Offspring Cardiometabolic Risk Factors Research Articles

The association of maternal gestational weight gain with cardiometabolic risk factors in offspring: a systematic review and meta-analysis.

Gestational weight gain (GWG) is known to be a risk factor for offspring obesity, a precursor of cardiometabolic diseases. Accumulating studies have investigated the association of GWG with offspring cardiometabolic risk factors (CRFs), leading to inconsistent results. This study synthesized available data from cohort studies to examine the effects of GWG on offspring CRFs. Four electronic databases, including PubMed, Web of Science, Scopus, and Embase, were searched through May 2023. Cohort studies evaluating the association between GWG and CRFs (fat mass [FM], body fat percentage [BF%], waist circumference [WC], systolic blood pressure [SBP] and diastolic blood pressure, high-density-lipoprotein cholesterol [HDL-C] and low-density-lipoprotein cholesterol, triglyceride [TG], total cholesterol, fasting blood glucose, and fasting insulin levels) were included. Regression coefficients, means or mean differences with 95% confidence intervals [CIs], or standard deviations were extracted. Thirty-three cohort studies were included in the meta-analysis. Higher GWG (per increase of 1 kg) was associated with greater offspring FM (0.041 kg; 95% CI, 0.016 to 0.067), BF% (0.145%; 95% CI, 0.116 to 0.174), WC (0.154 cm; 95% CI, 0.036 to 0.272), SBP (0.040 mmHg; 95% CI, 0.010 to 0.070), and TG (0.004 mmol/L; 95% CI, 0.001 to 0.007), and with lower HDL-C (-0.002 mmol/L; 95% CI, -0.004 to 0.000). Consistently, excessive GWG was associated with higher offspring FM, BF%, WC, and insulin, and inadequate GWG was associated with lower BF%, low-density lipoprotein cholesterol, total cholesterol, and TG, compared with adequate GWG. Most associations went non-significant or attenuated with adjustment for offspring body mass index or FM. Higher maternal GWG is associated with increased offspring adiposity, SBP, TG, and insulin and decreased HDL-C in offspring, warranting a need to control GWG and to screen for cardiometabolic abnormalities of offspring born to mothers with excessive GWG. PROSPERO registration no. CRD42023412098.

Effect of common pregnancy and perinatal complications on offspring metabolic traits across the life course: a multi-cohort study

BackgroundCommon pregnancy and perinatal complications are associated with offspring cardiometabolic risk factors. These complications may influence multiple metabolic traits in the offspring and these associations might differ with offspring age.MethodsWe used data from eight population-based cohort studies to examine and compare associations of pre-eclampsia (PE), gestational hypertension (GH), gestational diabetes (GD), preterm birth (PTB), small (SGA) and large (LGA) for gestational age (vs. appropriate size for gestational age (AGA)) with up to 167 plasma/serum-based nuclear magnetic resonance-derived metabolic traits encompassing lipids, lipoproteins, fatty acids, amino acids, ketones, glycerides/phospholipids, glycolysis, fluid balance, and inflammation. Confounder-adjusted regression models were used to examine associations (adjusted for maternal education, parity age at pregnancy, ethnicity, pre/early pregnancy body mass index and smoking, and offspring sex and age at metabolic trait assessment), and results were combined using meta-analysis by five age categories representing different periods of the offspring life course: neonates (cord blood), infancy (mean ages: 1.1–1.6 years), childhood (4.2–7.5 years); adolescence (12.0–16.0 years), and adulthood (22.0–67.8 years).ResultsOffspring numbers for each age category/analysis varied from 8925 adults (441 PTB) to 1181 infants (135 GD); 48.4% to 60.0% were females. Pregnancy complications (PE, GH, GD) were each associated with up to three metabolic traits in neonates (P≤0.001) with some evidence of persistence to older ages. PTB and SGA were associated with 32 and 12 metabolic traits in neonates respectively, which included an adjusted standardised mean difference of −0.89 standard deviation (SD) units for albumin with PTB (95% CI: −1.10 to −0.69, P=1.3×10−17) and −0.41 SD for total lipids in medium HDL with SGA (95% CI: −0.56 to −0.25, P=2.6×10−7), with some evidence of persistence to older ages. LGA was inversely associated with 19 metabolic traits including lower levels of cholesterol, lipoproteins, fatty acids, and amino acids, with associations emerging in adolescence, (e.g. −0.11 SD total fatty acids, 95% CI: −0.18 to −0.05, P=0.0009), and attenuating with older age across adulthood.ConclusionsThese reassuring findings suggest little evidence of wide-spread and long-term impact of common pregnancy and perinatal complications on offspring metabolic traits, with most associations only observed for newborns rather than older ages, and for perinatal rather than pregnancy complications.

