Associations of maternal early-pregnancy dietary glycemic index with childhood general, abdominal and ectopic fat accumulation

BACKGROUND & AIMS: Maternal hyperglycemia during pregnancy is an important risk factor for childhood adiposity. Maternal dietary glycemic index during pregnancy directly influences maternal and fetal glucose concentrations. We examined the associations of maternal early-pregnancy dietary glycemic index with offspring general, abdominal and ectopic fat accumulation among normal weight and overweight or obese pregnant women and their offspring. METHODS: In a population-based cohort study among 2488 Dutch pregnant women and their children, we assessed maternal dietary glycemic index by food frequency questionnaire at median 13.4 (95% range 10.7; 21.1) weeks gestation. Dietary glycemic index was used continuously and categorized into low (≤55), normal (56–69) and high (≥70) glycemic index diet. We measured offspring BMI, total fat mass and android/gynoid fat mass ratio by DXA, and visceral fat mass and liver fat fraction by MRI at 10 years. RESULTS: No associations of maternal early-pregnancy dietary glycemic index with offspring adiposity were present among normal weight women and their children. Among overweight and obese women and their children, 1-Standard Deviation Score (SDS) increase in maternal early-pregnancy dietary glycemic index was associated with higher childhood BMI (0.10 SDS, 95% Confidence Interval (CI) 0.01; 0.19), total fat mass index (0.13 SDS, 95% CI 0.05; 0.22), visceral fat mass index (0.19 SDS, 95% CI 0.07; 0.32) and tended to be associated with a higher android/gynoid fat mass ratio (0.09 SDS, 95% CI −0.01; 0.19) and higher risk of childhood overweight (Odds Ratio (OR) 1.20, 95% CI 0.97; 1.48). Overweight and obese women consuming an early-pregnancy low-glycemic index diet, as compared to an early-pregnancy normal-glycemic index diet, had children with lower BMI, total fat mass index, visceral fat mass index and android/gynoid fat mass ratio at 10 years (p-values<0.05). No women consumed a high-glycemic index diet. No associations were explained by maternal socio-economic, lifestyle and dietary characteristics, birth or childhood characteristics. No associations with liver fat fraction were present. CONCLUSIONS: In overweight or obese women and their children, a higher maternal early-pregnancy dietary glycemic index is associated with childhood general, abdominal and visceral fat accumulation, but not with liver fat. Intervention studies among overweight and obese pregnant women may need to target the dietary glycemic index to prevent childhood adiposity

Maternal early pregnancy dietary glycemic index and load, fetal growth, and the risk of adverse birth outcomes

Purpose: Maternal hyperglycemia is associated with adverse birth outcomes. Maternal dietary glycemic index and load influence postprandial glucose concentrations. We examined the associations of maternal early pregnancy dietary glycemic index and load with fetal growth and risks of adverse birth outcomes. Methods: In a population-based cohort study of 3471 pregnant Dutch women, we assessed dietary glycemic index and load using a food frequency questionnaire at median 13.4 (95% range 10.6; 21.2) weeks gestation. We measured fetal growth in mid- and late-pregnancy by ultrasound and obtained birth outcomes from medical records. Results: Mean maternal early pregnancy dietary glycemic index and load were 57.7 (SD 3.3, 95% range 52.8; 63.5) and 155 (SD 47, 95% range 87; 243), respectively. Maternal early pregnancy dietary glycemic index was not associated with fetal growth parameters. A higher maternal early pregnancy dietary glycemic load was associated with a higher fetal abdominal circumference and estimated fetal weight in late-pregnancy (p values &lt; 0.05), but not with mid-pregnancy or birth growth characteristics. A higher maternal early pregnancy dietary glycemic index was associated with a lower risk of a large-for-gestational-age infant (p value &lt; 0.05). Maternal early pregnancy glycemic index and load were not associated with other adverse birth outcomes. Conclusion: Among pregnant women without an impaired glucose metabolism, a higher early pregnancy dietary glycemic load was associated with higher late-pregnancy fetal abdominal circumference and estimated fetal weight. No consistent associations of maternal dietary glycemic index and load with growth parameters in mid-pregnancy and at birth were present. A higher glycemic index was associated with a lower risk of a large-for-gestational-age infant.</p

Smoking cessation in early-pregnancy, gestational weight gain and subsequent risks of pregnancy complications

