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Maternal Metabolic Complications in Pregnancy and Offspring Behavior Problems at 2 Years of Age

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Abstract

Objectives Prenatal maternal metabolic problems such as pre-pregnancy adiposity, excess gestational weight gain, and gestational diabetes mellitus (GDM) are associated with an increased risk of psychopathology in offspring. We examined whether these exposures were linked to symptoms of emotional and behavioral problems in offspring at 2 years of age, or if associations were due to confounding variables. Methods Data from 815 mother–child pairs enrolled at the Edmonton site of the Canadian Healthy Infant Longitudinal Development cohort were used to examine associations between gestational metabolic complications and scores on the externalizing and internalizing scales of the Child Behavior Checklist (CBCL-1½ to 5) at age two. Associations between maternal metabolic complications and offspring psychopathology were assessed before and after adjustment for gestational diet, socioeconomic status (SES), postpartum depression (PPD), prenatal smoking and breastfeeding. Results Pre-pregnancy body mass index and GDM, but not gestational weight gain, predicted more offspring externalizing and internalizing problems. However, after adjustment for confounding variables, these associations were no longer statistically significant. Post-hoc analyses revealed that gestational diet accounted for unique variance in both externalizing (semi-partial rdiet = − 0.20, p < 0.001) and internalizing (semi-partial rdiet = − 0.16, p = 0.01) problems. PPD and SES also accounted for a similar amount of variance for both externalizing (semi-partial rPPD = 0.17, p < 0.001; rses = − 0.11, p = 0.03) and internalizing problems (semi-partial rPPD = 0.21, p < 0.001; rses = − 0.14, p = 0.004). Conclusions for Practice Since the confounding effect of gestational diet persisted after adjustment for, and was similar in magnitude to, SES and PPD, future research should consider the impact of unhealthy prenatal diets on offspring neurodevelopment.

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Acknowledgements

CHILD Study investigators contributors: Subbarao P (Director), The Hospital for Sick Children; Turvey SE, University of British Columbia (co-Director); Anand SS, McMaster University; Azad M, University of Manitoba; Becker AB, University of Manitoba; Befus AD, University of Alberta; Brauer M, University of British Columbia; Brook JR, University of Toronto; Chen E, Northwestern University, Chicago; Cyr M, McMaster University; Daley D, University of British Columbia; Dell S, Sick Children’s Hospital; Denburg JA, McMaster University; Duan Q, Queen’s University; Eiwegger T, The Hospital for Sick Children; Grasemann H, Sick Children’s Hospital; HayGlass K, University of Manitoba; Hegele R, Sick Children’s Hospital; Holness DL, University of Toronto; Hystad, Perry, Oregon State University; Kobor MS, University of British Columbia; Kollman TR, University of British Columbia; Kozyrskyj AL, University of Alberta; Laprise C, Université du Québec à Chicoutimi; Lou WYW, University of Toronto; Macri J, McMaster University; Mandhane PM, University of Alberta; Miller G, Northwestern University, Chicago; Moraes T, Sick Children’s Hospital; Paré PD, University of British Columbia; Ramsey C, University of Manitoba; Ratjen F, Sick Children’s Hospital; Sandford A, University of British Columbia; Scott JA, University of Toronto; Scott J, University of Toronto; Sears MR, (Founding Director), McMaster University; Silverman F, University of Toronto; Simons E, University of Manitoba; Takaro T, Simon Fraser University; Tebbutt S, University of British Columbia; To T, Sick Children’s Hospital;

Funding

This study was supported by Canadian Institute for Health Research (CIHR), AllerGen Network of Centers of Excellence, the Women and Children’s Health Research Institute (WCHRI), and PolicyWise.

Author information

Authors and Affiliations

  1. Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada

    John E. Krzeczkowski

  2. Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

    Amanda Lau, Jennifer Fitzpatrick, Sukhpreet Tamana, Lisa Smithson, Anita L. Kozyrskyj, Piush J. Mandhane, A. L. Kozyrskyj & P. M. Mandhane

  3. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada

    Russell de Souza

  4. Department of Medicine, McMaster University, Hamilton, ON, Canada

    Diana Lefebvre, Malcolm R. Sears & M. R. Sears

  5. Manitoba Institute of Child Health, University of Manitoba, Winnipeg, MB, Canada

    Allan B. Becker & A. B. Becker

  6. Department of Pediatrics, University of Toronto, Toronto, ON, Canada

    Padmaja Subbarao & P. Subbarao

  7. Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada

    Stuart E. Turvey & S. E. Turvey

  8. Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada

    Jacqueline Pei

  9. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Louis A. Schmidt, Ryan J. Van Lieshout & P. M. Mandhane

  10. Department of Pediatrics, 4-590 Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada

    Piush J. Mandhane

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  1. John E. Krzeczkowski
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  2. Amanda Lau
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Consortia

the CHILD Study Investigators

  • P. Subbarao
  • , S. E. Turvey
  • , S. S. Anand
  • , M. Azad
  • , A. B. Becker
  • , A. D. Befus
  • , M. Brauer
  • , J. R. Brook
  • , E. Chen
  • , M. Cyr
  • , D. Daley
  • , S. Dell
  • , J. A. Denburg
  • , Q. Duan
  • , T. Eiwegger
  • , H. Grasemann
  • , K. HayGlass
  • , R. Hegele
  • , D. L. Holness
  • , Perry Hystad
  • , M. S. Kobor
  • , T. R. Kollman
  • , A. L. Kozyrskyj
  • , C. Laprise
  • , W. Y. W. Lou
  • , J. Macri
  • , P. M. Mandhane
  • , G. Miller
  • , T. Moraes
  • , P. D. Paré
  • , C. Ramsey
  • , F. Ratjen
  • , A. Sandford
  • , J. A. Scott
  • , J. Scott
  • , M. R. Sears
  • , F. Silverman
  • , E. Simons
  • , T. Takaro
  • , S. Tebbutt
  •  & T. To

Corresponding author

Correspondence to Piush J. Mandhane.

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Conflict of interest

JEK is funded by the Vanier Graduate Scholarship Program. The remaining authors have no conflicts of interest relevant to this article to disclose. The individuals acknowledged have no conflicts of interest relevant to this article to disclose.

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A complete list of active investigators in the CHILD study is provided in the Acknowledgements section.

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Krzeczkowski, J.E., Lau, A., Fitzpatrick, J. et al. Maternal Metabolic Complications in Pregnancy and Offspring Behavior Problems at 2 Years of Age. Matern Child Health J 23, 746–755 (2019). https://doi.org/10.1007/s10995-018-2691-y

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