Maternal obesity and risk of cardiovascular diseases in offspring: a population-based cohort and sibling-controlled study

医学 后代 超重 危险系数 肥胖 人口 怀孕 体质指数 队列 儿科 比例危险模型 队列研究 产科 内科学 置信区间 环境卫生 生物 遗传学
作者
Neda Razaz,Eduardo Villamor,Giulia M. Muraca,Anna‐Karin Edstedt Bonamy,Sven Cnattingius
出处
期刊:The Lancet Diabetes & Endocrinology [Elsevier BV]
卷期号:8 (7): 572-581 被引量:64
标识
DOI:10.1016/s2213-8587(20)30151-0
摘要

Background Maternal overweight and obesity might increase risks of adiposity and cardiovascular and metabolic diseases in offspring. We examined associations between maternal overweight and obesity severity and risk of cardiovascular diseases in young offspring. Methods In this population-based cohort study, we used data from live singleton births recorded in the Swedish Medical Birth Register. We calculated maternal BMI in early pregnancy from self-reported height and weight measurements at the first prenatal visit. We used multivariable Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% CIs. We calculated the proportion of the associations mediated through known consequences of obesity that also predicted cardiovascular diseases and did family case-control analyses. Findings We identified 2 230 115 live singleton infants (without congenital malformations) in Sweden registered between Jan 1, 1992, and Dec 31, 2016. Overall, 1741 (0·08%) offspring were diagnosed with a cardiovascular disease between ages 1 and 25 years. Cardiovascular disease rates by maternal BMI categories were 0·57 per 10 000 child-years (BMI 18·5–24·9 kg/m2; normal weight), 0·61 per 10 000 child-years (25·0–29·9 kg/m2; overweight), 0·67 per 10 000 child-years (30·0–34·9 kg/m2; obesity grade I), 1·02 per 10 000 child-years (35·0–39·9 kg/m2; obesity grade II), and 1·38 per 10 000 child-years (≥40·0 kg/m2; obesity grade III). Compared with offspring of mothers with normal BMI, HRs of cardiovascular diseases were 1·10 (95% CI 0·97–1·25) for overweight, 1·16 (0·95–1·43) for obesity grade I, 1·84 (1·36–2·49) for obesity grade II, and 2·51 (1·60–3·92) for obesity grade III. Risks of cerebrovascular diseases increased with maternal obesity severity and were partly mediated through asphyxia-related neonatal complications. The sibling-cohort analysis also indicated a positive trend between maternal BMI and cardiovascular disease rates. Interpretations Our findings indicate that maternal obesity might be a risk factor for cardiovascular diseases in childhood and early adulthood. These results need to be replicated and possible underlying mechanisms identified. Funding Swedish Research Council for Health, Working Life and Welfare.
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