Barts and the London School of Medicine and Dentistry, London, United Kingdom.
Imperial College School of Medicine, Imperial College London, United Kingdom.
Front Endocrinol (Lausanne). 2022 May 20;13:868441. doi: 10.3389/fendo.2022.868441. eCollection 2022.
Obesity and cardiovascular disease are major global public health problems. Maternal obesity has been linked to multiple adverse health consequences for both mother and baby. Obesity during pregnancy may adversely alter the intrauterine environment, which has been hypothesised to predispose the offspring to poorer cardiovascular health throughout life. In this paper, we systematically review current literature examining the links between maternal obesity and offspring cardiovascular health.
This study is registered with PROSPERO (CRD42021278567) and was conducted in accordance with the PRISMA guidelines. A comprehensive systematic literature search was conducted, including two electronic databases (Ovid Medline, Embase), cross-referencing, author searching, and grey literature searches. We selected studies exploring the relationship between maternal obesity and offspring cardiovascular health, using pre-defined eligibility criteria. Studies were critically appraised using the ROBINS-I tool.
From 1,214 results, 27 articles met the eligibility criteria. Multiple cardiovascular outcomes were considered, including congenital heart disease, cardiometabolic parameters, and cardiovascular diseases in neonates, children, and adults. In these studies, maternal obesity was consistently associated with congenital heart disease, several adverse cardiometabolic parameters throughout life including higher body mass index and insulin levels, and greater risk of cardiovascular disease in adulthood. Hypothesized underlying mechanisms are complex and multifactorial comprising genetic, environmental, and socioeconomic components, which can be difficult to quantify. Heterogeneity in study designs, highly selected study samples, and high risk of bias in some studies limit conclusions regarding causality.
We identified consistent evidence of links between maternal obesity and poorer offspring cardiovascular health throughout the lifecourse, extending from the neonatal period into adulthood. Although underlying mechanisms are unclear, our findings support consideration of targeted maternal obesity prevention for promotion of offspring cardiovascular health. This all-encompassing systematic review provides critical appraisal of the latest evidence, defines gaps and biases of existing literature, and may inform potential new public health strategies for cardiovascular disease prevention.
[https://www.crd.york.ac.uk/prospero], identifier PROSPERO (CRD42021278567).
肥胖和心血管疾病是全球主要的公共卫生问题。母体肥胖与母婴双方的多种不良健康后果有关。孕期肥胖可能会对宫内环境产生不利影响，这种影响被认为会使后代在整个生命周期中更容易出现心血管健康状况不佳的情况。本文系统地回顾了目前关于母体肥胖与后代心血管健康之间关系的文献。
本研究已在 PROSPERO（CRD42021278567）上注册，并按照 PRISMA 指南进行。我们进行了全面的系统文献检索，包括两个电子数据库（Ovid Medline、Embase）、交叉参考、作者搜索和灰色文献搜索。我们选择了探讨母体肥胖与后代心血管健康之间关系的研究，使用了预先确定的纳入标准。使用 ROBINS-I 工具对研究进行了批判性评价。
从 1214 项结果中，有 27 篇文章符合纳入标准。考虑了多种心血管结局，包括先天性心脏病、心脏代谢参数以及新生儿、儿童和成人的心血管疾病。在这些研究中，母体肥胖与先天性心脏病、整个生命周期中多种不良心脏代谢参数（包括更高的体重指数和胰岛素水平）以及成年后患心血管疾病的风险增加均有关联。潜在的机制很复杂，涉及遗传、环境和社会经济等多个因素，难以量化。研究设计的异质性、高度选择性的研究样本以及一些研究中的高偏倚风险限制了对因果关系的结论。
我们发现了一致的证据表明，母体肥胖与整个生命过程中后代心血管健康状况较差有关，这种关联从新生儿期延伸到成年期。虽然潜在机制尚不清楚，但我们的研究结果支持考虑针对母体肥胖的预防措施，以促进后代的心血管健康。这项全面的系统综述对最新证据进行了批判性评价，确定了现有文献的差距和偏倚，并可能为预防心血管疾病的新公共卫生策略提供信息。
[https://www.crd.york.ac.uk/prospero]，标识符 PROSPERO（CRD42021278567）。