OBJECTIVE: Smoking cessation is associated with weight gain. We first examined the associations of smoking cessation in early-pregnancy with gestational weight gain and subsequently evaluated the risks of pregnancy complications among women who quit smoking in early-pregnancy according to their gestational weight gain. METHODS: In a population-based prospective cohort study among 7,389 women, we measured weight in each pregnancy period. Information on smoking and pregnancy complications was obtained from questionnaires and medical records. RESULTS: As compared to continued smoking during pregnancy, smoking cessation in early-pregnancy was not associated with gestational weight gain. Smoking cessation in early-pregnancy was associated with decreased risks of delivering small-for-gestational-age infants (Odds Ratio (OR) 0.52 (95% Confidence Interval (CI) 0.37, 0.75)), but with increased risks of pre-eclampsia (OR 2.07 (95 % CI 1.01, 4.27)) and delivering large-for-gestational-age infants (OR 2.11 (95 % CI 1.45, 3.09)). Among women who quit smoking in early-pregnancy with >12 kg weight gain, the risks of pre-eclampsia and delivering large-for-gestational-age infants were slightly increased. CONCLUSION: As compared to continued smoking during pregnancy, smoking cessation in early-pregnancy is not associated with increased gestational weight gain. Among women who quit smoking in early-pregnancy, higher gestational weight gain does not strongly affect their risks of pregnancy complications

Associations of dietary glycemic index and load during pregnancy with blood pressure, placental hemodynamic parameters and the risk of gestational hypertensive disorders

PURPOSE: The aim of this study was to examine the associations of dietary glycemic index and load with gestational blood pressure, placental hemodynamic parameters and the risk of gestational hypertensive disorders. METHODS: In a population-based cohort among 3378 pregnant Dutch women, dietary glycemic index and load were assessed from food frequency questionnaires at median 13.4 (95% range 9.9–22.9) weeks gestation. Blood pressure was measured in early-, mid- and late-pregnancy. Placental hemodynamic parameters were measured in mid- and late-pregnancy by ultrasound. Data on gestational hypertensive disorders was acquired from medical records. RESULTS: Mean dietary glycemic index (SD) was 58 (3) and mean dietary glycemic load (SD) was 155 (47). Dietary glycemic index was not associated with blood pressure, placental hemodynamic parameters and the risk of gestational hypertensive disorders. Higher dietary glycemic load SDS was associated with a higher diastolic blood pressure in early-pregnancy, remaining after adjustment for socio-demographic and lifestyle factors ((0.98 (95% CI 0.35–1.61) mmHg per SDS increase in glycemic load). No other associations of glycemic load with blood pressure or placental hemodynamic parameters and the risk of gestational hypertensive disorders were present. No significant associations of dietary glycemic index and load quartiles with longitudinal blood pressure patterns from early to late-pregnancy were present. CONCLUSION: Within this low-risk pregnant population, we did not find consistent associations of dietary glycemic index and load with blood pressure, placental hemodynamic parameters and the risk of gestational hypertensive disorders. Further studies need to assess whether the effects on gestational hemodynamic adaptations are more pronounced among high-risk women with an impaired glucose metabolism. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00394-021-02670-5

Maternal Early-Pregnancy Glucose Concentrations and Liver Fat Among School-Age Children

Background and Aims: Gestational diabetes seems to be associated with offspring NAFLD. We hypothesized that maternal glucose concentrations across the full range may have persistent effects on offspring liver fat accumulation. Approach and Results: In a multiethnic, population-based, prospective cohort study among 2,168 women and their offspring, maternal early-pregnancy glucose concentrations were measured at a median of 13.1 weeks’ gestation (95% CI, 9.6-17.2). Liver fat fraction was measured at 10 years by MRI. NAFLD was defined as liver fat fraction ≥5.0%. We performed analyses among all mothers with different ethnic backgrounds and those of European ancestry only. The multiethnic group had a median maternal early-pregnancy glucose concentration of 4.3 mmol/L (interquartile range, 3.9-4.9) and a 2.8% (n = 60) prevalence of NAFLD. The models adjusted for child age and sex only showed that in the multiethnic group, higher maternal early-pregnancy glucose concentrations were associated with higher liver fat accumulation and higher odds of NAFLD, but these associations attenuated into nonsignificance after adjustment for potential confounders. Among mothers of European ancestry only, maternal early-pregnancy glucose concentrations were associated with increased odds of NAFLD (OR, 1.95; 95% CI, 1.32; 2.88, after adjustment for confounders) per 1-mmol/L increase in maternal early-pregnancy glucose concentration. These associations were not explained by maternal prepregnancy and childhood body mass index, visceral fat, and metabolic markers. Conclusions: In this study, maternal early-pregnancy glucose concentrations were only among mothers of European ancestry associated with offspring NAFLD. The associations of higher maternal early-pregnancy glucose concentrations with offspring NAFLD may differ between ethnic groups.</p

