Evolution of Maternal Weight During Pregnancy and Influence on the Endothelial Function in Her Offspring

Universitair Ziekenhuis Brussel143 enrolled

Overview

The rising worldwide prevalence of obesity and its subsequently rising incidence of concommitant diseases as diabetes and cardiovascular events impose a defiant obstacle for the health care and associated health care costs of future generations. Obese pregnant women are a growing population of interest because their offspring is at risk for childhood obesity, an adverse metabolic and inflammatory profile and possible endothelial dysfunction. However, strong evidence is still lacking regarding the hypotheses on the early origin of these long-term health consequences. Consequently there is no comprehensive data available on the contribution of changing maternal weight through lifestyle interventions or bariatric surgery and an eventual adverse metabolic and endothelial programming of the offspring. The investigators of this study want to provide additional data on the body composition, metabolic and inflammatory state as well as endothelial function of children of obese pregnant women women and compare the outcome with children born from normal weight women. Furthermore, the investigators of this study will stratify the obese pregnant women into 3 groups: women who did not underwent an intervention, women who underwent a weight changing intervention during pregnancy e.g. diet or lifestyle intervention and women who underwent bariatric surgery before pregnancy. The overall aim of the study is to prove that in all the diverse groups of participating children, except the control group, there will be a certain grade of endothelial dysfunction, even if there was a normalization of weight, insulin sensitivity and inflammation before conception or delivery in the mother.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

SCREENING

Masking

NONE

Enrollment

143

Interventions

Parental questionnairesOTHER

We will provide parents with questionnaires depending on the age of their children: * Children aged 0-6 years old: 1. Questionnaire on socio-demographic characteristics 2. Dutch Eating Behaviour Questionnaire 3. Food Frequency Questionnaire 4. Ages and Stages Questionnaire 5. Strengths and Difficulties Questionnaire 6. Questionnaire on developmental milestones 7. Questionnaire on behaviour * Children older than 6 years: 1. Questionnaire on socio-demographic characteristics 2. Dutch Eating Behaviour Questionnaire 3. Food Frequency Questionnaire 4. Pediatric Quality of Life Questionnaire 5. Children's Behaviour Questionnaire in Dutch 6. Questionnaire on developmental milestones 7. Developmental Coordination Disorder Questionnaire 8. Strengths and Difficulties Questionnaire

Blood sampleOTHER

We will determine the following biochemical parameters: glucose, insulin, total cholesterol, LDL, HDL, triglycerides, uric acid, IGF-1, adiponectin, leptin, hs-CRP, IL-6, TNF-α and ICAM-1.

Urine sampleOTHER

We will take a urine sample to evaluate the albumin to creatinin ratio.

Anthropometric measurementsOTHER

We will measure weight, Height, hip, waist and neck circumference, blood pressure, 4-site skinfold measurements and BIA.

UltrasoundOTHER

We will do an abdominal ultrasound to measure the abdominal fat accumulation

EndoPATOTHER

We will use the EndoPAT device to measure endothelial function, which is a non-invasive and innovative technique (peripheral pulse wave amplitude measurement).

Faces Pain ScaleOTHER

After performing the measurements with the EndoPAT device, Harpender kalliper and ultrasound, the children will be asked to fill out a Faces Pain Scale, validated for children aged 4-16 years old and obtained for use from the International Association for the Study of Pain

Eligibility

Sex: ALLMin age: 6 MonthsMax age: 11 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Children of women who previously participated in different cohort studies conducted in Flanders concerning maternal obesity are included after contacting the mothers again. During the initial clinical trials the mothers were informed of possible follow-up studies on their offspring. Exclusion Criteria: * There are no absolute exclusion criteria formulated. * For the peripheral pulse wave amplitude measurement we exclude children on growth hormone therapy. * We postpone the examination for 2 weeks if there is an ongoing infection. * We document the use of specific medication, but the use of it doesn't implicate exclusion of the participating children.

Outcomes

Primary Outcomes

Reactive Hyperemia Index (EndoPAT)

Reactive Hyperemia Index is one of the outcome parameters of the EndoPAT assessment of endothelial cell function