Association between maternal prepregnancy body mass index with offspring cardiometabolic risk factors: analysis of three Brazilian birth cohorts.

Evidence suggests that maternal prepregnancy body mass index (BMI) is associated with offspring cardiometabolic risk factors. This study was aimed at assessing the association of maternal prepregnancy BMI with offspring cardiometabolic risk factors in adolescence and adulthood. We also evaluated whether offspring BMI was a mediator in this association. The study included mother-offspring pairs from three Pelotas birth cohorts. Offspring cardiometabolic risk factors were collected in the last follow-up of each cohort [mean age (in years) 30.2, 22.6, 10.9]. Blood pressure was measured using an automatic device, cholesterol by using an enzymatic colorimetric method, and glucose from fingertip blood, using a portable glucose meter. In a pooled analysis of the cohorts, multiple linear regression was used to control for confounding. Mediation analysis was conducted using G-computation formula. In the adjusted model, mean systolic blood pressure of offspring from overweight and obese mothers was on average 1.25 (95% CI: 0.45; 2.05) and 2.13 (95% CI: 0.66; 3.59) mmHg higher than that of offspring from normal-weight mothers; for diastolic blood pressure, the means were 0.80 (95% CI: 0.26; 1.34) and 2.60 (95% CI: 1.62; 3.59) mmHg higher, respectively. Non-HDL cholesterol was positively associated with maternal BMI, whereas blood glucose was not associated. Mediation analyses showed that offspring BMI explained completely the association of maternal prepregnancy BMI with offspring systolic and diastolic blood pressure, and non-HDL cholesterol. Our findings suggest that maternal prepregnancy BMI is positively associated with offspring blood pressure, and blood lipids, and this association is explained by offspring BMI.

Mendelian randomization study of maternal influences on birthweight and future cardiometabolic risk in the HUNT cohort

There is a robust observational relationship between lower birthweight and higher risk of cardiometabolic disease in later life. The Developmental Origins of Health and Disease (DOHaD) hypothesis posits that adverse environmental factors in utero increase future risk of cardiometabolic disease. Here, we explore if a genetic risk score (GRS) of maternal SNPs associated with offspring birthweight is also associated with offspring cardiometabolic risk factors, after controlling for offspring GRS, in up to 26,057 mother–offspring pairs (and 19,792 father–offspring pairs) from the Nord-Trøndelag Health (HUNT) Study. We find little evidence for a maternal (or paternal) genetic effect of birthweight associated variants on offspring cardiometabolic risk factors after adjusting for offspring GRS. In contrast, offspring GRS is strongly related to many cardiometabolic risk factors, even after conditioning on maternal GRS. Our results suggest that the maternal intrauterine environment, as proxied by maternal SNPs that influence offspring birthweight, is unlikely to be a major determinant of adverse cardiometabolic outcomes in population based samples of individuals.

