Wen Jiaxing, Lv Axing, Aihemaitijiang Sumiya, Li Hongtian, Zhou Yubo, Liu Jianmeng
Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China.
Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China.
Nutr Rev. 2025 Feb 1;83(2):e106-e115. doi: 10.1093/nutrit/nuae027.
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.
孕期体重增加（GWG）是后代肥胖的一个风险因素，而后代肥胖是心脏代谢疾病的先兆。越来越多的研究调查了GWG与后代心脏代谢风险因素（CRFs）之间的关联，但结果并不一致。
本研究综合了队列研究中的现有数据，以检验GWG对后代CRFs的影响。
检索了四个电子数据库，包括PubMed、Web of Science、Scopus和Embase，检索截至2023年5月。
纳入评估GWG与CRFs（脂肪量[FM]、体脂百分比[BF%]、腰围[WC]、收缩压[SBP]和舒张压、高密度脂蛋白胆固醇[HDL-C]和低密度脂蛋白胆固醇、甘油三酯[TG]、总胆固醇、空腹血糖和空腹胰岛素水平）之间关联的队列研究。提取回归系数、均值或均值差异以及95%置信区间[CIs]或标准差。
荟萃分析纳入了33项队列研究。GWG增加（每增加1千克）与后代FM增加（0.041千克；95%CI，0.016至0.067）、BF%增加（0.145%；95%CI，0.116至0.174）、WC增加（0.154厘米；95%CI，0.036至0.272）、SBP增加（0.040毫米汞柱；95%CI，0.010至0.070）和TG增加（0.004毫摩尔/升；95%CI，0.001至0.007）相关，与HDL-C降低（-0.002毫摩尔/升；95%CI，-0.004至0.000）相关。同样，与适当的GWG相比，过度的GWG与后代更高的FM、BF%、WC和胰岛素相关，而不适当的GWG与更低的BF%、低密度脂蛋白胆固醇、总胆固醇和TG相关。在对后代体重指数或FM进行调整后，大多数关联变得不显著或减弱。
母亲较高的GWG与后代肥胖、SBP、TG和胰岛素增加以及后代HDL-C降低相关，因此有必要控制GWG，并对GWG过高的母亲所生后代进行心脏代谢异常筛查。
PROSPERO注册号CRD42023412098。
