April 25, 2016
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Maternal inflammation in pregnancy associated with childhood adiposity

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Maternal low-grade systemic inflammation, indicated by elevated C-reactive protein level, during the second trimester of pregnancy is associated with a higher risk for childhood overall and central adiposity, according to study findings published in Obesity.

“We observed that a higher maternal [C-reactive protein] level in the second trimester was associated with increased total body fat mass and truncal fat mass in the offspring,” Romy Gaillard, MSc, PhD, a postdoctoral researcher and MD student at Erasmus Medical Center in Rotterdam, Netherlands, and colleagues wrote. “These associations were independent of maternal prepregnancy BMI and not explained by the development of maternal pregnancy complications, including gestational diabetes and gestational hypertensive disorders, or gestational age and weight at birth.”

Gaillard and colleagues analyzed data from 1,116 mother–child pairs participating in Project Viva, an ongoing prospective prebirth cohort study (mean age, 32 years; mean prepregnancy weight, 67.4 kg; mean prepregnancy BMI, 24.6 kg/m²). Researchers measured maternal second-trimester C-reactive protein (CRP) plasma level and mid-childhood (mean age at follow-up, 8 years) fat mass index via DXA, as well as trunk fat mass index, fat-free mass index and early and mid-childhood BMI z score and waist circumference. Main analyses were adjusted for maternal sociodemographic and lifestyle-related characteristics, gestational age, and child’s age and sex.

At mid-childhood, mean total fat mass index for the cohort of children was 4.3 kg/m²; mean fat-free mass index was 13 kg/m²; mean truncal fat mass index was 1.4 kg/m²; mean BMI was 17.1 kg/m²; mean BMI z score was 0.35.

Higher maternal CRP levels were associated with higher mid-childhood fat mass index (adjusted difference, 0.15 kg/m²; 95% CI, 0.01-0.29) and trunk fat mass index (adjusted difference, 0.06 kg/m²; 95% CI, 0-0.12) per standard deviation increment in maternal CRP. No associations were found for fat-free mass index.

In addition, after adjustment for maternal characteristics, higher maternal CRP level was not associated with higher early and mid-childhood BMI z score (adjusted difference, 0.05 [95% CI, -0.03 to 0.13] and 0.07 [95% CI, –0.01 to 0.14], respectively) or waist circumference (adjusted difference, 0.1 cm [95% CI, –0.17 to 0.37] and 0.34 cm [95% CI, –0.25 to 0.94], respectively).

“These differences are relatively small, compared to previously reported effect estimates for associations of maternal prepregnancy BMI with offspring adiposity outcomes,” the researchers wrote. “However, our findings are of importance on a population level and from an etiological perspective, as they provide a potential underlying casual mechanism by which maternal prepregnancy obesity may influence adiposity levels in offspring.” by Regina Schaffer

Disclosure: This research was supported by an NIH grant. The researchers report no relevant financial disclosures.