Children of Upbeat: Child Heart Structure and Function 11 Years After the Upbeat Lifestyle Intervention in Obese Pregnancy (Interim Results)

Abstract Background Children exposed to maternal obesity in pregnancy are more likely to have altered heart structure and function and develop adult cardiovascular disease. Evidence suggests that diet and lifestyle interventions during obese pregnancy can limit the degree of cardiac remodelling, but existing studies are limited to small cohorts of young children ( 7 years old). Methods A follow-up study of 9–14-year-old children from the UK Pregnancies Better Eating and Activity Trial (UPBEAT) was conducted in four UK centres (Ethics Committee #23/LO/0410). Children had cardiac structure and function assessed by echocardiography (primary outcome: interventricular septal wall thickness). Linear regression adjusting for child age, sex and body surface area, maternal ethnicity and smoking in pregnancy, and study site was done. Analyses were also split by sex to determine sex-specific effects. Results An interim analysis of 210 children was completed; the mean (±SD) age was 11.8 ± 1.1 years, 50.5% were male (99 intervention, 111 control). There were no differences in baseline maternal or follow-up child characteristics between trial arms. The UPBEAT intervention did not reduce interventricular septal wall thickness when combining sexes (−0.02 cm, P = 0.16), but there was a sex-specific effect in boys (boys: −0.04 cm, P = 0.025; girls: −0.01 cm, P = 0.86). Similar results were seen for posterior wall thickness (combined: −0.01 cm, P = 0.29; boys: - 0.04 cm, P = 0.054; girls: +0.01 cm, P = 0.74) and left ventricular mass (combined: - 1.5 g, P = 0.52; boys: −6.6 g, P = 0.069; girls: +3.4, P = 0.24). There was no change in other echocardiography measures. Conclusions Preliminary findings indicate that the UPBEAT intervention in obese pregnancy reduces myocardial thickness in 9–14-year-old boys, which could indicate primordial prevention against future cardiovascular disease.