliminary, due to the very small sample size, they do suggest that the presence of hypertension in pregnancy may adversely affect the maternal microbiota post-partum, and that of their infants. Further analysis of postpartum microbiome data from future studies will be important to validate these early findings and provide further evidence about the changes in the microbiota in the offspring of women following hypertensive disorders of pregnancy (HDP), including possible links to the causes of long-term cardiovascular disease, the prevalence of which is increased in women who have experienced HDP.

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Section: Discussionmentioning

confidence: 99%

The P4 Study: Postpartum Maternal and Infant Faecal Microbiome 6 Months After Hypertensive Versus Normotensive Pregnancy

Susic

Wang

Roberts

et al. 2022

Front. Cell. Infect. Microbiol.

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“…found that GH/PE-exposed offspring with IUGR had a significantly lower birth weight but higher infant growth percentage (defined as weight gain from birth to infancy divided by birth weight) at 28 and 42 days postpartum compared to the group without IUGR ( 26 ). The other study found that PE-exposed infants with SGA had significantly greater weight Z score gain compared with PE-exposed infants without SGA from birth to 6 months ( 27 ). And among PE-exposed and non-exposed infants with VLBW, Silveira RC et al.…”

Section: Resultsmentioning

confidence: 95%

“…The study by Gow ML et al. found that at 6 months, the weight, and weight Z score of offspring exposed to PE remained significantly lower compared with the control group, but there was a significant absolute increase in BMI and weight from birth to 6 months ( 27 ). In a study by Jiang W et al., both GH and PE were inversely associated with offspring’s weight and weight-for-age Z score from birth to the age of 36 months, but the associations became nonsignificant after adjusting for birth weight in PE-exposed infants ( 28 ).…”

Section: Resultsmentioning

confidence: 98%

“…Maternal pre-pregnancy BMI, smoking status, parity, gestational diabetes, maternal tobacco usage during pregnancy, and maternal socioeconomic status are strong confounders of the association between maternal GH/PE and childhood obesity ( 30 , 33 ). In the study by Gow ML et al., there was a lower rate for PE mothers to be breastfeeding at discharge and 6 months ( 27 ), indicating potential influence caused by breastfeeding. Especially in the poor area with lower socioeconomic strata, vulnerable infants are less likely to be breastfed than in other more developed areas ( 57 ).…”

Section: Discussionmentioning

confidence: 94%

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Association of gestational hypertension and preeclampsia with offspring adiposity: A systematic review and meta-analysis

et al. 2022

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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.

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“…[8][9][10] There is increasing interest in the associations between transgenerational exposures, including the in utero environment, and growth of offspring. 11,12 Children exposed to hyperglycaemia from maternal type 2 diabetes (T2D) in pregnancy or gestational diabetes mellitus (GDM) are at a significantly higher risk of later T2D and have altered growth patterns. [13][14][15][16][17] These children are more likely to experience obesity and T2D at a younger age.…”

Section: Introductionmentioning

confidence: 99%

Association between hyperglycaemia in pregnancy and growth of offspring in early childhood: The PANDORA study

et al. 2022

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Summary Background Few studies have assessed whether children exposed to in utero hyperglycaemia experience different growth trajectories compared to unexposed children. Objectives To assess association of type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) with early childhood weight, length/height and body mass index (BMI) trajectories, and with timing and magnitude of peak BMI in infancy. Methods PANDORA is a birth cohort recruited from an Australian hyperglycaemia in pregnancy register, and women with normoglycaemia recruited from the community. Offspring growth measures were obtained from health records over a median follow‐up of 3.0 years (interquartile range 1.9–4.0). This analysis included children born to Aboriginal mothers with in utero normoglycaemia (n = 95), GDM (n = 228) or T2D (n = 131). Growth trajectories (weight, length/height and BMI) were estimated using linear mixed models with cubic spline functions of child age. Results After adjustment for maternal factors (age, BMI, parity, smoking, and socioeconomic measures) and child factors (age, gestational age at birth, and sex), children born to mothers with T2D or GDM had lower weight, length/height and BMI trajectories in infancy than children born to mothers with normoglycaemia, but similar weight and BMI by completion of follow‐up. Children exposed to T2D had lower mean peak BMI 17.6 kg/m2 (95% confidence interval [CI] 17.3–18.0) than children exposed to normoglycaemia (18.6 kg/m2 [18.1–18.9]) (p = 0.001). Conclusions Maternal hyperglycaemia was associated with differences in early childhood growth trajectories after adjustment for maternal BMI. Exploration of associations between in utero hyperglycaemia exposure and growth trajectories into later childhood is required.

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Growth from birth to 6 months of infants with and without intrauterine preeclampsia exposure

Cited by 5 publications

References 29 publications

The P4 Study: Postpartum Maternal and Infant Faecal Microbiome 6 Months After Hypertensive Versus Normotensive Pregnancy

The P4 Study: Postpartum Maternal and Infant Faecal Microbiome 6 Months After Hypertensive Versus Normotensive Pregnancy

Association of gestational hypertension and preeclampsia with offspring adiposity: A systematic review and meta-analysis

Association between hyperglycaemia in pregnancy and growth of offspring in early childhood: The PANDORA study

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