Dalrymple Kathryn V, Tydeman Florence A S, Taylor Paul D, Flynn Angela C, O'Keeffe Majella, Briley Annette L, Santosh Paramala, Hayes Louise, Robson Stephen C, Nelson Scott M, Sattar Naveed, Whitworth Melissa K, Mills Harriet L, Singh Claire, Seed CStat Paul T, White Sara L, Lawlor Deborah A, Godfrey Keith M, Poston Lucilla
Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Department of Mathematics and Statistics, Faculty of Science, University of Strathclyde, Glasgow, UK.
Pediatr Obes. 2021 Mar;16(3):e12725. doi: 10.1111/ijpo.12725. Epub 2020 Sep 11.
Maternal obesity is associated with offspring cardiometabolic risk. UPBEAT was a randomised controlled trial of an antenatal diet and physical activity intervention in 1555 women with obesity. The intervention was associated with lower gestational weight gain, healthier diet and metabolic profile in pregnancy, and reduced infant adiposity at six months.
We have investigated whether the UPBEAT intervention influenced childhood cardiometabolic outcomes or was associated with sustained improvements in maternal lifestyle 3-years after delivery.
In UPBEAT mother-child dyads at the 3-year follow-up, we assessed childhood blood pressure, resting pulse rate, and adiposity (body mass index, skinfold thicknesses, body fat, waist and arm circumferences) and maternal diet, physical activity, and anthropometry.
514 three-year-old children attended the appointment (49% intervention, 51% standard care). There was no difference in the main outcome of interest, subscapular skinfold thickness, between the trial arms (-0.30 mm, 95% confidence interval: -0.92, 0.31). However, the intervention was associated with a lower resting pulse rate (-5 bpm [-8.41, -1.07]). There was also a non-significant lower odds of overweight/obesity (OR 0.73; 0.50, 1.08). Maternal dietary improvements observed in the UPBEAT trial, including glycaemic load and saturated fat were maintained 3-years postpartum.
This study has demonstrated that an antenatal dietary and physical activity intervention in women with obesity is associated with lower offspring pulse rate and sustained improvement in maternal diet. Whilst larger than previous cohorts, there remains potential for bias from attrition and these findings require validation in future cohorts.
母亲肥胖与后代心血管代谢风险相关。UPBEAT是一项针对1555名肥胖女性的产前饮食和体育活动干预的随机对照试验。该干预与孕期体重增加减少、更健康的饮食和代谢状况以及六个月时婴儿肥胖程度降低有关。
我们调查了UPBEAT干预是否影响儿童心血管代谢结局，或与产后3年母亲生活方式的持续改善有关。
在UPBEAT母婴二元组的3年随访中，我们评估了儿童血压、静息心率和肥胖程度（体重指数、皮褶厚度、体脂、腰围和臂围）以及母亲的饮食、体育活动和人体测量学指标。
514名三岁儿童参加了此次随访（49%为干预组，51%为标准护理组）。在试验组之间，主要关注的结局指标——肩胛下皮褶厚度没有差异（-0.30毫米，95%置信区间：-0.92，0.31）。然而，干预与较低的静息心率相关（-5次/分钟[-8.41，-1.07]）。超重/肥胖的几率也有非显著性降低（比值比0.73；0.50，1.08）。在UPBEAT试验中观察到的母亲饮食改善，包括血糖负荷和饱和脂肪，在产后3年得以维持。
本研究表明，对肥胖女性进行产前饮食和体育活动干预与后代较低的心率以及母亲饮食的持续改善有关。虽然比之前的队列规模更大，但仍存在失访偏倚的可能性，这些发现需要在未来的队列中进行验证。
