August 02, 2019
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Maternal blood pressure mediates association between maternal postpartum weight, infant weight gain

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Higher maternal body weight at 1 month postpartum predicted greater infant weight gain over 6 months among a small cohort of mother-infant pairs, with maternal blood pressure mediating the association, according to findings published in Pediatric Obesity.

Paige K. Berger

Our data demonstrate that mothers inform infant growth and development through multiple means, Paige K. Berger, PhD, RD, a postdoctoral research fellow at the Saban Research Institute of Children’s Hospital Los Angeles and a lecturer at the University of Southern California, told Endocrine Today. “The combination of higher weight status with higher blood pressure has the potential to be a more marked contributor to long-term obesity risk in infants than either condition alone.”

Berger and colleagues analyzed data from 169 Hispanic mother-infant pairs (mean maternal age at delivery, 27 years; mean prepregnancy BMI, 28.1 kg/m²) recruited from maternity clinics affiliated with University of Southern California in 2016, as part of a longitudinal study on early growth and development. Mothers and their infants attended study visits at 1 and 6 months postpartum for assessment of maternal BMI and BP; infant weight was measured to calculate weight-for-age z score. Researchers used linear regression analysis to predict the mediating role of maternal BP at 1 month postpartum on the association between higher maternal weight at 1 month postpartum and greater infant weight gain over 6 months.

At 1 month postpartum, mean maternal BMI was 29.8 kg/m², mean maternal systolic BP was 107 mm Hg and mean diastolic BP was 70 mm Hg; 35.5% of mothers had overweight and 46.2% had obesity, according to researchers.

Gestational diabetes 2019 
Higher maternal body weight at 1 month postpartum predicted greater infant weight gain over 6 months among a small cohort of mother-infant pairs, with maternal blood pressure mediating the association.
Source: Adobe Stock

Researchers found that both maternal BMI and maternal systolic BP predicted infant weight-for-age z score (P .03 for both), with results persisting after controlling for maternal prepregnancy BMI, age, delivery mode, infant sex and infant birth weight. However, the association was no longer significant after adding maternal systolic BP to the model as a control variable, according to researchers.

In mediation analysis, researchers found that maternal systolic BP explained 23.6% of the association between infant weight-for-age z score gain and maternal BMI status.

The researchers noted two potential mechanisms for the association observed in early postpartum. One is that undiagnosed, elevated maternal BP during pregnancy persisted after pregnancy (reflected in 1 month postpartum measurements) and initial exposure impacted infant weight gain. The other is that higher maternal weight status and BP in early postpartum reflect dietary patterns that inform greater infant weight gain via breast milk composition.

“It may be prudent to monitor maternal weight status and blood pressure before, during and immediately after pregnancy if we are to gain insight into the influences of infant growth trajectory and long-term obesity risk,” Berger said. “Future studies should monitor maternal weight status and blood pressure on a continuous scale before, during and immediately after pregnancy. This will glean insight into thresholds of metabolic abnormalities that may inform rate of infant weight gain. This may also be used as a potential tool to screen for infant obesity risk.” – by Regina Schaffer

For more information:

Paige K. Berger, PhD, RD, can be reached at Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027; email: pberger@usc.edu.

Disclosures: The authors report no relevant financial disclosures.