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Prenatal exposure to very severe maternal obesity is associated with adverse neuropsychiatric outcomes in children

Published online by Cambridge University Press:  25 October 2016

T. H. Mina ,
M. Lahti ,
A. J. Drake ,
K. Räikkönen ,
H. Minnis ,
F. C. Denison ,
J. E. Norman  and
R. M. Reynolds
T. H. Mina
Affiliation:
University BHF Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK Tommy's Centre for Maternal and Fetal Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK
M. Lahti
Affiliation:
University BHF Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
A. J. Drake
Affiliation:
University BHF Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK
K. Räikkönen
Affiliation:
Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
H. Minnis
Affiliation:
Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
F. C. Denison
Affiliation:
Tommy's Centre for Maternal and Fetal Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK
J. E. Norman
Affiliation:
Tommy's Centre for Maternal and Fetal Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK
R. M. Reynolds*
Affiliation:
University BHF Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK Tommy's Centre for Maternal and Fetal Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK
*
*Address for correspondence: Professor R. M. Reynolds, University BHF Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, 47 Little France, Edinburgh EH16 4TJ, Scotland, UK. (Email: [email protected])
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Abstract

Background

Prenatal maternal obesity has been linked to adverse childhood neuropsychiatric outcomes, including increased symptoms of attention deficit hyperactivity disorder (ADHD), internalizing and externalizing problems, affective disorders and neurodevelopmental problems but few studies have studied neuropsychiatric outcomes among offspring born to very severely obese women or assessed potential familial confounding by maternal psychological distress.

Method

We evaluated neuropsychiatric symptoms in 112 children aged 3–5 years whose mothers had participated in a longitudinal study of obesity in pregnancy (50 very severe obesity, BMI ⩾40 kg/m2, obese class III and 62 lean, BMI 18.5–25 kg/m2). The mothers completed the Conners’ Hyperactivity Scale, Early Symptomatic Syndrome Eliciting Neurodevelopmental Clinical Examination Questionnaire (ESSENCE-Q), Child's Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ), and Child Behavior Checklist (CBCL) to assess child neuropsychiatric symptoms. Covariates included child's sex, age, birthweight, gestational age, socioeconomic deprivation levels, maternal age, parity, smoking status during pregnancy, gestational diabetes and maternal concurrent symptoms of anxiety and depression assessed using State Anxiety of Spielberger State-Trait Anxiety Index (STAI) and General Health Questionnaire (GHQ), respectively.

Results

Children exposed to prenatal maternal very severe obesity had significantly higher scores in the Conners’ Hyperactivity Scale; ESSENCE-Q; total sleep problems in CSHQ; hyperactivity, conduct problems and total difficulties scales of the SDQ; higher externalizing and total problems, anxious/depressed, aggressive behaviour and other problem syndrome scores and higher DSM-oriented affective, anxiety and ADHD problems in CBCL. Prenatal maternal very severe obesity remained a significant predictor of child neuropsychiatric problems across multiple scales independent of demographic factors, prenatal factors and maternal concurrent symptoms of anxiety and depression.

Conclusions

Prenatal maternal very severe obesity is a strong predictor of increased neuropsychiatric problems in early childhood.

Keywords

Affectiveattention deficitexternalizinghyperactivityneurodevelopmentalobesityprenatalsleep
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 2 , January 2017 , pp. 353 - 362
Copyright
Copyright © Cambridge University Press 2016 

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