Maternal overnutrition during pregnancy predisposes the offspring to cardiometabolic
diseases.This systematic review and meta-analysis aimed to investigate the association
between maternal overnutrition and offspring's blood pressure (BP) and the effect
of offspring's obesity on this association.PubMed, EMBASE, Clinicaltrials.gov, CENTRAL.Human
studies published in English before October 2021 were identified that presented quantitative
estimates of association between maternal overnutrition just before or during pregnancy
and the offspring's BP.Random-effect model with the DerSimonian and Laird weighting
method was used to analyse regression coefficients or mean differences.After selection,
17 observational studies (140,517 mother-offspring pairs) were included. Prepregnancy
body mass index (ppBMI) showed positive correlation with BP in offspring (regression
coefficient for systolic: 0.38 mmHg per kg/m2 , 95% confidence interval (CI) 0.17,
0.58; diastolic: 0.10 mmHg per kg/m2 , 95% CI 0.05, 0.14). These indicate 1.9 mmHg
increase in systolic and 0.5 mmHg increase in diastolic BP of offspring with every
5 kg/m2 gain in maternal ppBMI. Results on coefficients adjusted for offspring's BMI
also showed association (systolic: 0.08 mmHg per kg/m2 , 95% CI 0.04, 0.11; diastolic:
0.03 mmHg per kg/m2 , 95% CI 0.01, 0.04). Independent from ppBMI, gestational weight
gain (GWG) showed positive correlation with systolic BP (systolic BP: 0.05 mmHg per
kg, 95% CI 0.01, 0.09), but not after adjustment for offspring's BMI. Mean systolic
BP was higher in children of mothers with excessive GWG than in those of mothers with
optimal GWG (difference: 0.65 mmHg, 95% CI 0.25, 1.05).Independent from offspring's
BMI, higher prepregnancy BMI may increase the risk for hypertension in offspring.
The positive association between GWG and offspring's systolic BP is indirect via offspring's
obesity. Reduction in maternal obesity and treatment of obesity in children of obese
mothers are needed to prevent hypertension.