Association Between Maternal Prepregnancy Body Mass Index and Anthropometric Parameters, Blood Pressure, and Retinal Microvasculature in Children Age 4 to 6 Years

Maternal prepregnancy body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) has previously been associated with offspring cardiometabolic risk factors, such as fat mass, glucose and insulin levels, and blood pressure, but these associations appear to be largely mediated by offspring BMI. To our knowledge, no studies have assessed alterations in the retinal microvasculature in association with maternal prepregnancy BMI. To investigate the association between maternal prepregnancy BMI and anthropometric parameters, blood pressure, and retinal vessel parameters in children age 4 to 6 years. Participants included mother-child pairs of the population-based Environmental Influence on Early Aging (ENVIRONAGE) birth cohort study (Flanders, Belgium) who were recruited at birth from February 2010 to June 2014 and followed-up at age 4 to 6 years between October 2014 and July 2018. Data were analyzed from February 2019 to April 2019. Maternal prepregnancy BMI based on height and weight measurements at the first antenatal visit (weeks 7-9 of gestation). Children's anthropometric, blood pressure, and retinal microcirculation measurements at age 4 to 6 years. Retinal vessel diameters and the tortuosity index, a measure for the curvature of the retinal vasculature, were obtained by fundus image analysis. This study included 240 mothers and children with a mean (SD) age of 29. 9 (4.2) years and 54.8 (4.7) months, respectively. Of these, 114 children (47.5%) were boys. Maternal prepregnancy BMI was positively associated with the child's birth weight, BMI, waist circumference, blood pressure, and retinal vessel tortuosity. A 1-point increase in maternal prepregnancy BMI was associated with a 0.26-mm Hg (95% CI, 0.08-0.44) higher mean arterial pressure for their children, with similar estimates for systolic and diastolic blood pressure. Independent from the association with blood pressure, a 1-point increase in maternal prepregnancy BMI was associated with a 0.40 (95% CI, 0.01-0.80) higher retinal tortuosity index (× 103). The hypothesis that these associations reflect direct intrauterine mechanisms is supported by the following observations: associations were independent of the current child's BMI and the estimates for paternal BMI at the follow-up visit did not reach significance. Considering that blood pressure tracks from childhood into adulthood and microvascular changes may be early markers of cardiometabolic disease development, our results suggest that maternal prepregnancy BMI is an important modifiable risk factor for later-life cardiovascular health of the offspring.

Maternal Glucose Concentrations in Early Pregnancy and Cardiometabolic Risk Factors in Childhood.

ObjectiveThis study aimed to examine the associations of maternal early‐pregnancy glucose and insulin concentrations with offspring cardiometabolic risk factors and fat distribution.MethodsIn a population‐based prospective cohort study among 3,737 mothers and their children, random maternal glucose and insulin concentrations were measured at a median gestational age of 13.2 (95% range 10.5‐17.1) weeks. Childhood fat, blood pressure, and blood concentrations of lipids, glucose, and insulin at the age of 10 years were measured.ResultsHigher maternal early‐pregnancy glucose and insulin concentrations were associated with a higher risk of childhood overweight, and higher maternal early‐pregnancy insulin concentrations were associated with an increased childhood risk of clustering of cardiometabolic risk factors (all P < 0.05). These associations were explained by maternal prepregnancy BMI. Independent of maternal prepregnancy BMI, one SD score (SDS) higher maternal early‐pregnancy glucose and insulin concentrations were associated with higher childhood glucose (0.08 SDS, 95% CI: 0.04‐0.11) and insulin concentrations (0.07 SDS, 95% CI: 0.03‐0.10), but not with childhood blood pressure, lipids, and fat measures.ConclusionsThese results suggest that maternal early‐pregnancy random glucose and insulin concentrations are associated with childhood glucose and insulin concentrations but not with other childhood cardiometabolic risk factors.

