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Associations between a maternal healthy lifestyle score and adverse offspring birth outcomes and childhood obesity in the Lifeways Cross-Generation Cohort Study

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Abstract

Background/objectives

Maternal adherence to healthy lifestyle behaviors during pregnancy has been associated with reduced risk of obesity in the offspring. Our objective is to examine associations between a composite healthy lifestyle score (HLS) in expectant mothers and adverse offspring birth outcomes and childhood obesity.

Subjects/methods

The Lifeways Study comprises 665 mother–child pairs. A composite HLS (scored 0–5) based on high dietary quality (top 40% of the Healthy Eating Index (HEI)-2015), moderate to vigorous physical activity (MVPA), healthy pre-pregnancy BMI (18.5–24.9 kg/m2), never smoker, and no/moderate alcohol intake was calculated. Birth outcomes were abstracted from hospital records. Offspring waist circumference (WC) and BMI was determined at age 5 and 9. Logistic regression tested HLS associations with offspring outcomes.

Results

Offspring birth weight, length, and head circumference were positively associated with the maternal HLS (p < 0.001), whereas child BMI and incidence of overweight/obesity at age 5 and 9 were negatively associated (p < 0.05). In multivariable models, a lower maternal HLS was associated with increased risk of low birth weight (LBW) (P trend = 0.04) and lower likelihood of macrosomia (P trend = 0.03). Examined individually, poor maternal dietary quality, smoking, and alcohol intake were associated with higher risk of LBW (p < 0.04). Likelihood of macrosomia and combined overweight/obesity at age 5 and 9 years were greater among mothers with a pre-pregnancy BMI in the range with obesity (p < 0.04). Smoking during pregnancy was also linked to greater risk of childhood overweight/obesity (OR:1.91, 95% CI:1.01–3.61, p = 0.04 at age 5 and OR: 2.14, 95% CI:1.01–4.11, p = 0.03 at age 9).

Conclusions

Our findings suggest that maternal adherence to a healthy lifestyle during pregnancy, in particular having a good quality diet, not smoking, and no/low alcohol intake in combination with a healthy pre-pregnancy BMI, is associated with reduced risk of adverse offspring birth outcomes and childhood obesity.

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Fig. 1: Associations between maternal healthy lifestyle score and risk of adverse offspring birth outcomes and childhood overweight and obesity.

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Acknowledgements

The Lifeways Cross-Generation Cohort Study is funded by the Irish Health Research Board (reference HRC/2007/13) and is overseen by an inter-disciplinary steering group. We would like to thank all members of the Lifeways cohort for their valuable contribution to the study. The participation of families is much appreciated.

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Authors and Affiliations

  1. HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland

    Pilar Navarro, John Mehegan, Celine M. Murrin, Cecily C. Kelleher & Catherine M. Phillips

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  1. Pilar Navarro
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  2. John Mehegan
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  3. Celine M. Murrin
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  4. Cecily C. Kelleher
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for the Lifeways Cross Generation Cohort Study

Contributions

All authors designed and conducted the research, PN performed the data analysis, PN, CCK, and CMP wrote the paper. CMM contributed to data collection. JM oversaw data management and quality. CMP had primary responsibility for final content. All authors read and approved the final version of the manuscript for publication.

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Correspondence to Catherine M. Phillips.

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The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval was granted by ethical committees of the Coombe University Hospital, Dublin, University College Dublin, Irish College of General Practitioners and University College Hospital, Galway, Ireland.

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Written informed consent was collected from all women upon recruitment and at all subsequent sweeps of the study

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Navarro, P., Mehegan, J., Murrin, C.M. et al. Associations between a maternal healthy lifestyle score and adverse offspring birth outcomes and childhood obesity in the Lifeways Cross-Generation Cohort Study. Int J Obes 44, 2213–2224 (2020). https://doi.org/10.1038/s41366-020-00652-x

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