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133rd Annual Meeting & Exposition
December 10-14, 2005
Michael C. Lu, MD, MPH, Jennifer S. Huang, and Tiffany Lee. Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, 650 Charles E. Young Drive South, Box 951772, Los Angeles, CA 90095-1772, 310-825-5297, email@example.com
Objective: To review the epidemiological and biological evidence for prenatal programming of obesity.
Study Design: A systematic review of the literature was performed using PubMed and MDConsult to search for epidemiological studies examining the relationship between prenatal exposures and overweight/obesity in offspring. Prenatal exposures to maternal diabetes, malnutrition, and smoking were examined, and overweight/obesity was defined by either BMI or skinfold thickness at or over the age of 5.
Results: We identified 6 epidemiological studies of maternal diabetes during pregnancy and obesity in the offspring. All six showed increased risk, with reported odds ratios for childhood or adolescent obesity ranging from 1.4 to 6.9 among offspring of diabetic mothers. Of the 3 studies on maternal malnutrition and obesity in the offspring, two demonstrated increased risk, particularly among offspring exposed to malnutrition in utero in the first two trimesters of pregnancy. Our literature search generated 11 studies that met inclusion and exclusion criteria for a relationship between maternal smoking during pregnancy and risk of obesity in offspring; all 11 studies demonstrated a significant relationship, with reported odds ratios ranging from 1.2 to 2.9. The findings persisted even after adjustment for potential confounders in five studies. Biological mechanisms for these epidemiological associations were proposed, involving prenatal programming of insulin and leptin receptor insensitivity or resistance.
Conclusion: Existing evidence supports prenatal programming of obesity. Future research and interventions on childhood obesity need to consider the prenatal period a window of opportunity for obesity prevention.
Keywords: Obesity, Pregnancy
Presenting author's disclosure statement:
I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA