Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC29425, USA.
Department of Pediatrics, Medical University of South Carolina, Charleston, SC29425, USA.
J Dev Orig Health Dis. 2021 Feb;12(1):71-78. doi: 10.1017/S2040174420000033. Epub 2020 Feb 20.
The mechanism through which developmental programming of offspring overweight/obesity following in utero exposure to maternal overweight/obesity operates is unknown but may operate through biologic pathways involving offspring anthropometry at birth. Thus, we sought to examine to what extent the association between in utero exposure to maternal overweight/obesity and childhood overweight/obesity is mediated by birth anthropometry. Analyses were conducted on a retrospective cohort with data obtained from one hospital system. A natural effects model framework was used to estimate the natural direct effect and natural indirect effect of birth anthropometry (weight, length, head circumference, ponderal index, and small-for-gestational age [SGA] or large-for-gestational age [LGA]) for the association between pre-pregnancy maternal body mass index (BMI) category (overweight/obese vs normal weight) and offspring overweight/obesity in childhood. Models were adjusted for maternal and child socio-demographics. Three thousand nine hundred and fifty mother-child dyads were included in analyses (1467 [57.8%] of mothers and 913 [34.4%] of children were overweight/obese). Results suggest that a small percentage of the effect of maternal pre-pregnancy BMI overweight/obesity on offspring overweight/obesity operated through offspring anthropometry at birth (weight: 15.5%, length: 5.2%, head circumference: 8.5%, ponderal index: 2.2%, SGA: 2.9%, and LGA: 4.2%). There was a small increase in the percentage mediated when gestational diabetes or hypertensive disorders were added to the models. Our study suggests that some measures of birth anthropometry mediate the association between maternal pre-pregnancy overweight/obesity and offspring overweight/obesity in childhood and that the size of this mediated effect is small.
后代在子宫内暴露于母体超重/肥胖后超重/肥胖的发育编程机制尚不清楚，但可能通过涉及后代出生时人体测量学的生物学途径发挥作用。因此，我们试图研究在多大程度上，子宫内暴露于母体超重/肥胖与儿童超重/肥胖之间的关联受到出生人体测量的影响。分析是在一个从一个医院系统获得数据的回顾性队列中进行的。使用自然效应模型框架来估计出生人体测量（体重、长度、头围、体质量指数和小于胎龄儿[SGA]或大于胎龄儿[LGA]）与妊娠前母体体重指数（BMI）类别（超重/肥胖与正常体重）之间关联的儿童期超重/肥胖的自然直接效应和自然间接效应。模型调整了母婴社会人口统计学特征。在分析中纳入了 3950 对母婴对（1467 名[57.8%]母亲和 913 名[34.4%]儿童超重/肥胖）。结果表明，母体妊娠前 BMI 超重/肥胖对后代超重/肥胖的影响中，只有一小部分是通过出生时的后代人体测量学来发挥作用的（体重：15.5%，长度：5.2%，头围：8.5%，体质量指数：2.2%，SGA：2.9%，LGA：4.2%）。当将妊娠期糖尿病或高血压疾病添加到模型中时，介导的百分比略有增加。我们的研究表明，出生人体测量的某些指标可以介导母体妊娠前超重/肥胖与儿童期超重/肥胖之间的关联，而且这种中介效应的大小很小。
