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The fetal origins of disease: a prospective cohort study on the association of preeclampsia and childhood obesity

Published online by Cambridge University Press:  02 March 2021

Catarina R. Palma dos Reis*
Affiliation:
Maternidade Dr. Alfredo da Costa, Lisboa, Portugal NOVA Medical School, Lisboa, Portugal
Fátima Serrano
Affiliation:
Maternidade Dr. Alfredo da Costa, Lisboa, Portugal NOVA Medical School, Lisboa, Portugal
Maria João Fonseca
Affiliation:
EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
Ana Teresa Martins
Affiliation:
Maternidade Dr. Alfredo da Costa, Lisboa, Portugal NOVA Medical School, Lisboa, Portugal
Ana Campos
Affiliation:
Maternidade Dr. Alfredo da Costa, Lisboa, Portugal NOVA Medical School, Lisboa, Portugal
Gearoid M. McMahon
Affiliation:
Division of Nephrology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
Henrique Barros
Affiliation:
EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública. Faculdade de Medicina. Universidade do Porto, Porto, Portugal
*
Address for correspondence: Catarina Rebordão Simões Palma dos Reis, Maternidade Dr. Alfredo da Costa, Lisboa, Portugal. Email: palmareisc@gmail.com

Abstract

Cardiovascular diseases are the main cause of mortality worldwide, and childhood excess weight/obesity are strong correlators of accumulated risk in later life. A relationship between maternal preeclampsia and offspring’s childhood obesity is recognized, but most studies fail to control for strong confounders. Our goal is to analyze the association between preeclampsia and childhood excess weight/obesity, after accounting for important confounders. We recruited 5133 women with singleton pregnancies during admission for delivery. Sixty-seven pregnancies were complicated by preeclampsia. Maternal and children outcomes were assessed at 10 years of age. We analyzed the association between preeclampsia and childhood excess weight/obesity by fitting a linear regression model (using offspring body mass index (BMI) z-score at 10 years of age) and a logistic regression model (using excess weight/obesity status). We then controlled both models for known confounders, namely maternal prepregnancy BMI, parity, and smoking during pregnancy. At 10 years of age, offspring of preeclamptic mothers had a higher BMI z-score and were more likely classified as overweight/obese, but these differences were not statistically significant. After controlling for maternal prepregnancy BMI, parity, and smoking during pregnancy, there was a high magnitude change in the beta coefficient of preeclampsia in the linear (0.175; −0.014) and the logistic regression models (1.48; 1.23) suggesting that the association between preeclampsia and childhood excess weigh/obesity is significantly confounded by these variables. These confounders also showed a significant association with childhood obesity. This finding suggests that in utero exposure to preeclampsia seems to have less impact in childhood obesity than the previously described confounders.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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