Consequences of being overweight or obese during pregnancy on diabetes in the offspring: a record linkage study in Aberdeen, Scotland

Marius Lahti-Pulkkinen, Sohinee Bhattacharya, Sarah H. Wild, Robert S Lindsay, Katri Räikkönen, Jane E Norman, Siladitya Bhattacharya, Rebecca M Reynolds (Corresponding Author)

Research output: Contribution to journalArticle

Abstract

AIMS/HYPOTHESIS: Maternal obesity in pregnancy is associated with cardiovascular disease and mortality rate in the offspring. We aimed to determine whether maternal obesity is also associated with increased incidence of type 2 and type 1 diabetes in the offspring, independently of maternal diabetes as a candidate mechanistic pathway.

METHODS: Birth records of 118,201 children from 1950 to 2011 in the Aberdeen Maternity and Neonatal Databank were linked to Scottish Care Information-Diabetes, the national register for diagnosed diabetes in Scotland, to identify incident and prevalent type 1 and type 2 diabetes up to 1 January 2012. Maternal BMI was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on offspring outcomes was tested using time-to-event analysis with Cox proportional hazards regression to compare outcomes in offspring of mothers in underweight, overweight or obese categories of BMI, compared with offspring of women with normal BMI.

RESULTS: Offspring of obese (BMI ≥30 kg/m2) and overweight (BMI 25-29.9 kg/m2) mothers had an increased hazard of type 2 diabetes compared with mothers with normal BMI, after adjustment for gestation when weight was measured, maternal history of diabetes before pregnancy, maternal history of hypertension, age at delivery, parity, socioeconomic status, and sex of the offspring: HR 3.48 (95% CI 2.33, 5.06) and HR 1.39 (1.06, 1.83), respectively.

CONCLUSIONS/INTERPRETATION: Maternal obesity is associated with increased incidence of type 2 diabetes in the offspring. Evidence-based strategies that reduce obesity among women of reproductive age and that might reduce the incidence of diabetes in their offspring are urgently required.

Original languageEnglish
Pages (from-to)1412-1419
Number of pages8
JournalDiabetologia
Volume62
Issue number8
Early online date19 Jun 2019
DOIs
Publication statusPublished - Aug 2019

Fingerprint

Pregnancy in Diabetics
Scotland
Mothers
Obesity
Type 2 Diabetes Mellitus
Type 1 Diabetes Mellitus
Incidence
Birth Certificates
Weights and Measures
Pregnancy
Reproductive History
Thinness
Parity
Social Class
Cardiovascular Diseases

Keywords

  • diabetes
  • obesity
  • offspring
  • pregnancy

Cite this

Consequences of being overweight or obese during pregnancy on diabetes in the offspring : a record linkage study in Aberdeen, Scotland. / Lahti-Pulkkinen, Marius; Bhattacharya, Sohinee; Wild, Sarah H.; Lindsay, Robert S; Räikkönen, Katri; Norman, Jane E; Bhattacharya, Siladitya; Reynolds, Rebecca M (Corresponding Author).

In: Diabetologia, Vol. 62, No. 8, 08.2019, p. 1412-1419.

Research output: Contribution to journalArticle

Lahti-Pulkkinen, Marius ; Bhattacharya, Sohinee ; Wild, Sarah H. ; Lindsay, Robert S ; Räikkönen, Katri ; Norman, Jane E ; Bhattacharya, Siladitya ; Reynolds, Rebecca M. / Consequences of being overweight or obese during pregnancy on diabetes in the offspring : a record linkage study in Aberdeen, Scotland. In: Diabetologia. 2019 ; Vol. 62, No. 8. pp. 1412-1419.
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abstract = "AIMS/HYPOTHESIS: Maternal obesity in pregnancy is associated with cardiovascular disease and mortality rate in the offspring. We aimed to determine whether maternal obesity is also associated with increased incidence of type 2 and type 1 diabetes in the offspring, independently of maternal diabetes as a candidate mechanistic pathway.METHODS: Birth records of 118,201 children from 1950 to 2011 in the Aberdeen Maternity and Neonatal Databank were linked to Scottish Care Information-Diabetes, the national register for diagnosed diabetes in Scotland, to identify incident and prevalent type 1 and type 2 diabetes up to 1 January 2012. Maternal BMI was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on offspring outcomes was tested using time-to-event analysis with Cox proportional hazards regression to compare outcomes in offspring of mothers in underweight, overweight or obese categories of BMI, compared with offspring of women with normal BMI.RESULTS: Offspring of obese (BMI ≥30 kg/m2) and overweight (BMI 25-29.9 kg/m2) mothers had an increased hazard of type 2 diabetes compared with mothers with normal BMI, after adjustment for gestation when weight was measured, maternal history of diabetes before pregnancy, maternal history of hypertension, age at delivery, parity, socioeconomic status, and sex of the offspring: HR 3.48 (95{\%} CI 2.33, 5.06) and HR 1.39 (1.06, 1.83), respectively.CONCLUSIONS/INTERPRETATION: Maternal obesity is associated with increased incidence of type 2 diabetes in the offspring. Evidence-based strategies that reduce obesity among women of reproductive age and that might reduce the incidence of diabetes in their offspring are urgently required.",
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note = "We thank the AMND data management team (University of Aberdeen) and S. Nowell (ISD Scotland) for their help with data extraction and linkage. Some of the data were presented as an abstract at the 10th World Congress on Developmental Origins of Health and Disease in 2017. However, the work is not under consideration for publication with any other journal. Funding This work was supported by Tommy’s Centre for Maternal and Fetal Health and the Medical Research Council (MR/N022556/1). We acknowledge the support of the British Heart Foundation. The study sponsors had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.",
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AU - Lindsay, Robert S

AU - Räikkönen, Katri

AU - Norman, Jane E

AU - Bhattacharya, Siladitya

AU - Reynolds, Rebecca M

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N2 - AIMS/HYPOTHESIS: Maternal obesity in pregnancy is associated with cardiovascular disease and mortality rate in the offspring. We aimed to determine whether maternal obesity is also associated with increased incidence of type 2 and type 1 diabetes in the offspring, independently of maternal diabetes as a candidate mechanistic pathway.METHODS: Birth records of 118,201 children from 1950 to 2011 in the Aberdeen Maternity and Neonatal Databank were linked to Scottish Care Information-Diabetes, the national register for diagnosed diabetes in Scotland, to identify incident and prevalent type 1 and type 2 diabetes up to 1 January 2012. Maternal BMI was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on offspring outcomes was tested using time-to-event analysis with Cox proportional hazards regression to compare outcomes in offspring of mothers in underweight, overweight or obese categories of BMI, compared with offspring of women with normal BMI.RESULTS: Offspring of obese (BMI ≥30 kg/m2) and overweight (BMI 25-29.9 kg/m2) mothers had an increased hazard of type 2 diabetes compared with mothers with normal BMI, after adjustment for gestation when weight was measured, maternal history of diabetes before pregnancy, maternal history of hypertension, age at delivery, parity, socioeconomic status, and sex of the offspring: HR 3.48 (95% CI 2.33, 5.06) and HR 1.39 (1.06, 1.83), respectively.CONCLUSIONS/INTERPRETATION: Maternal obesity is associated with increased incidence of type 2 diabetes in the offspring. Evidence-based strategies that reduce obesity among women of reproductive age and that might reduce the incidence of diabetes in their offspring are urgently required.

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