Context: Maternal obesity and gestational weight gain are linked to offspring adverse metabolic profile, and lifestyle intervention during pregnancy in obese women may have long-term positive effect on their children. Furthermore, although the association between birth weight and later metabolic outcomes is well established, little is known about the predictive value of abdominal circumference at birth. Objectives: To study: i) effects of lifestyle intervention during pregnancy in obese women on offspring metabolic risk factors and ii) predictive values of birth weight (BW) and birth abdominal circumference (BAC). Design: Follow-up of a randomized controlled trial; the Lifestyle in Pregnancy (LiP) study Setting: Odense and Aarhus University Hospitals, Denmark Participants: Offspring of LiP study participants (n=157) and offspring of normal weight mothers (external reference group, ER, n=97) Intervention: Dietary advice, coaching and exercise during pregnancy Main outcome measures: BMI Z-score, abdominal circumference (AC), blood pressure and fasting plasma glucose, insulin, high density lipoprotein (HDL) and triglycerides at the age of 2.8 years Results: No differences were detected in BMI Z-score or metabolic risk factors between LiP intervention and control groups or between LiP and ER groups. BAC and BW were associated (all p<0.05) with: BMI Z-score (0.19; 0.23), AC (0.57; 0.70), plasma glucose (0.11; 0.09), insulin (4.33; 3.13) and triglycerides (0.07; 0.07), but not with blood pressure or HDL (regression coefficients per increase in BAC and BW of 1 standard deviation score, respectively). Conclusions: Early childhood metabolic risk factors were unaffected by lifestyle intervention in obese pregnant women. Offspring of obese mothers who participated in the LiP study were comparable to offspring of normal weight mothers, possibly indicating a general beneficial effect of trial participation. BAC and BW were both associated with later metabolic risk factors.
Journal of Clinical Endocrinology and Metabolism, 2014, Vol 100, Issue 1, p. 175-83