Intrauterine metformin exposure and offspring cardiometabolic risk factors (PedMet study): a 5–10 year follow-up of the PregMet randomised controlled trial

Metformin is increasingly used to treat gestational diabetes and type 2 diabetes in pregnancy, and in attempts to improve pregnancy outcomes in polycystic ovary syndrome and obesity. It passes across the placenta with possible long-term consequences for the offspring. We previously explored the effect of metformin, given to women with polycystic ovary syndrome during pregnancy, on children's growth up to 4 years of age. In this 5-10 year follow-up, we examined the cardiometabolic risk factors in these children. This is a follow-up of children from the PregMet study, a double-blind, randomised controlled trial comparing metformin with placebo in polycystic ovary syndrome pregnancies. In the PregMet study, between Feb 4, 2005, and Jan 27, 2009, 257 pregnant women aged 18-45 years with polycystic ovary syndrome according to the Rotterdam criteria were included with 274 singleton pregnancies at 5-12 weeks of gestation at 11 study centres in Norway. 17 women participated twice. Pregnant women were randomised to metformin (2000 mg/day) or placebo from inclusion in the first trimester to birth. Randomisation was stratified according to metformin use at conception. In this follow-up, the primary endpoint was body-mass index (BMI) in the offspring at 5-10 years of age assessed by the standard deviation score (Z score). The primary endpoint was analysed with independent sample t tests. ClinicalTrials.gov number NCT00159536. Of the 255 invited children from the PregMet study, 141 (55%) consented to participate and were included between April 29, 2014, and July 12, 2016. Maternal baseline characteristics in the first trimester were similar between groups. Children in the metformin group had a higher BMI Z score than those in the placebo group (difference in means=0·41, 95% CI 0·03-0·78, p=0·03). The increased BMI in metformin-exposed children might indicate a potential risk of inferior cardiometabolic health. Implications for adult health cannot be excluded. The Research Council of Norway, Novo Nordisk Foundation, St Olavs University Hospital, and the Norwegian University of Science and Technology.

Maternal Vitamin D Status at Week 30 of Gestation and Offspring Cardio-Metabolic Health at 20 Years: A Prospective Cohort Study over Two Decades.

Background/ObjectivesVitamin D deficiency is common among pregnant women and since the fetus relies exclusively on maternal supply, deficiency could potentially interfere with fetal development. Vitamin D blood concentrations during pregnancy have been associated with offspring cardio-metabolic health in a few previous studies but the evidence is still inconsistent and only one previous study has followed the offspring into adulthood. The aim of the present study was to investigate the association between maternal serum concentration of vitamin D (25(OH)D) in week 30 of gestation and offspring cardio-metabolic risk factors at 20 years.Subjects/MethodsA follow up study of a Danish birth cohort from 1988–89 (n = 965) was conducted. A blood sample was drawn from the women in week 30 of gestation. In 2008–2009, 95% of the original mother and child dyads could be identified in the central registration registry and were alive and living in Denmark. The offspring were followed up with self-reported anthropometrics (N = 629, 69%) and a clinical examination (N = 410, 45%). Multiple linear regression was used to estimate the association between maternal 25(OH)D and offspring cardio-metabolic risk factors adjusting for potential confounders.ResultsNo overall association was observed between maternal 25(OH)D in week 30 of gestation and offspring cardio-metabolic risk factors. However, the analyses did suggest a possible inverse association with blood pressure in females.ConclusionsNo clear association between maternal 25(OH)D concentration in week 30 of gestation and cardio-metabolic risk factors in the 20 year old offspring was found.

Association of early life exposure to bisphenol A with obesity and cardiometabolic traits in childhood

