Lifestyle intervention in obese pregnancy and cardiac remodelling in 3-year olds: children of the UPBEAT RCT

Media type: E-Article
Title: Lifestyle intervention in obese pregnancy and cardiac remodelling in 3-year olds: children of the UPBEAT RCT
Contributor: Taylor, Paul D.; Gu, Haotian; Saunders, Hannah; Fiori, Federico; Dalrymple, Kathryn V.; Sethupathi, Priyanka; Yamanouchi, Liana; Miller, Faith; Jones, Bethany; Vieira, Matias C.; Singh, Claire; Briley, Annette; Seed, Paul T.; Pasupathy, Dharmintra; Santosh, Paramala J.; Groves, Alan M.; Sinha, Manish D.; Chowienczyk, Philip J.; Poston, Lucilla; Poston, Lucilla; Shennan, Andrew; Briley, Annette; Singh, Claire; Seed, Paul; [...]
Published: Springer Science and Business Media LLC, 2022
Published in: International Journal of Obesity, 46 (2022) 12, Seite 2145-2155
Language: English
DOI: 10.1038/s41366-022-01210-3
ISSN: 0307-0565; 1476-5497
Keywords: Nutrition and Dietetics ; Endocrinology, Diabetes and Metabolism ; Medicine (miscellaneous)
Origination:
Footnote:
Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background/Objectives</jats:title> <jats:p>Obesity in pregnancy has been associated with increased childhood cardiometabolic risk and reduced life expectancy. The UK UPBEAT multicentre randomised control trial was a lifestyle intervention of diet and physical activity in pregnant women with obesity. We hypothesised that the 3-year-old children of women with obesity would have heightened cardiovascular risk compared to children of normal BMI women, and that the UPBEAT intervention would mitigate this risk.</jats:p> </jats:sec><jats:sec> <jats:title>Subjects/Methods</jats:title> <jats:p>Children were recruited from one UPBEAT trial centre. Cardiovascular measures included blood pressure, echocardiographic assessment of cardiac function and dimensions, carotid intima-media thickness and heart rate variability (HRV) by electrocardiogram.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Compared to offspring of normal BMI women (<jats:italic>n</jats:italic> = 51), children of women with obesity from the trial standard care arm (<jats:italic>n</jats:italic> = 39) had evidence of cardiac remodelling including increased interventricular septum (IVS; mean difference 0.04 cm; 95% CI: 0.018 to 0.067), posterior wall (PW; 0.03 cm; 0.006 to 0.062) and relative wall thicknesses (RWT; 0.03 cm; 0.01 to 0.05) following adjustment. Randomisation of women with obesity to the intervention arm (<jats:italic>n</jats:italic> = 31) prevented this cardiac remodelling (intervention effect; mean difference IVS −0.03 cm (−0.05 to −0.008); PW −0.03 cm (−0.05 to −0.01); RWT −0.02 cm (−0.04 to −0.005)). Children of women with obesity (standard care arm) compared to women of normal BMI also had elevated minimum heart rate (7 bpm; 1.41 to 13.34) evidence of early diastolic dysfunction (e prime) and increased sympathetic nerve activity index by HRV analysis.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Maternal obesity was associated with left ventricular concentric remodelling in 3-year-old offspring. Absence of remodelling following the maternal intervention infers in utero origins of cardiac remodelling.</jats:p> </jats:sec><jats:sec> <jats:title>Clinical trial registry name and registration number</jats:title> <jats:p>The UPBEAT trial is registered with Current Controlled Trials, ISRCTN89971375.</jats:p> </jats:sec>

Search in field:

Recently searched for: