دورية أكاديمية

Lifestyle intervention in obese pregnancy and cardiac remodelling in 3-year olds: children of the UPBEAT RCT

التفاصيل البيبلوغرافية
العنوان: Lifestyle intervention in obese pregnancy and cardiac remodelling in 3-year olds: children of the UPBEAT RCT
المؤلفون: Taylor, Paul D., Gu, Haotian, Saunders, Hannah, Fiori, Federico, Dalrymple, Kathryn V., Sethupathi, Priyanka, Yamanouchi, Liana, Miller, Faith, Jones, Bethany, Vieira, Matias C., Singh, Claire, Briley, Annette, Seed, Paul T., Pasupathy, Dharmintra, Santosh, Paramala J., Groves, Alan M., Sinha, Manish D., Chowienczyk, Philip J., Poston, Lucilla, Shennan, Andrew, Seed, Paul, Sandall, Jane, Sanders, Thomas, Patel, Nashita, Flynn, Angela, Badger, Shirlene, Barr, Suzanne, Holmes, Bridget, Goff, Louise, Hunt, Clare, Filmer, Judy, Fetherstone, Jeni, Scholtz, Laura, Tarft, Hayley, Lucas, Anna, Tekletdadik, Tsigerada, Ricketts, Deborah, Gill, Carolyn, Ignatian, Alex Seroge, Boylen, Catherine, Adegoke, Funso, Lawley, Elodie, Butler, James, Maitland, Rahat, Vieira, Matias, Oteng-Ntim, Eugene
المصدر: International Journal of Obesity ; volume 46, issue 12, page 2145-2155 ; ISSN 0307-0565 1476-5497
بيانات النشر: Springer Science and Business Media LLC
سنة النشر: 2022
مصطلحات موضوعية: Nutrition and Dietetics, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous)
الوصف: Background/Objectives Obesity in pregnancy has been associated with increased childhood cardiometabolic risk and reduced life expectancy. The UK UPBEAT multicentre randomised control trial was a lifestyle intervention of diet and physical activity in pregnant women with obesity. We hypothesised that the 3-year-old children of women with obesity would have heightened cardiovascular risk compared to children of normal BMI women, and that the UPBEAT intervention would mitigate this risk. Subjects/Methods Children were recruited from one UPBEAT trial centre. Cardiovascular measures included blood pressure, echocardiographic assessment of cardiac function and dimensions, carotid intima-media thickness and heart rate variability (HRV) by electrocardiogram. Results Compared to offspring of normal BMI women ( n = 51), children of women with obesity from the trial standard care arm ( n = 39) had evidence of cardiac remodelling including increased interventricular septum (IVS; mean difference 0.04 cm; 95% CI: 0.018 to 0.067), posterior wall (PW; 0.03 cm; 0.006 to 0.062) and relative wall thicknesses (RWT; 0.03 cm; 0.01 to 0.05) following adjustment. Randomisation of women with obesity to the intervention arm ( n = 31) prevented this cardiac remodelling (intervention effect; mean difference IVS −0.03 cm (−0.05 to −0.008); PW −0.03 cm (−0.05 to −0.01); RWT −0.02 cm (−0.04 to −0.005)). Children of women with obesity (standard care arm) compared to women of normal BMI also had elevated minimum heart rate (7 bpm; 1.41 to 13.34) evidence of early diastolic dysfunction (e prime) and increased sympathetic nerve activity index by HRV analysis. Conclusions Maternal obesity was associated with left ventricular concentric remodelling in 3-year-old offspring. Absence of remodelling following the maternal intervention infers in utero origins of cardiac remodelling. Clinical trial registry name and registration number The UPBEAT trial is registered with Current Controlled Trials, ISRCTN89971375.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1038/s41366-022-01210-3
الإتاحة: https://doi.org/10.1038/s41366-022-01210-3Test
https://www.nature.com/articles/s41366-022-01210-3.pdfTest
https://www.nature.com/articles/s41366-022-01210-3Test
حقوق: https://creativecommons.org/licenses/by/4.0Test ; https://creativecommons.org/licenses/by/4.0Test
رقم الانضمام: edsbas.4F491617
قاعدة البيانات: BASE