BackgroundBisphenol A (BPA) is a chemical used extensively worldwide in the manufacture of plastic polymers. The environmental obesogen hypothesis suggests that early life exposure to endocrine disrupting chemicals such as BPA may increase the risk for wt gain later in childhood but few prospective epidemiological studies have investigated this relationship. ObjectivesWe examined the association of early life BPA exposure with offspring obesity and cardiometabolic risk factors in 500 mother-child pairs from the RHEA pregnancy cohort in Crete, Greece. MethodsBPA concentrations were measured in spot urine samples collected at the 1st trimester of pregnancy) and from children at 2.5 and 4 years of age. We measured birth wt, body mass index (BMI) from 6 months to 4 years of age, waist circumference, skinfold thickness, blood pressure, serum lipids, C-reactive protein, and adipokines at 4 years of age. BMI growth trajectories from birth to 4 years were estimated by mixed effects models with fractional polynomials of age. Adjusted associations were obtained via multivariable regression analyses. ResultsThe prevalence of overweight/obesity was 9% at 2, 13% at 3% and 17% at 4 years of age. Geometric mean BPA concentrations were 1.2μg/g creatinine±7.9 in 1st trimester, 5.1μg/g±13.3 in 2.5 years and 1.9μg/g±4.9 in 4 years. After confounder adjustment, each 10-fold increase in BPA at 4 years was associated with a higher BMI z-score (adj. β=0.2; 95% CI: 0.01, 0.4), waist circumference (adj. β=1.2; 95% CI: 0.1, 2.2) and sum of skinfold thickness (adj. β=3.7mm; 95% CI: 0.7, 6.7) at 4 years. Prenatal BPA was negatively associated with BMI and adiposity measures in girls and positively in boys. We found no associations of early life exposure to BPA with other offspring cardiometabolic risk factors. ConclusionsPrenatal BPA exposure was not consistently associated with offspring growth and adiposity measures but higher early childhood BPA was associated with excess child adiposity.

Early Life Exposure To Bisphenol A In Association With Obesity And Cardiometabolic Traits In Early Childhood

Introduction: Bisphenol A (BPA) is a chemical used extensively worldwide in the manufacture of plastic polymers. The environmental obesogen hypothesis suggests that early life exposure to endocrine disrupting chemicals such as BPA may increase the risk for weight gain later in childhood but few prospective epidemiological studies have investigated this relationship. We examined the association of early life BPA exposure with offspring obesity and cardiometabolic risk factors in 500 mother-child pairs from the RHEA pregnancy cohort in Crete, Greece. Methods: BPA concentrations were measured in spot urine samples collected from mothers (1st trimester of pregnancy) and their children at 2.5 and 4 years of age. We measured birth weight, body mass index (BMI) from 6 months to 4 years of age, waist circumference, skinfold thickness, blood pressure, serum lipids, C-reactive protein, and adipokines at 4 years of age. BMI growth trajectories from birth to 4 years were estimated by linear mixed effects models with fractional polynomials of age. Adjusted associations were obtained via multivariable regression analyses. Results: The prevalence of overweight was 9% at 2, 13% at 3 and 17% at 4 years of age. Geometric mean BPA concentrations were 1.2 μg/g creatinine (SD 7.9) in 1st trimester, 5.1 μg/g (13.3) in 2.5 years and 1.9 μg/g (4.9) in 4 years. After confounder adjustment, each 10-fold increase in BPA at 4 years was associated with a higher BMI z-score (β log10 μg/g= 0.2; 95% CI: -0.01, 0.4), higher waist circumference (β = 1.2 cm; 95% CI: 0.1, 2.2) and greater sum of skinfold thickness (β=3.7 mm; 95% CI: 0.7, 6.7) at 4 years. Prenatal and 2.5 years BPA was not associated with child anthropometry from birth to 4 years. We found no significant associations of early life exposure to BPA with other offspring cardiometabolic risk factors. Discussion: Early childhood BPA exposure was associated with excess child adiposity.

Gestational weight gain in normal weight women and offspring cardio-metabolic risk factors at 20 years of age.

