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Maternal BMI, gestational diabetes, and weight gain in relation to childhood obesity: The mediation effect of placental weight.
Obesity (Silver Spring) 2016; 24(4):938-46O

Abstract

OBJECTIVE

High prepregnancy body mass index (BMI), excessive gestational weight gain (GWG), and gestational diabetes mellitus (GDM) are associated with the risk of childhood obesity. This study aims to examine the extent to which these effects may be mediated through the placenta.

METHODS

Data included 33,893 mothers and their singleton infants from birth to 7 years old (total 154,590 visits) in the Collaborative Perinatal Project, a U.S. multicenter prospective cohort study from 1959 to 1976. The placentas were weighed after removing cord and membranes. We performed sequential generalized estimating equation-linear models excluding and including placental weight to evaluate its mediation effect.

RESULTS

In this population, 21.7% of mothers had overweight or obesity, 17.3% had excessive GWG, and 350 (1%) had diagnosed GDM; in addition, 7.2% children had obesity. After adjustment for prepregnancy BMI and other covariates, childhood BMI was 0.23 (95% CI: 0.05, 0.40) kg/m(2) higher for children born to mothers with GDM versus those without GDM. Inclusion of placental weight in the model attenuated the association by 52% to 0.11 (95% CI: -0.06, 0.28) and similarly attenuated the associations with childhood BMI for GWG by 25% and maternal prepregnancy BMI by 17%.

CONCLUSIONS

Placental weight partly mediates the effects of prepregnancy BMI, excessive GWG, and GDM on childhood BMI.

Authors+Show Affiliations

MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. Department of Obstetrics and Gynecology, Sainte-Justine Hospital, University of Montreal, Montreal, Quebec, Canada.MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Department of Pathology, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China. Department of Bio-Bank, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China.MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. Department of Developmental and Behavioral Pediatrics, Shanghai Pediatric Transitional Institution, Shanghai Children's Medical Center Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China.Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26853692

Citation

Ouyang, Fengxiu, et al. "Maternal BMI, Gestational Diabetes, and Weight Gain in Relation to Childhood Obesity: the Mediation Effect of Placental Weight." Obesity (Silver Spring, Md.), vol. 24, no. 4, 2016, pp. 938-46.
Ouyang F, Parker MG, Luo ZC, et al. Maternal BMI, gestational diabetes, and weight gain in relation to childhood obesity: The mediation effect of placental weight. Obesity (Silver Spring). 2016;24(4):938-46.
Ouyang, F., Parker, M. G., Luo, Z. C., Wang, X., Zhang, H. J., Jiang, F., ... Zhang, J. (2016). Maternal BMI, gestational diabetes, and weight gain in relation to childhood obesity: The mediation effect of placental weight. Obesity (Silver Spring, Md.), 24(4), pp. 938-46. doi:10.1002/oby.21416.
Ouyang F, et al. Maternal BMI, Gestational Diabetes, and Weight Gain in Relation to Childhood Obesity: the Mediation Effect of Placental Weight. Obesity (Silver Spring). 2016;24(4):938-46. PubMed PMID: 26853692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal BMI, gestational diabetes, and weight gain in relation to childhood obesity: The mediation effect of placental weight. AU - Ouyang,Fengxiu, AU - Parker,Margaret G, AU - Luo,Zhong-Cheng, AU - Wang,Xia, AU - Zhang,Hui-Juan, AU - Jiang,Fan, AU - Wang,Xiaobin, AU - Gillman,Matthew W, AU - Zhang,Jun, Y1 - 2016/02/08/ PY - 2015/07/18/received PY - 2015/10/11/revised PY - 2015/11/01/accepted PY - 2016/2/9/entrez PY - 2016/2/9/pubmed PY - 2016/12/15/medline SP - 938 EP - 46 JF - Obesity (Silver Spring, Md.) JO - Obesity (Silver Spring) VL - 24 IS - 4 N2 - OBJECTIVE: High prepregnancy body mass index (BMI), excessive gestational weight gain (GWG), and gestational diabetes mellitus (GDM) are associated with the risk of childhood obesity. This study aims to examine the extent to which these effects may be mediated through the placenta. METHODS: Data included 33,893 mothers and their singleton infants from birth to 7 years old (total 154,590 visits) in the Collaborative Perinatal Project, a U.S. multicenter prospective cohort study from 1959 to 1976. The placentas were weighed after removing cord and membranes. We performed sequential generalized estimating equation-linear models excluding and including placental weight to evaluate its mediation effect. RESULTS: In this population, 21.7% of mothers had overweight or obesity, 17.3% had excessive GWG, and 350 (1%) had diagnosed GDM; in addition, 7.2% children had obesity. After adjustment for prepregnancy BMI and other covariates, childhood BMI was 0.23 (95% CI: 0.05, 0.40) kg/m(2) higher for children born to mothers with GDM versus those without GDM. Inclusion of placental weight in the model attenuated the association by 52% to 0.11 (95% CI: -0.06, 0.28) and similarly attenuated the associations with childhood BMI for GWG by 25% and maternal prepregnancy BMI by 17%. CONCLUSIONS: Placental weight partly mediates the effects of prepregnancy BMI, excessive GWG, and GDM on childhood BMI. SN - 1930-739X UR - https://www.unboundmedicine.com/medline/citation/26853692/Maternal_BMI_gestational_diabetes_and_weight_gain_in_relation_to_childhood_obesity:_The_mediation_effect_of_placental_weight_ L2 - https://doi.org/10.1002/oby.21416 DB - PRIME DP - Unbound Medicine ER -