Maternal overnutrition elevates offspring’s blood pressure—A systematic review and meta‐analysis

Background Maternal overnutrition during pregnancy predisposes the offspring to cardiometabolic diseases. Objectives This systematic review and meta‐analysis aimed to investigate the association between maternal overnutrition and offspring's blood pressure (BP) and the effect of offspring'...

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Published in:Paediatric and perinatal epidemiology 2022-03, Vol.36 (2), p.276-287
Main Authors: Eitmann, Szimonetta, Mátrai, Péter, Németh, Dávid, Hegyi, Péter, Lukács, Anita, Bérczi, Bálint, Czumbel, László Márk, Kiss, István, Gyöngyi, Zoltán, Varga, Gábor, Balaskó, Márta, Pétervári, Erika
Format: Article
Language:English
Subjects:
Blood pressure
Blood Pressure - physiology
Body mass
Body Mass Index
Body size
Body weight gain
Child
Children
Confidence intervals
developmental programming
Female
Gestational Weight Gain
Humans
Hypertension
Hypertension - epidemiology
Hypertension - etiology
maternal obesity
Meta-analysis
Mothers
Obesity
Offspring
Overnutrition
Pediatric Obesity - epidemiology
Pediatric Obesity - etiology
Pregnancy
Pressure effects
Regression coefficients
Review
Statistical analysis
Systematic review
Systematic Reviews
Weighting methods
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Summary:Background Maternal overnutrition during pregnancy predisposes the offspring to cardiometabolic diseases. Objectives This systematic review and meta‐analysis aimed to investigate the association between maternal overnutrition and offspring's blood pressure (BP) and the effect of offspring's obesity on this association. Data sources PubMed, EMBASE, Clinicaltrials.gov, CENTRAL. Study selection and data extraction Human studies published in English before October 2021 were identified that presented quantitative estimates of association between maternal overnutrition just before or during pregnancy and the offspring's BP. Synthesis Random‐effect model with the DerSimonian and Laird weighting method was used to analyse regression coefficients or mean differences. Results After selection, 17 observational studies (140,517 mother‐offspring pairs) were included. Prepregnancy body mass index (ppBMI) showed positive correlation with BP in offspring (regression coefficient for systolic: 0.38 mmHg per kg/m2, 95% confidence interval (CI) 0.17, 0.58; diastolic: 0.10 mmHg per kg/m2, 95% CI 0.05, 0.14). These indicate 1.9 mmHg increase in systolic and 0.5 mmHg increase in diastolic BP of offspring with every 5 kg/m2 gain in maternal ppBMI. Results on coefficients adjusted for offspring's BMI also showed association (systolic: 0.08 mmHg per kg/m2, 95% CI 0.04, 0.11; diastolic: 0.03 mmHg per kg/m2, 95% CI 0.01, 0.04). Independent from ppBMI, gestational weight gain (GWG) showed positive correlation with systolic BP (systolic BP: 0.05 mmHg per kg, 95% CI 0.01, 0.09), but not after adjustment for offspring's BMI. Mean systolic BP was higher in children of mothers with excessive GWG than in those of mothers with optimal GWG (difference: 0.65 mmHg, 95% CI 0.25, 1.05). Conclusions Independent from offspring's BMI, higher prepregnancy BMI may increase the risk for hypertension in offspring. The positive association between GWG and offspring's systolic BP is indirect via offspring's obesity. Reduction in maternal obesity and treatment of obesity in children of obese mothers are needed to prevent hypertension.
ISSN:0269-5022
1365-3016
1365-3016
DOI:10.1111/ppe.12859