“There is a direct relationship between maternal obesity and decreased cognitive function of the child”

30/05/2013

 

Interview with Maribel Casas, author of the study “Maternal pre-pregnancy overweight and obesity, and child neuropsychological development: two Southern European birth cohort studies”

First of all, explain briefly that motivated them to push this study …
Obesity is a major public health problem and its prevalence is especially important in the countries of central, eastern and southern Europe. Obesity is characterized as a systemic inflammation that can be transferred to the fetus, increasing oxidative stress and causing a series of changes in the nervous system, and these changes may cause a decrease of cognitive function of the child. Several epidemiological studies have demonstrated the existence of neuropsychological effects in children of obese mothers, but has not yet been shown whether these changes are due to intrauterine mechanisms as may be inflammation or due to other factors, especially related to socioeconomic status, closely linked to overweight and child neurodevelopment. The aim of our study was to evaluate whether states of overweight and obesity of the mother before pregnancy were associated with neuropsychological development of children between 11 and 22 months in Spain (INMA cohort) and Greece (RHEA cohort).

What methodology was followed?
In this study we use individual neuropsychological tests, we evaluate the impact of potential mediating factors, as could be markers of inflammation, and also use the parent as a negative control exposure. This methodology is to use the parent as an indicator of all those social factors that may be confusing our real partnership. In our case, if the effect of overweight and obesity on child neurodevelopment was due to intrauterine mechanisms or owned by the mother, this association alone would, or would be more consistent, in the mother than the father. This methodology has been used previously to assess the association between snuff smoke exposure during pregnancy and neuropsychological development of the child.

“The aim of our study was to evaluate whether the
of overweight and obesity of the mother before pregnancy
were associated with neuropsychological development of children
between 11 and 22 months in Spain (INMA cohort) and Greece (RHEA cohort). “

What are the main conclusions that can be drawn from the study?
In this study we have seen that maternal obesity was associated with reduced cognitive function of the child at 14 months of age. This reduction was observed even taking into account different socio-economic factors and not observed in obese parents. It is noteworthy that these results, we were able to replicate in the two cohorts of INMA and RHEA.

What are the worst factors for both the mother and the baby, who exposed pregnant mothers who are obese?
Different studies have reported that maternal obesity during pregnancy increases the risk of preeclampsia and gestational diabetes mellitus and congenital malformations in the fetus.


“In this study we have seen obesity of the mother was
associated with a reduction of cognitive function of the child
at 14 months of age. This reduction was observed even taking
into account different socio-economic factors. “

What is the role of socioeconomic and demographic factors on the findings of the study?
Socioeconomic and demographic factors are closely related to obesity of the mother and neurodevelopment of the child, so it was very important to include the more better socioeconomic variables in our analysis. Although age and education of both the mother and father were available in both cohorts, socioeconomic status was available only at INMA. Therefore, RHEA cohort may persist what we call “residual confounding” that is attributed to the existence of factors that can not be taken into account and that prevent the association we see is correct. We believe this may have influenced the results, since the associations between maternal obesity and child neurodevelopment are clearer in the INMA cohort in RHEA.

“Socioeconomic and demographic factors are
closely related to obesity in mothers and neurodevelopment
of the child, so it was very important to more variables
include socioeconomic best in our analysis.”

Have any significant differences between the two cohorts analyzed? What do they obey?
Note that in both obesity INMA mother and the father were closely related to education, age, and socioeconomic status. In RHEA, however, only obesity of the mother and not the father was related to education and age. RHEA This means that there may be other factors related to obesity father not consider and make negative exposure control is not as clear as in INMA.

Obesity, say, in the pandemic of the century and Spain is in the lead at European level From a medical standpoint, and although not part of the study, believes what initiatives should be promoted to end this problem?
Personally I think it would have to inform mothers that obesity, especially before pregnancy can be harmful to her and the child. This could inform the level of primary care centers but could also be campaigning to raise awareness of these recommendations on a larger scale.
To read the study: http://www.ncbi.nlm.nih.gov/pubmed/23569191