Limited knowledge exists on the long-term implications of maternal gestational weight gain (GWG) on offspring health. Our objective was to examine whether high GWG in normal weight women is associated with adult offspring cardio-metabolic risk factors. We used a cohort of 308 Danish women who gave birth in 1988-89 and whose offspring participated in a clinical examination at 20 years of age. Main outcome measures were offspring body mass index (BMI), waist circumference, weight-regulating hormones, blood lipids and glucose metabolism. Associations were assessed using multivariable linear and logistic regression models. A weak positive association was observed between GWG during the first 30 weeks and offspring anthropometry. Each 1-kg increase in maternal GWG was associated with 0.1-kg m(-2) higher (95% confidence interval (CI): 0.01, 0.2) offspring BMI and 10% (95% CI: 0.1%, 20%) higher odds of offspring overweight at the age of 20 years, with similar associations observed in both sexes. However, sex differences were observed for the association between maternal GWG and specific cardio-metabolic risk factors. Hence, a 1-kg increase in GWG was associated with 3.4% (95% CI; 0.8, 6.0%) higher homeostasis model assessment-estimated insulin resistance (HOMA-IR), 3.7% (95% CI: 1.4%, 6.2%) higher insulin and 10.7% (95% CI: 5.7%, 15.9%) higher leptin levels in male offspring. These associations were not observed in females, which may partly be explained by more frequent reports of dieting and physical exercise at follow-up among female offspring. In normal-weight women, high GWG may have modest long-term implications on offspring cardio-metabolic risk factors at adult age.

Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes. The Generation R Study.

Excessive gestational weight gain seems to be associated with offspring cardio-metabolic risk factors. Little is known about the critical periods of gestational weight gain. We examined the associations of maternal weight gain in different periods of pregnancy with childhood cardio-metabolic risk factors. In a population-based prospective cohort study from early pregnancy onwards among 5908 mothers and their children, we obtained maternal prepregnancy weight and weight in early, mid and late pregnancy. At the age of 6 years (median: 72.6 months; 95% range: 67.9, 95.8), we measured childhood body mass index (BMI), total body and abdominal fat distribution, blood pressure and blood levels of lipids, insulin and c-peptide. Overall, the associations of maternal prepregnancy weight with childhood outcomes were stronger than the associations of maternal gestational weight gain. Independent from maternal prepregnancy weight and weight gain in other periods, higher weight gain in early pregnancy was associated with higher childhood BMI, total fat mass, android/gynoid fat mass ratio, abdominal subcutaneous fat mass and systolic blood pressure (P-values<0.05). Independent associations of maternal weight gain in early pregnancy with childhood abdominal preperitoneal fat mass, insulin and c-peptide were of borderline significance. Higher weight gain in mid pregnancy was independently associated with higher childhood BMI, total and abdominal subcutaneous fat mass and systolic blood pressure (P-values<0.05). The associations for childhood cardio-metabolic outcomes attenuated after adjustment for childhood BMI. Weight gain in late pregnancy was not associated with childhood outcomes. Higher weight gain in early, but not in mid or late pregnancy, was associated with increased risks of childhood overweight and clustering of cardio-metabolic risk factors (odds ratio (OR) 1.19 (95% confidence interval (CI): 1.10, 1.29) and OR 1.20 (95% CI: 1.07, 1.35) per standard deviation increase in early gestational weight gain, respectively). Higher weight gain in early pregnancy is associated with an adverse cardio-metabolic profile in offspring. This association is largely mediated by childhood adiposity.

Parental smoking during pregnancy and offspring cardio-metabolic risk factors at ages 17 and 32

ObjectiveTo examine the association of maternal and/or paternal smoking during pregnancy with offspring cardio-metabolic risk (CMR) factors at adolescence and early adulthood, taking into account socio-demographic, medical and lifestyle characteristics of parents and offspring, as well as offspring common genetic variation. MethodsWe used a population-based cohort of all 17 003 births in Jerusalem during 1974–76, with available archival data on parental and birth characteristics. Measurements at age 17 were assessed at military induction examinations for 11 530 offspring. 1440 offspring from the original 1974–1976 birth cohort were sampled using a stratified sampling approach, and were interviewed and examined at age 32. Parental smoking during pregnancy (i.e. maternal, paternal and any parent) was primarily defined dichotomously (any number of cigarettes smoked daily by mother or father during pregnancy vs. non-smokers). Additionally, smoking was assessed by quantity of cigarettes smoked daily. Linear regression models were used to evaluate the associations of parental smoking during pregnancy with various offspring CMR factors, after controlling for potential confounders and for genetic variation in candidate genes. ResultsPrevalence of exposure to parental smoking in-utero (i.e. smoking of any parent) was 53.2% and 48.4% among the 17 years old and 32 years old samples, respectively. At age 17, smoking of at least one parent during pregnancy was significantly associated with weight (B = 1.39), height (B = 0.59), BMI (B = 0.32) and pulse rate (B = −0.78) (p-values < 0.001). At age 32, parental smoking, adjusted for covariates, was associated with 2.22 kg higher mean offspring weight, 0.95 cm higher mean offspring height, 0.57 kg/m2 higher BMI, and 1.46 cm higher waist-circumference (p-values ≤ 0.02). Similar results, reflecting a dose response, were observed when maternal and paternal smokings were assessed by number of cigarettes smoked daily. ConclusionsThis prospective study demonstrates a potential long-term adverse effect of parental smoking during pregnancy on offspring health and calls for increasing efforts to promote smoking cessation of both parents before pregnancy.

