Parental pre‐pregnancy BMI is a dominant early‐life risk factor influencing BMI of offspring in adulthood.

Rath, Shoshana; Marsh, Julie A.; Newnham, John P.; Zhu, Kun; Atkinson, Helen C.; Mountain, Jenny; Oddy, Wendy H.; Hughes, Ian; Harris, Max; Leong, Gary M.; Cotterill, Andrew; Sly, Peter D.; Pennell, Craig E.; Choong, Catherine S

doi:10.1002/osp4.28

Cited by 36 publications

(42 citation statements)

References 40 publications

(46 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We are unaware of any study that has examined these associations with offspring BMI change at three significant time points, except for a study conducted by Rath et al among European‐descendant population in Western Australia, which found similar findings . However, like ours, previous studies found that parental pre‐pregnancy BMI has a strong influence on offspring BMI later in life , and this risk was substantially greater when both parents were obese .…”

Section: Discussionsupporting

confidence: 69%

Parental pre‐pregnancy obesity and the risk of offspring weight and body mass index change from childhood to adulthood

et al. 2017

View full text Add to dashboard Cite

The purpose of this study was to examine the association of parental pre-pregnancy weight and body mass index (BMI) on offspring weight and BMI change from childhood to adulthood. We analysed BMI data from a subsample of parents (n = 1494) from the Mater-University of Queensland Study of Pregnancy cohort that started in the early 1980s in Brisbane, Australia: data were collected at pre-pregnancy and then also for offspring at 5, 14 and 21-year follow-ups. Multiple regression for continuous outcomes and multinomial regression for categorical outcomes were performed. A total of 14.7% of offspring experienced BMI change from normal at 5 years to overweight or obese (OW/OB) at 14 years, 15.3% of normal at 14 years to OW/OB at 21 years and 22.8% from normal at 5 years to OW/OB at 21 years. Overall, the strength of the association of parental BMI with offspring BMI was stronger as offspring become older. Pre-pregnancy parental BMI differentially impacts offspring OW/OB across the life course. For every unit increase in paternal and maternal BMI z-score, offspring BMI z-score increased, on average, by between 0.15% (kg m ) and 0.24% (kg m ) throughout all three stages of life when both parents were OW/OB; these associations were stronger than with one parent. Parental pre-pregnancy BMI and OW/OB is a strong predictor of offspring weight and BMI change from early life to adulthood.

show abstract

Section: Discussionsupporting

confidence: 69%

Parental pre‐pregnancy obesity and the risk of offspring weight and body mass index change from childhood to adulthood

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The finding that maternal pregnancy weight gain only up to the 18th week was associated with NAFLD in adolescent females suggests a possible vulnerability of the female fetus to excessive gestational weight gain early in pregnancy, particularly the first trimester. The strength of the association of early gestational weight gain with female offspring NAFLD suggests that the intrauterine environment during that period may be critical to metabolic risk, as proposed by other investigators …”

Section: Discussionmentioning

confidence: 66%

“…Higher maternal early‐pregnancy weight gain was associated with an increased metabolic risk in adolescent offspring . In the Raine study, adult offspring obesity was associated more with maternal obesity than paternal obesity . Environmental factors have been suggested to have a dominant effect over genetic influences on sex‐different associations of parent‐child BMI .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Sex differences between parental pregnancy characteristics and nonalcoholic fatty liver disease in adolescents

et al. 2017

View full text Add to dashboard Cite

Nonalcoholic fatty liver disease (NAFLD) is a complex chronic liver disorder. Examination of parental pregnancy-related characteristics may provide insights into the origins of risk of NAFLD in offspring. We examined relationships between parental pregnancy-related characteristics and NAFLD in 1,170 adolescent offspring aged 17 years participating in the Western Australian Pregnancy (Raine) Cohort Study. Fatty liver was diagnosed using liver ultrasound. NAFLD was diagnosed in 15.2% of adolescents at age 17 years. In univariate analysis, maternal factors associated with NAFLD in female offspring were younger maternal age (P 5 0.02), higher maternal prepregnancy BMI (P < 0.001), higher maternal weight gain by 18 weeks' gestation (P < 0.001), and maternal smoking during pregnancy (P 5 0.04). Paternal age or body mass index (BMI) were not associated with NAFLD in female offspring. In contrast, higher paternal BMI (P < 0.001), maternal prepregnancy BMI (P < 0.001), and lower family socioeconomic status (SES) at time of birth (P 5 0.001), but not parental age nor maternal gestational weight gain, were associated with NAFLD in male offspring. Using multivariate logistic regression, factors independently associated with NAFLD after adjusting for obesity in adolescent females included maternal obesity (odds ratio [OR], 3.46; 95% confidence interval [CI], 1.49-8.05; P 5 0.004) and maternal weight gain 6.0 kg by the 18th week of gestation (OR, 1.10; 95% CI, 1.04-1.15; P < 0.001). In adolescent males, family SES at the time of birth (OR, 9.07; 95% CI, 1.54-53.29; P 5 0.02) remained significantly associated with NAFLD after multivariate modeling adjusted for adolescent obesity. Conclusion: Early-life contributors to NAFLD show considerable sexual dimorphism. Maternal obesity and higher early-mid gestational weight gain were associated with NAFLD in female offspring, whereas lower family SES at birth was associated with NAFLD in male offspring independent of adolescent obesity. (HEPATOLOGY 2018;67:108-122). SEE EDITORIAL ON PAGE 7N onalcoholic fatty liver disease (NAFLD) is a common, potentially progressive, complex chronic liver disorder. NAFLD associates with insulin resistance (IR) and features of metabolic syndrome (MetS).(1,2) Obesity is a dominant risk factor for NAFLD, with both subcutaneous and visceral adiposity being associated with NAFLD.(3) Recent data describe considerable risk of liver-related morbidity and mortality with progressive adiposity gains during the life course, from childhood through adulthood. (4)(5)(6)(7)(8)(9)

