Obesity in mothers and metabolic disorders in both mothers and children: possible influences

Aim. To study the relationship between obesity of the mother, the body weight of the newborn and the formation of metabolic disturbances in subsequent periods of life.

Materials and methods. A prospective study was conducted in which 1,000 women of reproductive age and their newborns were included by the random number method. The mean age is 29.5 [25.0; 33.5] years. The examination included the collection of anamnesis, measurement of body height and body weight, blood pressure, waist circumference and body mass index determination. Micro- and macrosomia in term infants was diagnosed with a birth weight less than 15 and more than 97 percentiles (WHO, 2005). The laboratory study included the determination of glucose, cholesterol, triglycerides, high and low density lipoproteins, insulin and C-peptides of basal and stimulated levels, leptin, adiponectin, determination of insulin resistance indices (HOMA-IR) and pancreatic β-cell function (HOMA-β). The statistical analysis of the material was carried out using the Statistica 10 software package, SPSS 13.0. Statistically significant differences were taken into account at a level of p < 0.05.

Results. It was found that when pregnancy occurs, 41.0% of women are overweight or obese. In the study, the pathological mass of the body in the neonatal period was detected in every fourth newborn (24.8%), including microsomia (11.3%) and macrosomia (13.5%). As a result, differences in the body weight of newborns were found, depending on the maternal pregestational BMI. For example, women with obesity of the first degree were more likely to have children with macrosomia in 33.3% of cases than women with normal body weight, whose incidence of children with macrosomia was detected in 12.0% of cases (OR 6.8; 95% CI 2.66–17.56; p < 0.001). In women in the reproductive period, macrosomia at birth was more characteristic for people with a metabolic syndrome, and was associated with hormone-metabolic changes.

Conclusion. Тhe results demonstrate the effect of pre-gestational body weight in women with obesity on the body weight of offspring at birth. Both macrosomia and microsomia at birth can be risk factors for the development of the metabolic syndrome in the long term, which confirms the importance of preventing overweight and obesity in women of childbearing age in the pre-gestational period. 

1. Кардиоваскулярная профилактика. Российские национальные рекомендации «Кардиоваскулярная терапия и профилактика». 2011; 10 (6), прил. 2: 64. [Cardiovascular prevention. Russian national recommendations “Сardiovascular therapy and prevention”. 2011; 10 (6), рril. 2: 64 (in Russ.)].

2. Sassi F., Devaux M., Cecchini M., Rusticelli E. The obesity epidemic: analysis of past and projected future trends in selected OECD countries OECD health working papers. OECD. 2009; 45: 87.

3. Ng M., Fleming T., Robinson M., Thomson B. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014; 384 (9945): 766–781.

4. Global action plan for the prevention and control of NCDs 2013–2020. World Health Organization, 2013: 103.

5. OECD (2014). Health at a Glance: Europe 2014. OECD Publishing. URL: http://dx.doi.org/10.1787/health_ glance_eur-2014-en.

6. Рекомендации по диабету, предиабету и сердечнососудистым заболеваниям EASD/ESC. Российский кардиологический журнал. 2014; 3 (107): 7–61. [Advice on diabetes, pre-diabetes, and cardiovascular disease EASD/ ESC. Rossijskij kardiologicheskij zhurnal. 2014; 3 (107): 7–61 (in Russ.)].

7. Zera C., McGirr S., Oken E. Screening for obesity in reproductive-aged women. Prev. Chronic. Dis. 2011; 8: 125.

8. The IDF consensus worldwide definition of the metabolic syndrome. International Diabetes Federation, 2006: 24.

9. Григорян О.Р., Шереметьева Е.В., Андреева Е.Н. и др. Влияние прибавки массы тела во время беременности на риск развития гестационного сахарного диабета (обзор литературы). Проблемы репродукции. 2010; 4: 72–77. [Grigorjan O.R., Sheremet’eva E.V., Andreeva E.N. et al. The effect of body weight gain during pregnancy on risk of development of gestational diabetes mellitus (review of literature). Problemy reprodukcii. 2010; 4: 72–77 (in Russ.)].

10. Никифоровский Н.К., Покусаева В.Н., Отвагина Н.М. и др. Влияние углеводно-жирового обмена матери на внутриутробный рост плода и формирование патологических отклонений его массы. Российский вестник акушера-гинеколога. 2013; 2: 77–81. [Nikiforovskij N.K., Pokusaeva V.N., Otvagina N.M., Mel’nikova A.B., Vahrushina A.S. et al. Influence of carbohydrate-fat metabolism of the mother on fetal growth and formation of pathological deviations of its mass. Rossijskij vestnik akushera-ginekologa – The Russian Bulletin of the obstetrician-gynecologist. 2013; 2: 77–81 (in Russ.)].

11. Красноперова О.И., Смирнова Е.Н., Мерзлова Н.Б. и др. Роль наследственных, перинатальных и внешнесредовых факторов в формировании ожирения в детском возрасте. Детская больница. 2013; 3: 19–24. [Krasnoperova O.I., Smirnova E.N., Merzlova N.B. et al. The role of hereditary, perinatal and external factors in the formation of obesity in childhood. Detskaja bol’nica. 2013; 3: 19–24 (in Russ.)].

12. Guelinckx I., Devlieger R., Beckers K. et al. Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Obes. Rev. 2008; 9 (2): 140–150.

13. Европейские клинические рекомендации по профилактике сердечно-сосудистых заболеваний (пересмотр 2012 г.). Российский кардиологический журнал. 2012; 4 (96), прил. 2: 84. [European clinical guidelines for the prevention of cardiovascular disease (revised 2012). Rossijskij kardiologicheskij zhurnal. 2012; 4 (96), рril. 2: 84 (in Russ.)].

14. Eriksson J.G., Sandboge S., Salonen M. et al. Maternal weight in pregnancy and offspring body composition in late adulthood: Findings from the Helsinki Birth Cohort Study (HBCS). Ann. Med. 2015; 23: 1–6.

15. Risnes K.R. Vatten L.J., Baker J.L. et al. Birthweight and mortality in adulthood: a systematic review and metaanalysis. Int. J. Epidemiol. 2011; 40 (3): 647–661.

16. Li Y. Weight gain in pregnancy, maternal age and gestational age in relation to fetal macrosomia. Clin. Nutr. Res. 2015; 4 (2): 104–109.

17. Barker D.J., Winter P.D., Osmond C. et al. Weight in infancy and death from ischaemic heart disease. Lancet. 1989; 9 (2): 577–580.

18. Barker D.J., Martyn C.N., Osmond C. et al. Growth in utero and serum cholesterol concentrations in adult life. BMJ. 1993; 307: 1524–1527.

19. Benyshek D.C. The “early life” origins of obesity-related health disorders: new discoveries regarding the intergenerational transmission of developmentally programmed traits in the global cardiometabolic health crisis. Am. J. Phys. Anthropol. 2013; 152 (57): 79–93.

20. Vickers M.H. Developmental programming and transgenerational transmission of obesity. Ann. Nutr. Metab. 2014; 64 (1): 26–34.