Associations between prenatal and postnatal factors and child adiposity at 5 years of age in a longitudinal, observational cohort

Authors: MCGEHEE, DIAMOND - University Arkansas For Medical Sciences (UAMS); SIMS, CLARK - University Arkansas For Medical Sciences (UAMS); TURNER, DONALD - Arkansas Children'S Hospital; DIAZ, EVA - University Arkansas For Medical Sciences (UAMS); SOBIK, SRARH R - University Arkansas For Medical Sciences (UAMS); THAKALI, KESHARI - University Arkansas For Medical Sciences (UAMS); KRUKOWSKI, REBECCA - University Of Virginia; SHANKAR, KARTIK - University Of Colorado; WILLAIMS, KEITH - University Arkansas For Medical Sciences (UAMS); BORSEIM, ELISABET - University Arkansas For Medical Sciences (UAMS)

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 4/24/2023
Publication Date: N/A
Citation: N/A

Interpretive Summary:

Technical Abstract: Objectives: While maternal obesity has been linked to increased risk of childhood obesity, other maternal, paternal, or child factors may influence that association. The objective of this study was to identify prenatal and postnatal factors that influence child adiposity at age 5 years. Methods: Participants from a longitudinal cohort (NCT01131117) were invited to participate in a follow-up study visit at age 5 years (n = 102 mother/child dyads of which n=68 had triads data [mother/father/child triads]). Children were assessed at age 5 years. Mothers were assessed either <10 weeks of gestation (early pregnancy) or every 6 weeks during gestation (average gestation). Fathers were assessed during gestation or postpartum (0-24 months). Dietary records during gestation and at 5 years were analyzed using the Nutrition Data System for Research. Anthropometrics, body composition (air displacement plethysmography [maternal: <10 weeks pregnancy, paternal: pregnancy or <24 months postpartum] for parents and, quantitative nuclear magnetic resonance for children [child: 5 years]), dietary records (Nutrition Data System for Research), average gestational physical activity (tri-axial accelerometer), and average gestational resting energy expenditure (indirect calorimetry) measures were obtained using standardized protocols. Fasted blood samples were collected for biochemical analyses. Variable selection was performed with and without paternal variables using best subsets and LASSO regressions Results: Bivariate analyses identified that child adiposity (fat mass, %) at age 5 years is associated with early pregnancy maternal fat mass (%, ß = 0.219, p=0.02), paternal C-reactive protein serum levels (mg/l, ß = 0.512, p<0.01), child male sex (ß = -6.615, p < 0.001 ), child time in sedentary activity (minutes/day, ß = 0.014, p=0.048), child time in vigorous activity (minutes/day, ß = -0.108, p=0.011), fasted child serum leptin (pg/ml, ß = 0.0034, p<0.001) and fasted child serum insulin (pg/ml, ß = 0.023, p=0.034). The best subset selection model identified that Cchild adiposity (fat mass, %) at 5 years was significantly associated with early pregnancy maternal fat mass (%, ß = 0.405, p < 0.001 ), early pregnancy maternal fat-free mass (kg, ß = 0.358, p = 0.032), maternal average gestational resting energy expenditure (kcal/d, ß = -0.014, p = 0.017), maternal average gestational interleukin-6 (pg/ml, ß = -3.33, p = 0.020), nNon-Caucasian race (ß = -3.90, p = 0.009) and male child sex (ß = -7.63, p < 0.001). When paternal variables were included, maternal fat mass (%, ß = 0.281, p = 0.002), Non-Caucasian race (ß = -4.00, p = 0.034), and male sex (ß = -7.91, p < 0.001) were associated with child adiposity at 5 years. No paternal variables were associated with child adiposity at 5 years. Conclusions: Early pregnancy maternal fat and fat-free mass as well as average gestational resting energy expenditure are modifiable factors associated with child fat mass at 5 years of age. Strategies to prevent excessive maternal pre-conception adiposity weight and enhance pre-conception muscle mass prior to conception and to modulate maternal metabolism during gestation may impact the future risk of childhood obesity. Funding Sources: USDA-ARS Project 6026-51000-010-05S