730: Association of parent smoking during pregnancy with offspring cardio-metabolic risk factors at age 17

730: Association of parent smoking during pregnancy with offspring cardio-metabolic risk factors at age 17

729: Deconstructing trends in perinatal ethnic disparities in Hawaii

ethnic disparities in Hawaii Timothy Dye, Hyeong Jun Ahn, John Chen, Marjorie Mau, Donald Hayes, Dena Towner John A. Burns School of Medicine, University of Hawaii, Obstetrics, Gynecology, and Women’s Health, Honolulu, HI, John A. Burns School of Medicine, University of Hawaii, Biostatistics, Honolulu, HI, John A. Burns School of Medicine, University of Hawaii, Native Hawaiian Health, Honolulu, HI, Hawaii State Department of Health, Family Services Division, Honolulu, HI OBJECTIVE: US OMB Directive 15 (OMB15) outlines requirements for reporting race/ethnicity. Oftentimes a range of distinct ethnicities are aggregated (e.g. “Asians”) in OMB15, perhaps masking important differences. These aggregations are particularly significant in Hawaii, a multiracial/multiethnic state significantly impacted by OMB15. This study’s purpose was to examine perinatal risk trends in Hawaii (HI) and among its ethnicities. STUDY DESIGN: Average Annual Percent Change (AAPC) in neonatal mortality rate (NNMR) and low birthweight (LBW) by state/ethnicity from 1969-2009 was computed using National Center for Health Statistics’ data. Birthweight distribution (BWD) reflecting LBW ( 2500 grams) and VLBW ( 1500 grams), and birthweight-specific mortality rate (BWSM) were generated from HI Department of Health (DOH) published data. RESULTS: HI’s NNMR declined 10 percent faster than did the US NNMR during the 1970s-80s (Table). Similarly, HI’s LBW/VLBW rates declined more rapidly than did US rates. In the 1990s, however, HI’s NNMR declined less rapidly than did the US and HI’s VLBW rate increased faster. These patterns worsened in the 2000s. Three concerning trends emerge. First, the Filipino LBW rate remains highest in Hawaii, 3/4ths higher than the white rate (Figure). Secondly, the Japanese NNMR rapidly increased throughout the 2000s, at a rate almost double that of Hawaiians, for instance (Table). Additionally, the Japanese LBW/VLBW rates increased much faster through the 2000s than they did in other ethnicities. Thirdly, the NNMR among Native Hawaiians remained at 50 percent higher than other ethnicities (Figure). This excess Native Hawaiian mortality is associated with higher BWSM (i.e. higher mortality among LBWs) when compared with other ethnic groups, rather than a skewed BWD. CONCLUSION: OMB15 aggregations mask important perinatal differences among Hawaii’s ethnicities. These patterns suggest that a range of strategies may be required to sufficiently address perinatal-related disparities. (NCRR U54RR026136/ NIMHD U54MD007584). 730 Association of parent smoking during pregnancy with offspring cardio-metabolic risk factors at age 17 Uri Dior, Yechiel Friedlander, Liron Kogan, Shani Shulman, Hagit Hochner Hadassah Medical Center and Hebrew University-Hadassah Medical School, Department of Obstetrics and Gynecology, Jerusalem, Israel, Hebrew University School of Public Health, Epidemiology unit, Jerusalem, Israel OBJECTIVE: Accumulating evidence demonstrates an association of maternal smoking during pregnancy with adverse metabolic neonatal outcomes. However, less is known about the influence of maternal or paternal smoking on cardio-metabolic risk factors in adolescence. Hence, we examined the association of maternal and paternal smoking during pregnancy with offspring weight, height, Body Mass Index (BMI), systolic and diastolic blood pressure (BP) at age 17. STUDY DESIGN: We used a population-based cohort of 11,729 births in Western Jerusalem during 1974-76, with available archival data on maternal, paternal and birth characteristics. Measurements at age 17 were assessed at military induction examinations. Linear regression models were used to evaluate the associations of parental smoking during pregnancy with offspring cardio-metabolic outcomes, after controlling for potential confounders. RESULTS: Maternal smoking during pregnancy, independent of paternal smoking and confounders (including socioeconomic status, maternal prepregnancy BMI and gestational weight gain, and offspring gender and birthweight) was positively associated with offspring’s height, weight and BMI at age 17 (all p-values 0.001, Table). For example, mean weight of offspring of smoking mothers was 1.5kg higher than weight of offspring whose mothers did not smoke. Paternal smoking was independently and positively associated with adolescent weight (p 0.001) and BMI (p 0.002) and negatively associated with systolic BP (p 0.02). An analysis examining whether smoking of at least one parent was associated with offspring outcomes yielded similar results. 3-yr combined low birthweight rate, birthweightspecific mortality rate (<2500 gr), and neonatal mortality rate by ethnicity, Hawaii 2007-2009 (Source: HI DoH) Average annual percent change (AAPC %) for selected perinatal outcomes, 1969-2009, USA, Hawaii, and Hawaii’s largest ethnic groups

