Even before conception, a mother's obesity may affect cognitive development in her baby-to-be.
A mother’s health during pregnancy has measurable effects on her
baby’s well-being, but a new study shows that her fitness before
pregnancy matters too. Researchers say that cognitive deficits found in
premature babies can be traced to a number of mom-related factors, and
one of them is a woman’s pre-pregnancy weight.
The new study, published in the journal Pediatrics, involved
921 preterm infants born before 28 weeks gestation and at
lower-than-normal birth weight. About 11% of the babies showed cognitive
problems at age 2. Among the infants, the researchers found, those
whose mothers were obese (with a body mass index, or BMI, over 30)
before they became pregnant had double the risk of developing these
cognitive issues.
“What parents need to know is that when it comes to a baby’s brain
development, everything is important — even factors prior to getting
pregnant. And any changes that they can make toward a healthier
lifestyle might improve the outcomes for their babies,” says the study’s
lead author Dr. Jennifer Helderman, an assistant professor of
pediatrics at Wake Forest Baptist Medical Center.
The babies and parents participating in the study came from 14
different institutes and agreed to participate in a number of tests to
help the researchers determine which factors were most important in
influencing brain development. The mothers agreed to give placental
biopsies immediately after giving birth, and the babies participated in
neurological evaluations and developmental assessments around age 2.
The placental samples helped scientists to determine whether any
blockages in the blood vessels feeding the fetus may have impaired the
flow of nutrients and oxygen to the developing fetus, thus inhibiting
brain development. Indeed, babies who developed in placental
environments with blood clots were at a threefold greater risk of lower
cognitive scores, compared with infants whose mothers had fewer
placental clots.
But of all the mother-related factors that influenced cognitive
development, pre-pregnancy obesity stood out. While it’s not entirely
clear how a woman’s weight before conception may impact her baby’s
brain, Helderman says the leading theory involves inflammation. Excess
weight can keep levels of potentially destructive immune cells high;
these are the cells that rush to the site of trauma to clear away
debris. Studies show that inflammation
can adversely affect the brain, and it’s possible that an expectant
mom’s heightened inflammatory response could filter through to her
developing baby.
Other factors that Helderman and her team identified included
familiar ones such as a mother’s education and race. Previous studies
have found, as Helderman’s did, that mothers with less than a high
school education and those from racial and ethnic minorities were more
likely to have babies with cognitive problems.
And while the results are sobering, they also contain some hope.
“This is a factor that is potentially modifiable,” says Helderman.
“We’re not saying that weight loss or that maintaining a healthy weight
is easy, but for mothers who are interested in doing everything they can
for a healthy pregnancy and a healthy baby, this might be one area they
want to target.”
Expectant moms already give up smoking and drinking alcohol while
pregnant, so addressing weight issues may become another part of a
pre-pregnancy checklist. That’s not to say that all normal weight women
have healthy babies without cognitive issues, but such deficits are more
common among those born premature, and, as these results show, to moms
who are obese. “This is important because almost universally, parents
interested in this outcome — brain development in their babies,” says
Helderman. “If they want to increase their chances of having healthy
children, managing their weight may be one thing they can do.”

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