show abstract

“…It is likely that the developmental programming that leads to adult obesity occurs from early gestation onward. Using data from the Western Australian Pregnancy Cohort (Raine) Study examining parental and early‐life variables to identify risk factors for adulthood overweight and obesity in offspring, parents' pre‐pregnancy BMI was the strongest determinant of adult offspring BMI …”

Section: Wellbeing Of the Childmentioning

confidence: 99%

It is ethical to recommend against assisted reproductive treatment for women with a high body mass index

Robson

Norman

2017

Aust NZ J Obst Gynaeco

View full text Add to dashboard Cite

Ethical judgements in medicine in general, and assisted reproductive technology (ART) in particular, can be difficult to make. This is particularly so outside of a hospital environment where diverse skills and opinions are more difficult to obtain. The four classical principles that guide ethical judgements -respect for autonomy, beneficence, non-maleficence and justice -usually have multiple dimensions. For example, it is possible to argue that discouraging treatment of women with a high body mass index (BMI) from having ART is unethical because it contravenes the principle of justice. It may be argued that women with a high BMI have similar or, in many cases, higher chances of a live birth than women in an older age group. Thus patients in a similar position are not treated in a similar way and therefore denial of treatment is unjust.On the surface this argument seems reasonable, but the reasoning is flawed for two important reasons. First, patients' ages are not reversible -an older patient in a poorer prognosis group cannot become younger -whereas a high BMI is potentially reversible. Second, offering ART to women with a high BMI may contravene the ethical principles of beneficence (balancing the treatment risks against the desired outcome) and nonmaleficence (avoiding harm to the patient, or ensuring harm is not disproportionate) especially when the wellbeing of any child is considered. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists statement C-Gyn2 poses the question, 'Is ovarian stimulation appropriate in women with a BMI greater than 35?' and provides the opinion: It is inappropriate to recommend ovarian stimulation (including in vitro fertilization (IVF)) as part of first line therapy in the female with a BMI >35 unless there are exceptional circumstances. Ovarian stimulation in these circumstances should be deferred until appropriate weight loss by appropriate measures (eg diet, exercise, bariatric surgery, etc.) has occurred. This is expected to improve general health, may restore normal ovulatory function and enhance pregnancy outcome. 1The advice in C-Gyn2 is accompanied by an important caveat: 'This information is intended to provide general advice to practitioners, and should not be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of any patient.' It is indeed obvious that the effect of having a high BMI on the chance of having a live baby is less than that of advancing age. Whereas age is inviolable, with support and patience many women may be assisted to return to a normal weight range. RISKS TO THE WOMAN UNDERGOING ARTImportantly, women with a high BMI face greater risks procedurally and with pregnancy outcomes. 2 Oocyte retrieval procedures are more challenging in women with high BMI and obese patients may have difficult venous access. 3 Anaesthesia or sedation of oocyte retrieval can be more hazardous since response to sedation

show abstract

Parental pre‐pregnancy BMI is a dominant early‐life risk factor influencing BMI of offspring in adulthood.

Cited by 36 publications

References 40 publications

Parental pre‐pregnancy obesity and the risk of offspring weight and body mass index change from childhood to adulthood

Parental pre‐pregnancy obesity and the risk of offspring weight and body mass index change from childhood to adulthood

Sex differences between parental pregnancy characteristics and nonalcoholic fatty liver disease in adolescents

It is ethical to recommend against assisted reproductive treatment for women with a high body mass index

Contact Info

Product

Resources

About