Increasing maternal prepregnancy body mass index is associated with reduced insulin sensitivity and increased blood pressure in their children

ObjectiveWe aimed to assess the effects of maternal prepregnancy body mass index (BMI) on insulin sensitivity, metabolism and blood pressure in the offspring. MethodsWe studied 70 prepubertal children aged 8919years (range 4-11years), born 38-40weeks of gestation and appropriate-for-gestational-age birthweight. Maternal prepregnancy body mass index (MPP BMI) was calculated from self-reported weight. Children's insulin sensitivity was measured using intravenous glucose tolerance tests and Bergman's minimal model. Other clinical assessments included auxology, fasting lipid and hormonal profiles, DXA-derived body composition and 24-h ambulatory blood pressure monitoring. Data were analysed using random effect mixed models, adjusting for important confounders and a random factor to account for sibling clusters. ResultsIncreasing MPP BMI was correlated with increasing BMI standard deviation scores (SDS) (r=030; P=0012) and lower insulin sensitivity in their children (r=-034; P=0004). In multivariate regression models, increasing MPP BMI was associated with lower insulin sensitivity (=-0040; P=0005), with every 1kg/m(2) increase in MPP BMI associated with a 40% decrease in offspring insulin sensitivity. Greater MPP BMI was associated with higher systolic blood pressure in the daytime (=0794; P=0010) and night-time (=0800; P=0017), as well as higher 24-h mean arterial pressure (=0508; P=0025) in the offspring. ConclusionGreater maternal prepregnancy BMI is associated with lower insulin sensitivity and higher blood pressure in their children, effects that were independent of offspring adiposity. Thus, higher maternal BMI prior to pregnancy (even among women of normal BMI) may contribute to increased risk of type 2 diabetes and other metabolic diseases in the subsequent generation.