Grandmaternal obesity in early pregnancy and risk of grandoffspring preterm birth: a nationwide three-generation study.

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Eduardo Villamor, Sven Cnattingius
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引用次数: 0

Abstract

Objective: Obesity in pregnancy increases risk of preterm birth (PTB), a leading cause of infant mortality and morbidity. The heritability of obesity suggests associations of grandmaternal obesity with grandoffspring outcomes, but a potential effect on PTB has not been interrogated. We studied whether grandmaternal (F0 generation) body mass index (BMI) in early pregnancy was related to grandoffspring (F2 generation) PTB risk by type, and to maternal (F1 generation) preeclampsia risk.

Methods: Among 315,240 singleton live-born infants from a countrywide three-generation Swedish cohort, we compared risks of spontaneous and medically indicated PTB, defined as gestational age <37 completed gestation weeks, between categories of maternal grandmaternal BMI in early pregnancy. We also interrogated associations of grandmaternal BMI categories with risk of maternal preeclampsia, a major cause of medically indicated PTB. We assessed whether the associations were mediated through consequences of obesity. In a subset, we examined associations with paternal grandmaternal BMI. To address unmeasured confounding by shared familial factors, we assessed the associations of parental full sisters' BMI with PTB.

Results: Maternal grandmaternal obesity (BMI ≥ 30.0) was related to increased risks of grandoffspring medically indicated PTB and maternal preeclampsia, compared with normal BMI. Adjusted hazard and risk ratios (95% confidence intervals) were, respectively, 1.54 (1.28, 1.86) and 1.32 (1.16, 1.49). Maternal sisters' BMI was unrelated to PTB or preeclampsia risks. Maternal obesity or preeclampsia mediated most (85%) of the maternal grandmaternal obesity-grandoffspring medically indicated PTB association, whereas the association with maternal preeclampsia was primarily mediated (61%) through maternal obesity. There were no associations with spontaneous PTB. Paternal grandmaternal obesity was unrelated to grandoffspring's PTB risk.

Conclusion: Medically indicated PTB in grandoffspring is associated with maternal grandmaternal obesity.

孕早期祖母肥胖与孙辈早产风险:一项全国范围的三代研究。
目的:妊娠期肥胖增加早产(PTB)的风险,这是婴儿死亡和发病的主要原因。肥胖的遗传性表明,祖母肥胖与后代的结局有关,但对肺结核的潜在影响尚未被质疑。我们研究了外祖母(F0代)妊娠早期体重指数(BMI)是否与外祖母(F2代)PTB风险分型相关,以及与外祖母(F1代)子痫前期风险相关。方法:在全国范围内的瑞典三代队列中,我们比较了315,240名单胎活产婴儿自发性和医学指征PTB的风险,定义为胎龄。结果:与正常BMI相比,外祖母肥胖(BMI≥30.0)与外祖母患医学指征PTB和母体先兆子痫的风险增加有关。调整后的危险比和风险比(95%置信区间)分别为1.54(1.28,1.86)和1.32(1.16,1.49)。母姐妹的BMI与PTB或子痫前期风险无关。母亲肥胖或先兆子痫介导了大多数(85%)外祖母肥胖与外孙医学指示的PTB关联,而与母亲先兆子痫的关联主要是通过母亲肥胖介导的(61%)。与自发性肺结核无关联。祖父祖母肥胖与孙辈患肺结核的风险无关。结论:医学上指征的外孙肺结核与外祖母肥胖有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Obesity
International Journal of Obesity 医学-内分泌学与代谢
CiteScore
10.00
自引率
2.00%
发文量
221
审稿时长
3 months
期刊介绍: The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders. We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.
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