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Preconception obesity treatment: maternal bariatric surgery and long-term child health outcomes

孕前肥胖治疗：孕产妇减肥手术和长期儿童健康结果

基本信息

批准号：
10707144
负责人：
Janne Boone-Heinonen
金额：
$ 45.98万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-19 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10707144
关键词：
6 year old Address Adult Affect Age Anemia Animals Anthropometry Benefits and Risks Birth Birth Weight Blood Pressure Body Weight Body Weight decreased Body mass index Characteristics Child Child Health Childhood Chronic Disease Clinical Data Conceptions Control Groups Cost Analysis Costs and Benefits Data Data Set Female of child bearing age Future General Population Gestational Age Gestational Diabetes Goals Growth Health High Risk Woman Human Hypertension Infant Interdisciplinary Study Intervention Life Style Link Literature Mediating Medical Meta-Analysis Metabolic Micronutrients Minority Morbid Obesity Mothers Obesity Operative Surgical Procedures Oregon Outcome Outcome Study Pathway interactions Pharmaceutical Preparations Population Heterogeneity Pregnancy Pregnant Women Prevalence Reporting Research Risk Role Sample Size Science Site Small for Gestational Age Infant Subgroup Universities Weight Weight Gain Woman absorption bariatric surgery blood pressure elevation child bearing cohort comorbidity disorder risk ethnic diversity ethnic minority fetal gestational weight gain high risk improved interest lifestyle intervention maternal obesity maternal outcome maternal risk maternal weight neonatal outcome next generation obesity management obesity risk obesity treatment offspring postnatal pregnancy disorder pregnant prenatal prepregnancy primary outcome racial diversity racial minority secondary outcome study population

项目摘要

Project Summary/Abstract Obesity prevalence has been steadily rising in the U.S. over the past three decades, including among pregnant women, children, and minorities. Accumulating evidence links maternal obesity – particularly severe obesity – to increased risk for obesity and other chronic diseases in their offspring. Moreover, intervention strategies targeting the prenatal period have yielded disappointing results, shifting focus to the preconception period. Utilization of bariatric surgery procedures have become more common, including among women of childbearing age, as it achieves weight losses averaging between 20% and 30% of total body weight (roughly 3-4 times more effective than lifestyle interventions) and is sustained long-term (seven years and longer). However, the risks and benefits of preconception weight loss by bariatric surgery to children are poorly understood, particularly in the longer-term. The overall goal of the proposed research is to determine if surgically-induced preconception weight loss can reduce their offspring's long-term risk of obesity and obesity-related health. We will utilize information collected from a large cohort (n=2120) of women with obesity who lost weight by bariatric surgery before becoming pregnant and their children. We will compare weight and weight related health (size for gestational age, infant weight gain, BMI through 6 years of age) in children of women who received bariatric surgery prior to pregnancy to two control groups born to women who did not undergo bariatric surgery (n=21,200). The first control group will be matched to the mother's pre-surgical BMI; the second control group will be matched to the mother's pre-pregnancy BMI (after surgery). We will then determine the extent to which pregnancy conditions (gestational diabetes mellitus, hypertensive disorders, anemia, gestational weight gain) mediate associations between bariatric surgery and child outcomes. We will further examine if smaller size for gestational age – one known risk following bariatric surgery – is associated with child outcomes similarly in children born to mothers with and without bariatric surgery, and without and without pregnancy anemia. Our large, unique dataset created by a consortium of Kaiser Permanente and Oregon Health & Science University sites, will allow us to address these questions in a diverse study population, with representation of racial and ethnic minority women at highest risk of severe obesity. Study findings will provide understanding of the role of preconception weight loss on long-term child health outcomes, the specific influence of achieving this weight loss by bariatric surgery on these outcomes, and guide future outcome studies that focus on improving maternal preconception weight by lifestyle, medical, and surgical means.

项目总结/文摘