Preconception obesity treatment: maternal bariatric surgery and long-term child health outcomes

孕前肥胖治疗：孕产妇减肥手术和长期儿童健康结果

基本信息

批准号：
10707144
负责人：
Janne Boone-Heinonen
金额：
$ 45.98万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-19 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10707144
关键词：
6 year old Address Adult Affect Age Anemia Animals Anthropometry Benefits and Risks Birth Birth Weight Blood Pressure Body Weight Body Weight decreased Body mass index Characteristics Child Child Health Childhood Chronic Disease Clinical Data Conceptions Control Groups Cost Analysis Costs and Benefits Data Data Set Female of child bearing age Future General Population Gestational Age Gestational Diabetes Goals Growth Health High Risk Woman Human Hypertension Infant Interdisciplinary Study Intervention Life Style Link Literature Mediating Medical Meta-Analysis Metabolic Micronutrients Minority Morbid Obesity Mothers Obesity Operative Surgical Procedures Oregon Outcome Outcome Study Pathway interactions Pharmaceutical Preparations Population Heterogeneity Pregnancy Pregnant Women Prevalence Reporting Research Risk Role Sample Size Science Site Small for Gestational Age Infant Subgroup Universities Weight Weight Gain Woman absorption bariatric surgery blood pressure elevation child bearing cohort comorbidity disorder risk ethnic diversity ethnic minority fetal gestational weight gain high risk improved interest lifestyle intervention maternal obesity maternal outcome maternal risk maternal weight neonatal outcome next generation obesity management obesity risk obesity treatment offspring postnatal pregnancy disorder pregnant prenatal prepregnancy primary outcome racial diversity racial minority secondary outcome study population

项目摘要

Project Summary/Abstract Obesity prevalence has been steadily rising in the U.S. over the past three decades, including among pregnant women, children, and minorities. Accumulating evidence links maternal obesity – particularly severe obesity – to increased risk for obesity and other chronic diseases in their offspring. Moreover, intervention strategies targeting the prenatal period have yielded disappointing results, shifting focus to the preconception period. Utilization of bariatric surgery procedures have become more common, including among women of childbearing age, as it achieves weight losses averaging between 20% and 30% of total body weight (roughly 3-4 times more effective than lifestyle interventions) and is sustained long-term (seven years and longer). However, the risks and benefits of preconception weight loss by bariatric surgery to children are poorly understood, particularly in the longer-term. The overall goal of the proposed research is to determine if surgically-induced preconception weight loss can reduce their offspring's long-term risk of obesity and obesity-related health. We will utilize information collected from a large cohort (n=2120) of women with obesity who lost weight by bariatric surgery before becoming pregnant and their children. We will compare weight and weight related health (size for gestational age, infant weight gain, BMI through 6 years of age) in children of women who received bariatric surgery prior to pregnancy to two control groups born to women who did not undergo bariatric surgery (n=21,200). The first control group will be matched to the mother's pre-surgical BMI; the second control group will be matched to the mother's pre-pregnancy BMI (after surgery). We will then determine the extent to which pregnancy conditions (gestational diabetes mellitus, hypertensive disorders, anemia, gestational weight gain) mediate associations between bariatric surgery and child outcomes. We will further examine if smaller size for gestational age – one known risk following bariatric surgery – is associated with child outcomes similarly in children born to mothers with and without bariatric surgery, and without and without pregnancy anemia. Our large, unique dataset created by a consortium of Kaiser Permanente and Oregon Health & Science University sites, will allow us to address these questions in a diverse study population, with representation of racial and ethnic minority women at highest risk of severe obesity. Study findings will provide understanding of the role of preconception weight loss on long-term child health outcomes, the specific influence of achieving this weight loss by bariatric surgery on these outcomes, and guide future outcome studies that focus on improving maternal preconception weight by lifestyle, medical, and surgical means.

项目概要/摘要过去三十年来，美国的肥胖率一直在稳步上升，其中包括孕妇越来越多的证据表明，妇女、儿童和少数民族与孕产妇肥胖（尤其是严重肥胖）存在关联。此外，干预策略也会增加其后代患肥胖症和其他慢性疾病的风险。以产前为目标的做法取得了令人失望的结果，将重点转移到了孕前期。减肥手术的使用已经变得越来越普遍，包括在以下地区的女性中：育龄期，因为其体重减轻平均占总体重的 20% 至 30%（大约比生活方式干预有效 3-4 倍）并且可以长期持续（七年或更长时间）。然而，通过减肥手术对儿童进行孕前减肥的风险和益处却很差。理解，尤其是从长远来看。拟议研究的总体目标是确定手术引起的孕前减肥是否可以降低后代肥胖和肥胖相关健康的长期风险。我们将利用收集到的信息。来自一大群 (n=2120) 肥胖女性，她们在成为之前通过减肥手术减肥我们将比较孕妇及其孩子的体重和体重相关的健康状况（胎龄大小、婴儿大小）。之前接受过减肥手术的妇女的孩子的体重增加（BMI 至 6 岁）怀孕的两个对照组是未接受减肥手术的妇女所生的（n = 21,200）。对照组将与母亲的术前 BMI 相匹配；第二个对照组将与母亲的术前 BMI 相匹配；然后我们将根据母亲怀孕前的BMI（手术后）来确定怀孕状况的程度。（妊娠期糖尿病、高血压病、贫血、妊娠期体重增加）介导关联我们将进一步检查体重是否小于胎龄——一。减肥手术后的已知风险——与母亲所生的孩子的儿童结局相关有或没有减肥手术，有或没有妊娠贫血。我们由 Kaiser Permanente 和俄勒冈健康与科学联盟创建的大型、独特的数据集大学网站将使我们能够在不同的研究人群中解决这些问题，其中包括研究结果将有助于了解严重肥胖风险最高的种族和族裔女性。孕前减肥对长期儿童健康结果的作用，实现目标的具体影响通过减肥手术减轻体重对这些结果的影响，并指导未来的结果研究，重点关注通过生活方式、医疗和手术手段改善母亲孕前体重。