Maternal early pregnancy dietary glycemic index and load, fetal growth, and the risk of adverse birth outcomes

Purpose: Maternal hyperglycemia is associated with adverse birth outcomes. Maternal dietary glycemic index and load influence postprandial glucose concentrations. We examined the associations of maternal early pregnancy dietary glycemic index and load with fetal growth and risks of adverse birth outcomes. Methods: In a population-based cohort study of 3471 pregnant Dutch women, we assessed dietary glycemic index and load using a food frequency questionnaire at median 13.4 (95% range 10.6; 21.2) weeks gestation. We measured fetal growth in mid- and late-pregnancy by ultrasound and obtained birth outcomes from medical records. Results: Mean maternal early pregnancy dietary glycemic index and load were 57.7 (SD 3.3, 95% range 52.8; 63.5) and 155 (SD 47, 95% range 87; 243), respectively. Maternal early pregnancy dietary glycemic index was not associated with fetal growth parameters. A higher maternal early pregnancy dietary glycemic load was associated with a higher fetal abdominal circumference and estimated fetal weight in late-pregnancy (p values < 0.05), but not with mid-pregnancy or birth growth characteristics. A higher maternal early pregnancy dietary glycemic index was associated with a lower risk of a large-for-gestational-age infant (p value < 0.05). Maternal early pregnancy glycemic index and load were not associated with other adverse birth outcomes. Conclusion: Among pregnant women without an impaired glucose metabolism, a higher early pregnancy dietary glycemic load was associated with higher late-pregnancy fetal abdominal circumference and estimated fetal weight. No consistent associations of maternal dietary glycemic index and load with growth parameters in mid-pregnancy and at birth were present. A higher glycemic index was associated with a lower risk of a large-for-gestational-age infant

Maternal Glucose Concentrations in Early Pregnancy and Cardiometabolic Risk Factors in Childhood

Objective: This study aimed to examine the associations of maternal early-pregnancy glucose and insulin concentrations with offspring cardiometabolic risk factors and fat distribution. Methods: In a population-based prospective cohort study among 3,737 mothers and their children, random maternal glucose and insulin concentrations were measured at a median gestational age of 13.2 (95% range 10.5-17.1) weeks. Childhood fat, blood pressure, and blood concentrations of lipids, glucose, and insulin at the age of 10 years were measured. Results: Higher maternal early-pregnancy glucose and insulin concentrations were associated with a higher risk of childhood overweight, and higher maternal early-pregnancy insulin concentrations were associated with an increased childhood risk of clustering of cardiometabolic risk factors (all P < 0.05). These associations were explained by maternal prepregnancy BMI. Independent of maternal prepregnancy BMI, one SD score (SDS) higher maternal early-pregnancy glucose and insulin concentrations were associated with higher childhood glucose (0.08 SDS, 95% CI: 0.04-0.11) and insulin concentrations (0.07 SDS, 95% CI: 0.03-0.10), but not with childhood blood pressure, lipids, and fat measures. Conclusions: These results suggest that maternal early-pregnancy random glucose and insulin concentrations are associated with childhood glucose a

Is the association between mothers’ autistic traits and childhood autistic traits moderated by maternal pre-pregnancy body mass index?

