Obesity and associated health risks - outcomes of maternal early pregnancy obesity and child's cognition
Year: 2019
Type: dissertation
Study design: Observational Study
Abstract: Alarming rates of the world’s adult population is meeting the criteria for obesity. Moreover, increasing amount of women at reproductive age are entering pregnancy with obesity. Growing evidence suggests that excessive maternal weight during pregnancy does not only pose a risk for poorer maternal physical and mental health but is also resulting in adverse outcomes in offspring. One of the proposed mechanisms linking maternal obesity with offspring health outcomes include the early life programming of hypothalamic-pituitary-adrenocortical (HPA) axis. Moreover, poorer childhood cognitive functioning is suggested as a risk factor for later life obesity and lower rates of physical activity. The aim of this thesis was to examine the associations of maternal early pregnancy body mass index (BMI) with health related outcomes of mother and offspring and the effects of childhood cognitive ability on adulthood obesity and obesity-promoting health behaviours. The participants came from two study cohorts. The Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study is a prospective study consisting of 4777 Finnish women who gave a birth between 2006 and 2010. Of the 4745 women with data on early pregnancy BMI derived from the Finnish Medical Birth Register, 3234 completed the Centre for Epidemiological Studies for Depression scale biweekly during pregnancy and at an average of 2.4 weeks and/or 28.2 weeks after pregnancy (Study I). The Arvo Ylppö Longitudinal Study originally consisted of 2193 participants born between 1985-1986. Of these neonates, 1583 provided valid data on at least one of the four tests for cognitive ability at a mean age of 56 months. Between 2009-2012, 1136 individuals participated in the follow-up that included clinical and psychological examination at a mean age of 25 years. Of these 1136, 848 took part in salivary cortisol sampling, 988 went through clinical examination including a measurement of body composition with estimates of body fat percentage and 676 provided data on objectively measured physical activity. This resulted in 635 participants with data on maternal early pregnancy BMI and data on salivary cortisol (Study II), 816 participants with data on childhood cognitive abilities and body composition (Study III) and 500 participants with data on childhood cognitive abilities and data on objectively measured physical activity (Study IV). The results showed that maternal early pregnancy overweight and obesity were associated with consistently higher levels of depressive symptoms throughout and after pregnancy (Study II). Furthermore, offspring born to mothers with higher early pregnancy BMI had lower diurnal salivary cortisol levels and lower morning cortisol levels in adulthood (Study II). The results showed that only lower visuomotor integration was associated with higher BF% in young adulthood (Study III) whereas higher general intelligence in childhood was associated with lower overall daily physical activity, less time spent in light physical activity and higher sedentary time in young adulthood (Study IV). The results provide evidence for the adverse effects of maternal early pregnancy overweight and obesity on maternal mental health during and after pregnancy and suggests that higher maternal early pregnancy BMI may have programming effects on the offspring HPA-axis activity extending into adulthood. Furthermore, the results challenge the view that lower childhood cognitive functioning poses a risk for adiposity and less physically active lifestyle in adulthood.
Source: Työväentutkimus Vuosikirja
Author: Satu Kumpulainen
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: European Commission
OpenAlex ID: W2921976499