Weight gain during pregnancy does not influence the bone parameters of offspring in obesity

"Our findings suggest that there is no benefit in gaining excess weight during pregnancy for the child's bone mass, especially in women who start an overweight pregnancy," Maria Teresa Monjardino, MPH, A PhD student from the Noncommunicable Disease Epidemiology Unit of the Faculty of Medicine of the University of Porto, Portugal, confided Endocrine today. "Our findings add skeletal health to the long list of results for mother and child targeted by weight gain guidelines during pregnancy."

Monjardino and her colleagues analyzed prospective data from 2,167 mother-child pairs of the Generation XXI birth cohort, including women from one of five public maternity wards in Porto, Portugal, who gave birth to 2005 to 2006 (46.8% of girls). Initially, women completed the questionnaires and BMI in early pregnancy and weight gain during pregnancy were assessed. In a 7-year follow-up assessment, all children in the cohort underwent full-body DXA testing between December 2012 and August 2013. Mothers were stratified as follows: underweight / normal or overweight / obese at baseline of pregnancy, and the researchers evaluated gestational weight gain as a continuous measure using the guidelines of the American Institute of Medicine (IOM). The researchers used local polynomial regression and smoothing spline models to evaluate the forms of associations between gestational weight gain and bone parameters in offspring, stratified by BMI group in early pregnancy.

At the beginning of pregnancy, 35.8% of mothers were overweight or obese. The mean gestational weight gain in mothers was 13.2 kg and 36.6% of the children were born to women who had gained excessive weight during pregnancy, in accordance with IOM standards, according to the researchers.

Women with a high BMI in early pregnancy were more likely to have children with increased bone mineral content, bone mineral density and bone mineral content corrected for height at age of onset. 7 years old, the researchers wrote.

Compared with women who had adequate gestational weight gain in accordance with IOM guidelines, women in the underweight / underweight weight group had children with BMD with an average of 0.14 deviation. Lower Type (DS) (95% CI, 0.02 to 0.26) and an average size-adjusted bone mineral content 0.19 SD (95% CI, 0.07 to 0) , 3) at the age of 7 years, with persistent results after adjustment for confounding factors.

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According to the researchers, no such relationship has been observed in overweight or obese women with insufficient weight gain.

"Interestingly, for both groups of BMI in early pregnancy, there was no difference in average bone measurements between children born to women with [gestational weight gain] relative to adequate [gestational weight gain], Wrote the researchers.

In sensitivity analyzes limited to participants whose weight information in early pregnancy was collected from the primary source, associations between gestational weight gain and bone properties of offspring persisted, according to the researchers.

"This study supports the inclusion of children's skeletal health in the context of weight counseling during pregnancy," Monjardino said. "Women should be informed that adherence to weight gain recommendations during pregnancy will also help to optimize the health of their child's skeleton."

Monjardino said she was considering whether the results of this study would have a lasting impact on the bone mass of children in their teens and adulthood.

"Hopefully, future generations of researchers will be able to determine whether maternal weight gain during pregnancy will affect the most relevant long-term clinical outcome, namely, the risk of fragility fracture in individuals over older women, "she said. – by Regina Schaffer

For more information:

Maria Teresa Monjardino, MPH, can be contacted at EPIUnit, Institute of Public Health, Universidade do Porto (ISPUP), Institute of Public Health of the University of Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; email: [email protected].

Disclosure: One of the authors of the study indicates that he has received personal expenses from the Alliance for Better Bone Health, Amgen, Eli Lilly, GlaxoSmithKline, Medtronic, Merck, Novartis, Pfizer, Roche, Servier, Takeda and UCB.