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

ABSTRACT Introduction While inflammation is a normal physiological process of pregnancy, exposure to excess inflammation in utero may have unfavourable consequences for the offspring's health. This analysis investigated associations of prenatal inflammation with offspring adiposity in early childhood. Methods Among 555 mother–offspring pairs in the Healthy Start Study, we measured three inflammation biomarkers—C‐reactive protein, interleukin‐6 and tumour necrosis factor‐α—at ~28 gestational weeks. We internally standardised each biomarker and took its average as an indicator of overall exposure to prenatal inflammation. When offspring were 4–6 years old, we measured weight and height for body mass index (BMI) z ‐score calculation; waist circumference; and % fat mass (%FM) using air displacement plethysmography. In the analysis, we used linear regression to examine associations of the prenatal inflammation z ‐score with offspring outcomes. As an exploratory analysis, we conducted stratified analysis by maternal race/ethnicity, which is known to modify associations in maternal–child health studies. Results 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, 1.43 (0.61, 2.25) cm higher waist circumference and 1.47 (0.43, 2.51) higher %FM in offspring. Further adjustment for maternal pre‐pregnancy BMI attenuated estimates to the null for BMI z ‐score and waist circumference, but less for %FM (0.77 −0.39, 1.94; p = 0.19). These associations were driven by Hispanic mother–offspring pairs. Conclusions Prenatal inflammation may predispose offspring to greater adiposity during early childhood. This association is partially explained by maternal BMI and driven by participants of Hispanic ethnicity. Trial Registration NCT #002273297