NEW RESEARCH carried out by King’s College London, UK, has found that lifestyle intervention in diet and exercise during pregnancy offers protection against cardiovascular risk in infants. The study, which was funded by the British Heart Foundation (BHF), discovered that children whose mothers were clinically obese in pregnancy had a higher likelihood of exhibiting risk factors for future heart disease. However, it was also found that this risk could be mitigated with behavioural lifestyle intervention.
Over half of females who attend antenatal care classes in the UK are classed as clinically overweight or obese. Increasing evidence shows that obesity in pregnancy could be linked to cardiometabolic dysfunction in offspring, and also that severe cardiovascular disease could begin to develop during gestation.
The UPBEAT trial, carried out by Guy’s and St Thomas’ NHS Foundation Trust, London, UK, used a cohort in which females with obesity, classed as having a BMI of over 30 kg/m2, were randomised either to receive standard pregnancy care, or to undergo a diet and exercise regime. This intervention was made up of restricting intake of saturated fat, eating foods lower in glucose, counselling, and moderate, monitored physical activity which was recorded.
The intervention cohort reported improvements in weight gain during pregnancy, a healthier diet, and subsequently a healthier metabolic profile. Follow-up, which occurred 3 years later, demonstrated that children born to females with clinical obesity showed evidence of cardiac remodelling, which indicates a risk for future cardiovascular disease. Changes which were pinpointed included elevated resting heart rate, early impairment of the heart’s relaxation function, increased sympathetic nerve activity, and increased thickness of the heart muscle. Children whose mothers were allocated to the intervention arm of the study were protected from changes in their heart function and structure in early life.
Paul Taylor, King’s College London, who led the study, commented: “A complex lifestyle intervention in pregnancy was associated with protection against cardiac remodelling in infants. We can hypothesise that these changes to the heart and its function will get worse over time, putting the child at increased risk of cardiovascular disease in the future.”