Body Composition

Associations of Maternal Prenatal Inflammation With Child Adiposity: The Healthy Start Study.

TL;DR

Prenatal inflammation was associated with greater offspring adiposity in early childhood, with associations partially explained by maternal pre-pregnancy BMI and driven by Hispanic mother-offspring pairs.

Key Findings

Each increment in the prenatal inflammation z-score was associated with higher offspring BMI z-score after adjusting for offspring age and sex.

  • Each increment in the prenatal inflammation z-score corresponded with 0.31 (95% CI: 0.14, 0.48) higher BMI z-score in offspring.
  • This association was attenuated to the null after further adjustment for maternal pre-pregnancy BMI.
  • Analysis was conducted among 555 mother-offspring pairs in the Healthy Start Study.
  • Inflammation was measured at approximately 28 gestational weeks using three biomarkers: C-reactive protein, interleukin-6, and tumour necrosis factor-α.

Each increment in the prenatal inflammation z-score was associated with higher offspring waist circumference after adjusting for offspring age and sex.

  • Each increment in the prenatal inflammation z-score corresponded with 1.43 (95% CI: 0.61, 2.25) cm higher waist circumference in offspring.
  • This association was attenuated to the null after further adjustment for maternal pre-pregnancy BMI.
  • Waist circumference was measured when offspring were 4–6 years old.

Each increment in the prenatal inflammation z-score was associated with higher offspring percent fat mass after adjusting for offspring age and sex.

  • Each increment in the prenatal inflammation z-score corresponded with 1.47 (95% CI: 0.43, 2.51) higher %FM in offspring.
  • After further adjustment for maternal pre-pregnancy BMI, the estimate was attenuated to 0.77 (95% CI: -0.39, 1.94; p = 0.19), but was attenuated less than for BMI z-score and waist circumference.
  • Percent fat mass was measured using air displacement plethysmography when offspring were 4–6 years old.

The associations of prenatal inflammation with offspring adiposity were driven by Hispanic mother-offspring pairs in stratified analyses.

  • An exploratory stratified analysis by maternal race/ethnicity was conducted because race/ethnicity is known to modify associations in maternal-child health studies.
  • Associations were driven by Hispanic mother-offspring pairs specifically.
  • This stratified analysis was described as exploratory.

The study used an internally standardised composite inflammation z-score derived from three biomarkers measured at approximately 28 gestational weeks.

  • Three inflammation biomarkers were measured: C-reactive protein, interleukin-6, and tumour necrosis factor-α.
  • Each biomarker was internally standardised and their average was taken as an indicator of overall exposure to prenatal inflammation.
  • The study included 555 mother-offspring pairs from the Healthy Start Study (NCT #002273297).
  • Linear regression was used to examine associations of the prenatal inflammation z-score with offspring outcomes.

Maternal pre-pregnancy BMI partially explained the association between prenatal inflammation and offspring adiposity.

  • Adjustment for maternal pre-pregnancy BMI attenuated estimates to the null for BMI z-score and waist circumference.
  • The attenuation was less complete for percent fat mass, with the estimate reduced from 1.47 to 0.77 (p = 0.19) after adjustment.
  • The paper concludes that the association 'is partially explained by maternal BMI.'

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Citation

Moran M, Salmon K, Dhaliwal S, Dabelea D, Perng W. (2026). Associations of Maternal Prenatal Inflammation With Child Adiposity: The Healthy Start Study.. Pediatric obesity. https://doi.org/10.1111/ijpo.70088