Dataset Information

Association between maternal overweight or obesity and cerebral palsy in children: A meta-analysis.

ABSTRACT:

Context

There is no consensus regarding the association between maternal obesity or overweight and cerebral palsy (CP) in children.

Objectives

To investigate whether maternal obesity or overweight is associated with CP and identify the factors that explain the differences in the study results.

Data sources

We conducted a meta-analysis of studies published in English with titles or abstracts that discussed the relationships between maternal obesity or overweight and CP before August 23, 2017, using Ovid Medline, EMBASE and Web of Science.

Study selection

Of 2699 initially identified studies, 8 studies that addressed the association between maternal obesity and CP met our final inclusion criteria.

Data extraction

Information from the individual studies was abstracted using standardized forms by 2 independent observers who were blinded to the authors' names and journal titles.

Data synthesis

According to a random effects model, maternal overweight was significantly associated with CP in offspring [RR = 1.29 (95% CI, 1.04-1.60), heterogeneity (I2 = 45.5%, P = 0.103)]; maternal obesity was significantly associated with CP in offspring [RR = 1.45 (95% CI, 1.25-1.69), heterogeneity (I2 = 24.1%, P = 0.253)]; and maternal obesity III was significantly associated with CP in offspring [RR = 2.25 (95% CI, 1.82-2.79), heterogeneity (I2 = 0%, P = 0.589)]. However, maternal underweight was not significantly associated with CP in offspring [RR = 1.11 (95% CI, 0.88-1.38), low heterogeneity (I2 = 0%, P = 0.435)]. Factors that explained the differences in the meta-analysis results included study design, study location, and whether individual studies adjusted for potential confounders.

Conclusion

This study suggests that maternal obesity and overweight increase the risk of CP in offspring. Further studies are required to confirm these results and determine the influence of variables across studies.

SUBMITTER: Xiao D

PROVIDER: S-EPMC6191132 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association between maternal overweight or obesity and cerebral palsy in children: A meta-analysis.

Xiao Dongqiong D Qu Yi Y Huang Lan L Wang Yan Y Li Xihong X Mu Dezhi D Mu Dezhi D

PloS one 20181016 10

<h4>Context</h4>There is no consensus regarding the association between maternal obesity or overweight and cerebral palsy (CP) in children.<h4>Objectives</h4>To investigate whether maternal obesity or overweight is associated with CP and identify the factors that explain the differences in the study results.<h4>Data sources</h4>We conducted a meta-analysis of studies published in English with titles or abstracts that discussed the relationships between maternal obesity or overweight and CP befor ...[more]

PMID: 30325944

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Project description:ImportanceThe first pediatric lead screening typically occurs at 1-year well-child care visits. However, data on the extent of maternal lead exposure and its long-term consequences for child health are lacking.ObjectiveTo investigate the associations between maternal red blood cell (RBC) lead levels and intergenerational risk of overweight or obesity (OWO) and whether adequate maternal folate status is associated with a reduction in OWO risk.Design, setting, and participantsProspective birth cohort study. The analysis was conducted from July 14, 2018, to August 2, 2019, at Johns Hopkins Bloomberg School of Public Health. This study included 1442 mother-child pairs recruited at birth from October 27, 2002, to October 10, 2013, and followed up prospectively at Boston Medical Center.Main outcomes and measuresChild body mass index (BMI) z score, calculated according to US national reference data, and OWO, defined as BMI at or exceeding the 85th percentile for age and sex. Maternal RBC lead levels and plasma folate levels were measured in samples obtained 24 to 72 hours after delivery; child whole-blood lead level was obtained from the first pediatric lead screening.ResultsThe mean (SD) age of mothers and children was 28.6 (6.5) years and 8.1 (3.1) years, respectively; 50.1% of children were boys. The median maternal RBC lead level and plasma folate level were 2.5 (interquartile range [IQR], 1.7-3.8) μg/dL and 32.2 (IQR, 22.1-44.4) nmol/L, respectively. The median child whole-blood lead level and child BMI z score were 1.4 (IQR, 1.4-2.0) μg/dL and 0.78 (IQR, -0.08 to 1.71), respectively. Maternal RBC lead level was associated with child OWO risk in a dose-response fashion, with an odds ratio (OR) of 1.65 (95% CI, 1.18-2.32) for high maternal RBC lead level (≥5.0 μg/dL) compared with low maternal RBC lead level (<2.0 μg/dL). Child OWO was highest among children of OWO mothers with high RBC lead levels (adjusted OR, 4.24; 95% CI, 2.64-6.82) compared with children of non-OWO mothers with low RBC lead levels. Children of OWO mothers with high RBC lead levels had 41% lower OWO risk (OR, 0.59; 95% CI, 0.36-0.95; P = .03) if their mothers had adequate plasma folate levels (≥20.4 nmol/L) compared with their counterparts.Conclusions and relevanceIn this sample of a US urban population, findings suggest that maternal elevated lead exposure was associated with increased risk of intergenerational OWO independent of postnatal blood lead levels. Adequate maternal folate status appeared to be associated with lower OWO risk. If confirmed by additional studies, these findings have implications for prenatal lead screening and management to minimize adverse health consequences on children.

Project description:Introduction Cerebral palsy (CP) is the most common motor disability in childhood, but its causes are only partly known. Early-life exposure to toxic metals and inadequate or excess amounts of essential elements can adversely affect brain and nervous system development. However, little is still known about these as perinatal risk factors for CP. This study aims to investigate the associations between second trimester maternal blood levels of toxic metals, essential elements, and mixtures thereof, with CP diagnoses in children. Methods In a large, population-based prospective birth cohort (The Norwegian Mother, Father, and Child Cohort Study), children with CP diagnoses were identified through The Norwegian Patient Registry and Cerebral Palsy Registry of Norway. One hundred forty-four children with CP and 1,082 controls were included. The relationship between maternal blood concentrations of five toxic metals and six essential elements and CP diagnoses were investigated using mixture approaches: elastic net with stability selection to identify important metals/elements in the mixture in relation to CP; then logistic regressions of the selected metals/elements to estimate odds ratio (OR) of CP and two-way interactions among metals/elements and with child sex and maternal education. Finally, the joint effects of the mixtures on CP diagnoses were estimated using quantile-based g-computation analyses. Results The essential elements manganese and copper, as well as the toxic metal Hg, were the most important in relation to CP. Elevated maternal levels of copper (OR = 1.40) and manganese (OR = 1.20) were associated with increased risk of CP, while Hg levels were, counterintuitively, inversely related to CP. Metal/element interactions that were associated with CP were observed, and that sex and maternal education influenced the relationships between metals/elements and CP. In the joint mixture approach no significant association between the mixture of metals/elements and CP (OR = 1.00, 95% CI = [0.67, 1.50]) was identified. Conclusion Using mixture approaches, elevated levels of copper and manganese measured in maternal blood during the second trimester could be related to increased risk of CP in children. The inverse associations between maternal Hg and CP could reflect Hg as a marker of maternal fish intake and thus nutrients beneficial for foetal brain development.

Dataset Information

Association between maternal overweight or obesity and cerebral palsy in children: A meta-analysis.

Context

Objectives

Data sources

Study selection

Data extraction

Data synthesis

Conclusion

Publications

Association between maternal overweight or obesity and cerebral palsy in children: A meta-analysis.

Similar Datasets

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