Abstract
BackgroundRates of overweight and obesity among women of reproductive age have been steadily increasing worldwide and in Thailand. There is mounting evidence that maternal obesity during pregnancy is associated with an increased risk of obesity and other adverse health outcomes in the offspring, but such data are lacking for Thailand. We examined the associations between maternal body mass index (BMI) and anthropometry (particularly the likelihood of obesity) and cardiometabolic parameters in young adult offspring.MethodsThis was a prospective follow-up study of a birth cohort in Chiang Mai (Thailand). Pregnant women carrying singletons were recruited at their first antenatal visit (< 24 weeks of gestation) and followed until delivery in 1989–1990. Participants were their young adult offspring followed up in 2010. Maternal BMI was recorded at the first antenatal visit. The offspring underwent clinical assessments, including anthropometry, lipid profile, insulin sensitivity (HOMA-IR), blood pressure, and carotid intima-media thickness. The primary outcome of interest was the likelihood of obesity in the offspring.ResultsWe assessed 628 young adults (54% were females) at 20.6 ± 0.5 years of age (range 19.1–22.1 years). The young adult offspring of mothers with overweight/obesity was 14.1 kg (95%CI 9.7, 18.5; p < 0.0001) and 9.4 kg (95% CI 6.1, 12.8; p < 0.0001) heavier than those born to mothers with underweight or normal weight, respectively, and had BMI 3.46 kg/m2 (95%CI 2.26, 4.67; p < 0.0001) and 5.27 kg/m2 (95%CI 3.67, 8.68; p < 0.0001) greater, respectively. For every 1-kg/m2 increase in maternal BMI, the adjusted odds ratio (aOR) of offspring obesity was 25% greater (95%CI 1.10, 1.42; p < 0.001). Thus, the aOR of obesity in offspring of mothers with overweight/obesity was 4.6 times greater (95%CI 1.86, 11.26; p < 0.001) and nearly 17-fold greater (95%CI 1.96, 146.4; p = 0.010) compared to young adults born to mothers with normal weight or underweight, respectively. There were no observed associations between maternal BMI status and offspring metabolism or blood pressure.DiscussionMaternal overweight/obesity early in pregnancy was associated with increased BMI and greater odds of obesity in their young adult offspring in Thailand. These findings highlight the public health importance of fostering healthier lifestyle choices among women of reproductive age.
Highlights
Rates of overweight and obesity among women of reproductive age have been steadily increasing worldwide and in Thailand
Mothers who were underweight early in pregnancy were younger and better educated, and their partners were better educated compared to mothers who were of normal weight or had overweight/obesity (Table 1)
There was a progressive increase in infant birth weight according to maternal body mass index (BMI) status, with babies born to mothers with overweight/obesity being approximately 200 g and 360 g heavier than babies born to mothers who were of normal weight or underweight, respectively (Table 1)
Summary
We examined the associations between maternal body mass index (BMI) and anthropometry ( the likelihood of obesity) and cardiometabolic parameters in young adult offspring. The prevalence of obesity [i.e., body mass index (BMI) ≥30.0 kg/m2] among pregnant women has been gradually increasing, from approximately 10% in the 1990s to 16– 22% in the early 2000s [3, 4], and to as much as 30% in the present decade [1, 5, 6]. While there seems to be no published data looking at the trends in the prevalence of maternal obesity during pregnancy over the last decades in Thailand, these would most likely mirror the trends observed for young adult women in general
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