Background: Previous studies showed that there is a positive association between mothers’ and children’s autistic traits. We also tested if this association is more pronounced in mothers with a higher pre-pregnancy body mass index (BMI). Method: The study was embedded in two cohorts with information available for 4,659 participants from the Generation R and for 179 participants from the Cambridge Ultrasound Siblings and Parents Project (CUSP) cohort. In both cohorts, maternal autistic traits were assessed using the short form of the Autism Spectrum Quotient, and information about maternal height and weight before pregnancy was obtained by questionnaire. Child autistic traits were assessed with the short form of Social Responsiveness Scale in Generation R (M = 13.5 years) and with the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in the CUSP cohort (M = 1.6 years). Result: Higher maternal autistic traits were associated with higher autistic traits in toddlerhood (CUSP cohort; βadjusted = 0.20, p &lt; 0.01), in early childhood (Generation R; βadjusted = 0.19, p &lt; 0.01), and in early adolescence (Generation R; βadjusted = 0.16, p &lt; 0.01). Furthermore, a higher maternal pre-pregnancy BMI was associated with higher child autistic traits, but only in Generation R (βadjusted = 0.03, p &lt; 0.01). There was no significant moderating effect of maternal pre-pregnancy BMI on the association between autistic traits of mothers and children, neither in Generation R nor in CUSP. In addition, child autistic traits scores were significantly higher in mothers who were underweight and in mothers who were overweight compared to mothers with a healthy weight. Conclusion: We confirm the association between maternal and child autistic traits in toddlerhood, early childhood, and early adolescence. Potential interacting neurobiological processes remain to be confirmed.</p

Is the association between mothers’ autistic traits and childhood autistic traits moderated by maternal pre-pregnancy body mass index?

Background: Previous studies showed that there is a positive association between mothers’ and children’s autistic traits. We also tested if this association is more pronounced in mothers with a higher pre-pregnancy body mass index (BMI). Method: The study was embedded in two cohorts with information available for 4,659 participants from the Generation R and for 179 participants from the Cambridge Ultrasound Siblings and Parents Project (CUSP) cohort. In both cohorts, maternal autistic traits were assessed using the short form of the Autism Spectrum Quotient, and information about maternal height and weight before pregnancy was obtained by questionnaire. Child autistic traits were assessed with the short form of Social Responsiveness Scale in Generation R (M = 13.5 years) and with the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in the CUSP cohort (M = 1.6 years). Result: Higher maternal autistic traits were associated with higher autistic traits in toddlerhood (CUSP cohort; βadjusted = 0.20, p &lt; 0.01), in early childhood (Generation R; βadjusted = 0.19, p &lt; 0.01), and in early adolescence (Generation R; βadjusted = 0.16, p &lt; 0.01). Furthermore, a higher maternal pre-pregnancy BMI was associated with higher child autistic traits, but only in Generation R (βadjusted = 0.03, p &lt; 0.01). There was no significant moderating effect of maternal pre-pregnancy BMI on the association between autistic traits of mothers and children, neither in Generation R nor in CUSP. In addition, child autistic traits scores were significantly higher in mothers who were underweight and in mothers who were overweight compared to mothers with a healthy weight. Conclusion: We confirm the association between maternal and child autistic traits in toddlerhood, early childhood, and early adolescence. Potential interacting neurobiological processes remain to be confirmed.</p

Smoking cessation in early-pregnancy, gestational weight gain and subsequent risks of pregnancy complications

Objective: Smoking cessation is associated with weight gain. We first examined the associations of smoking cessation in early-pregnancy with gestational weight gain and subsequently evaluated the risks of pregnancy complications among women who quit smoking in early-pregnancy according to their gestational weight gain. Methods: In a population-based prospective cohort study among 7,389 women, we measured weight in each pregnancy period. Information on smoking and pregnancy complications was obtained from questionnaires and medical records. Results: As compared to continued smoking during pregnancy, smoking cessation in early-pregnancy was not associated with gestational weight gain. Smoking cessation in early-pregnancy was associated with decreased risks of delivering small-for-gestational-age infants (Odds Ratio (OR) 0.52 (95 % Confidence Interval (CI) 0.37, 0.75)), but with increased risks of pre-eclampsia (OR 2.07 (95 % CI 1.01, 4.27)) and delivering large-for-gestational-age infants (OR 2.11 (95 % CI 1.45, 3.09)). Among women who quit smoking in early-pregnancy with >12 kg weight gain, the risks of pre-eclampsia and delivering large-for-gestational-age infants were slightly increased. Conclusion: As compared to continued smoking during pregnancy, smoking cessation in early-pregnancy is not associated with increased gestational weight gain. Among women who quit smoking in early-pregnancy, higher gestational weight gain does not strongly affect their risks of pregnancy complications