Pregnancy Determinants of Child Growth and Neurodevelopment: Adiposity, gestational diabetes mellitus, and diet
Abstract
Maternal lifestyle and health during pregnancy may have far-reaching effects on the
health of children. The aim in this thesis was to investigate the extent to which
adiposity, gestational diabetes mellitus (GDM), and diet in pregnancy influence the
growth and neurodevelopment of children up to 5–6 years of age. Also, the impact
of maternal fish oil and/or probiotics intervention on a child’s growth was studied.
The mothers, with overweight or obesity, were randomised into intervention
groups (fish oil + placebo, probiotics + placebo, fish oil + probiotics, placebo +
placebo) from early pregnancy onwards. The mothers were followed throughout
pregnancy and their children for 5–6 years postpartum (n=159–373). The growth
data (0–2 years) were collected from welfare clinic cards and body composition was
measured by an air displacement plethysmography (2 years). Neurodevelopmental
assessments were performed at 2 and 5–6 years of age. Diet (diet patterns from food
diaries, Index of Dietary Quality) and body composition were evaluated in early and
late pregnancy. GDM was diagnosed by an oral glucose tolerance test. The data were
analysed using linear/logistic regression models and Pearson/Spearman correlations.
A good dietary quality in pregnancy associated with an increased height and head
circumference standard deviation score (SDS) at 0–2 years, but a lower adiposity in
children at 2 years. GDM led to a lower infantile head circumference SDS while a
higher maternal body fat mass to an increased height and head circumference SDS
at 0–12 months. Maternal consumption of probiotics was associated with lower
weight and lower odds for overweight in children at 2 years. Considering
neurodevelopment, a good dietary quality and a healthy dietary pattern in pregnancy
associated with better expressive language and motor skills in children at 2 and 5–6
years. GDM associated with less favourable language skills in children while a
higher maternal body fat percentage and fat mass associated with less favourable
cognitive, language, and motor skills at 2 and 5–6 years.
A health-promoting diet as well as consumption of probiotics during pregnancy
by mothers with overweight or obesity, which are risk groups for pregnancy-related
complications such as GDM, likely support their children’s growth and
neurodevelopment.
