Table 1. Summary of epidemiological studies assessing the effect of maternal obesity on offspring risk of chronic disease.
| Study name | Year of publishing | Country | Study design | Sample size | Outcome of interest | Main findings | Adjusted variables | P-value | Level of evidence |
|---|---|---|---|---|---|---|---|---|---|
| Obesity in adulthood | |||||||||
| Eriksson et al. [11] | 2015 | Denmark | Retrospective cohort | 2003 | Adult BMI (mean age: 62 years) | Higher maternal BMI was associated with significantly higher BMI in offspring | Current age | P=0.002 | III-3 |
| Schack-Nielsen et al. [12] | 2010 | Denmark | Retrospective cohort | 1540 | Adult BMI (mean age: 42 years) | Higher gestational weight gain was associated with significantly higher BMI in offspring | Sex, maternal age/pre-pregnancy, BMI, parental social status, education/single-mother status, prematurity, birth weight, and smoking | P=0.003 | III-2 |
| Laitinen et al. [13] | 2001 | Finland | Retrospective cohort | 6280 | Adult BMI (mean age: 31 years) | Offspring overweight/obesity was more common if the mother was overweight/obese during pregnancy, BMI at the age of 31 correlated with BMI at the age of 14 | N/a | P<0.001 | III-3 |
| Cardiovascular disease in adulthood | |||||||||
| Eriksson et al. [14] | 2014 | Finland | Retrospective hospital archive medication register | 13345 | Cardiovascular disease (coronary heart disease and stroke) | Higher maternal BMI was associated with increased risk of cardiovascular disease; as well as coronary heart disease and stroke in offspring when analyzed separately (P=0.003 and P=0.04, respectively) | Childhood socioeconomic status, adult socioeconomic status, income, education, sex, and year of birth | P=0.002 | |
| Reynolds et al. [7] | 2013 | Scotland | Retrospective cohort | 37709 | All-cause mortality | Offspring of obese mothers had a 35% higher risk of mortality compared with offspring of mothers of normal weight. Offspring of obese mothers had an increased risk of cardiac-related hospitalization | Maternal age at delivery, socioeconomic status, offspring sex, birth weight, gestation at delivery, and gestation at measurement of BMI | HR: 1.17–1.55 | III-2 |
| Hospitalized for a cardiovascular event | |||||||||
| Forsen et al. [8] | 1997 | Denmark | Retrospective cohort | 3300 (men only) | Death from coronary heart disease (ICD) | Higher maternal BMI was associated with increased risk of death from cardiovascular disease | N/a | P=0.008 | III-3 |
| T2D in adulthood | |||||||||
| Eriksson et al. [14] | 2014 | Finland | Retrospective hospital archive/medication register | 13345 | T2D (as determined by use of antidiabetic medications) | The risk of T2D was increased with higher maternal BMI; the association was stronger in women | Childhood and adult socioeconomic status, income, education, sex, and year of birth | P=0.004 | III-3 |
| NAFLD | |||||||||
| Patel et al. [15] | 2016 | U.K. | Prospective pregnancy cohort | 1581 | NAFLD as determined by liver ultrasound at the age of 17–18 years | Maternal overweight/obesity and pre-pregnancy BMI were associated with greater odds of NAFLD in offspring, even when adjusting for confounders (lost significance when adjusted for neonatal offspring adiposity) | Age at assessment, gender, maternal age at delivery, parity, maternal pre-pregnancy alcohol intake, household social class, birth weight | P<0.05 | III-2 |
This table highlights major studies that have identified the significant influence of maternal obesity on chronic disease risk. Level of evidence is derived from NHMRC levels of evidence where level I evidence is a systematic review of level II evidence, II is a randomized controlled trial, III is a comparative study; -2 concurrent controls, -3 historical controls or two single arm studies [18].