Maternal Overweight, Inflammation and Neurological Consequences for the Preterm Child: Results of the ELGAN Study

Abstract

Maternal overweight and obesity are prenatal risk factors for obstetrical complications, preterm birth, neonatal morbidity as well as cognitive and behavioural developmental disorders in children. Paediatric morbidity and mortality as well as child development disorders are significantly associated with maternal obesity. Particularly in the neurodevelopmental and psychiatric area, it is becoming increasingly clear that, in children of mothers with an increased body mass index (BMI), there is a high correlation with childhood cognitive disabilities, attention disorders, and diseases on the autistic spectrum. The ELGAN (Extremely Low Gestational Age Newborn) study is a multicentre study which has been supported since 2000 by the National Institutes of Health (NIH) and whose objective is to research predictors for neonatal brain damage and neurological-cognitive sequelae in premature infants. The areas of focus are the connection between maternal overweight and obesity and pregnancy complications, APGAR scores and systemic inflammatory markers. In this overview, our aim is to summarise the work in this area and discuss it critically on the basis of current literature. We will examine the hypothesis whether maternal overweight and obesity in terms of a chronic inflammatory state is associated with neonatal inflammation which in turn is associated with an unfavourable development prognosis.

Eating Habits During Pregnancy of Women Giving Birth Very Prematurely: An Exploratory Analysis

“…16 This may probably be modulated by epigenetic mechanisms due to circulating cytokines that are particularly elevated in obese pregnant women. 17,25 Conversely, high consumption of fruit, vegetables, nuts, legumes, low-fat dairy products, whole grains, and a low consumption of sodium, sweetened beverages, and red and processed meats, have been reported to have a potential role in controlling high blood pressure during pregnancy. 26 Under certain circumstances, the Mediterranean diet may have a protective effect against oxidative stress 27 and some authors have reported that a Mediterranean-type diet was associated with a lower risk of preterm delivery 28 while others did not find such an association.…”

Pre-eclampsia Complicated With Maternal Renal Dysfunction Is Associated With Poor Neurological Development at 3 Years Old in Children Born Before 34 Weeks of Gestation

“…Poor neurological development of preterm infants is related to delivery weeks ( 1 , 2 ), fetal growth restriction ( 3 , 4 ), chorioamnionitis, maternal infection ( 5 ), maternal increased body mass index (BMI) ( 6 ), socioeconomic disadvantage ( 7 , 8 ), not receiving breast milk at discharge ( 7 ), neonatal intensive care unit (NICU) noise ( 9 ), longer intensive care unit stay, more complex forms of congenital heart disease ( 8 ), and maternal preeclampsia (PE) ( 10 , 11 ).…”