Mother’s Pre-Pregnancy Weight May Affect Offspring’s Heart Disease Risk

Adults born to women who were overweight or obese before pregnancy may be more likely to die from cardiovascular disease (CVD) or stroke, according to data presented at the American Heart Association’s Scientific Sessions 2014.

The researchers who conducted the study noted that there are already numerous important reasons to focus on reducing excess adiposity among young adults prior to their childbearing years to improve their own health. A new potential benefit for their children may be an additional reason.

“We conducted this study to further contribute to the growing body of evidence linking maternal pre-pregnancy health and adverse cardiometabolic health outcomes among their offspring. Data on long-term offspring outcomes are lacking. We wanted to show that what has already been demonstrated with elevated early cardiovascular disease risk factors among offspring also extends to associations with increases in heart attacks and death,” said  lead study author Michael Mendelson, MD, a cardiology research fellow at Boston Children’s Hospital.

He said previous studies had shown that people whose mothers were overweight before pregnancy were at higher risk for obesity, diabetes and dyslipidemia. This current study examined whether that translated into higher rates of CVD and death. 

Dr. Mendelson and his colleagues analyzed prospectively collected data on 879 participants (52% female) in the Framingham Heart Study Offspring cohort with information about their mothers’ pre-pregnancy weight status. The age at enrollment was 32 years, and participants were followed from 1971 to 2012.

About 10% of the participants’ mothers had been overweight with a BMI of at least 25 before pregnancy.

Since 1971, there were 193 CV events (coronary heart disease [CHD], stroke and heart failure), 28 CV deaths and 138 total deaths among the offspring.

Results revealed a hazard ratio (HR) of 1.9 (P=.03) for CVD events and all-cause mortality for adults born to mothers who had been overweight vs. those born to mothers who had not been overweight. In addition, this association appears to be partly mediated by the offspring’s own classical CVD risk factors, such as obesity, hypertension, diabetes and dyslipidemia.

“This is not the first study to show the link between maternal pre-pregnancy adiposity and increased cardiovascular events and death. This study benefits from the prospective follow-up and adjudicated cardiovascular disease outcomes that were conducted in the Framingham Heart Study,” Dr. Mendelson told Endocrinology Advisor. 

“We were also able to demonstrate the contribution of the offspring’s cardiovascular disease risk factor in mediating the relationship between maternal weight status and cardiovascular events and mortality.”

Currently, it is estimated that up to 50% of all pregnant women in the United States are either overweight or obese. Dr. Mendelson said for this reason, there is an urgent need for women of childbearing age to be aware of their weight status and the risk to offspring. 

In this study, the participants were all Caucasian. Dr. Mendelson said further studies are warranted to see whether these findings apply to other racial or ethnic groups.

Nieca Goldberg, MD, who is the Director, NYU Center for Women’s Health in New York, said this is the first study linking maternal obesity to CV risk in prospectively collected data. She said the findings should affect clinical practice. 

“It is important for the health care team of internists, endocrinologists, gynecologists and cardiologists to address obesity through lifestyle changes in women of childbearing age. They should point out the benefit to the future mom and her offspring,” Dr. Goldberg told Endocrinology Advisor. 

“Endocrinologists play a key role, as they take care of many of these women, as they are risk for diabetes and prediabetes.”

Reference

1. Mendelson M et al. Abstract 20038. Presented at: American Heart Association’s Scientific Sessions 2014; Nov. 15-19, 2014; Chicago.