Circulation : Clinical Summaries

<i>Circulation</i> : Clinical Summaries

Associations of Maternal Prepregnancy Body Mass Index and Gestational Weight Gain With Adult Offspring Cardiometabolic Risk Factors

Background— Accumulating evidence demonstrates that both maternal prepregnancy body mass index (mppBMI) and gestational weight gain (GWG) are associated with adult offspring adiposity. However, whether these maternal attributes are related to other cardiometabolic risk factors in adulthood has not been comprehensively studied. Methods and Results— We used a birth cohort of 1400 young adults born in Jerusalem who had extensive archival data and clinical information at 32 years of age to prospectively examine the associations of mppBMI and GWG with adiposity and related cardiometabolic outcomes. Greater mppBMI, independently of GWG and confounders, was significantly associated with higher offspring BMI, waist circumference, systolic and diastolic blood pressures, insulin, and triglycerides and with lower high-density lipoprotein cholesterol. For example, the effect sizes were translated to nearly 5 kg/m 2 higher mean BMI, 8.4 cm higher waist circumference, 0.13 mmol/L (11.4 mg/dL) higher triglycerides, and 0.10 mmol/L (3.8 mg/dL) lower high-density lipoprotein cholesterol among offspring of mothers within the upper mppBMI quartile (mppBMI &gt;26.4 kg/m 2 ) compared with the lower quartile (mppBMI &lt;21.0 kg/m 2 ). GWG, independently of mppBMI, was positively associated with offspring adiposity; differences of 1.6 kg/m 2 in BMI and 2.4 cm in waist were observed when offspring of mothers in the upper (GWG &gt;14 kg) and lower (GWG &lt;9 kg) quartiles of GWG were compared. Further adjustment for offspring adiposity attenuated the observed associations to the null. Conclusions— Maternal size both before and during pregnancy is associated with cardiometabolic risk factors in young adult offspring. The associations appear to be driven mainly by offspring adiposity. Future studies that explore mechanisms underlying the intergenerational cycle of obesity are warranted to identify potentially novel targets for cardiometabolic risk-reduction interventions.