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Pediatrics

Child physical activity as a modifier of the relationship between prenatal exposure to maternal overweight/obesity and neurocognitive outcomes in offspring

International Journal of Obesity volume 45, pages 1310–1320 (2021)Cite this article

Subjects

Abstract

Background/Objectives

With rising obesity rates among pregnant women, more children are exposed in utero to maternal obesity. In prior epidemiological studies, exposure to maternal obesity was associated with lower intelligence quotient (IQ) scores and worse cognitive abilities in offspring. Further studies have shown that offspring exposed to maternal obesity, exhibit differences in the white matter microstructure properties, fractional anisotropy (FA) and mean diffusivity (MD). In contrast, physical activity was shown to improve cognition and white matter microstructure during childhood. We examined if child physical activity levels modify the relationship between prenatal exposure to maternal obesity with IQ and white matter microstructure in offspring.

Subjects/Methods

One hundred children (59% girls) age 7–11 years underwent brain magnetic resonance imaging and IQ testing. Maternal pre-pregnancy BMI was abstracted from electronic medical records. White matter was assessed using diffusion tensor imaging with the measures, global FA, MD. The 3-day physical activity recall was used to measure moderate-to-vigorous physical activity and vigorous physical activity (VPA). Linear regression was used to test for interactions between prenatal exposure to maternal overweight/obesity and child PA levels on child IQ and global FA/MD.

Results

The relationship between prenatal exposure to maternal overweight/obesity and child IQ and global FA varied by child VPA levels. Children exposed to mothers with overweight/obesity who engaged in more VPA had higher IQ scores and global FA compared to exposed children who engaged in less VPA. Associations were independent of child age, sex, BMI Z-score and socioeconomic status. Children born to normal-weight mothers did not differ in either IQ or global FA by time in VPA.

Conclusions

Our findings support findings in rodent models and suggest that VPA during childhood modifies the relationship between prenatal exposure to maternal obesity and child IQ and white matter microstructure.

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Fig. 1: IQ scores and global FA for children above and below median VPA.
Fig. 2: TBSS results show clusters where FA was greater for children who engaged in above the median VPA compared to children below the median VPA.
Fig. 3: Interaction between maternal pre-pregnancy weight status and VPA levels on child IQ score and global FA.

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Data availability

The datasets generated during and analyzed during the current study are available from the corresponding author (KAP), on reasonable request.

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Acknowledgements

The authors would like to thank the families who participate in the BrainChild Study. The authors would also like to thank Ana Romero for managing the BrainChild study, Alexis Defendis for study assistance, Mayra Martinez and Janet Mora-Marquez for recruiting volunteers, the staff at Dana and David Dornsife Cognitive Neuroimaging Center at USC and the staff at the USC Diabetes and Obesity Research Institute.

Funding

This work was supported by an American Diabetes Association Pathway Accelerator Award (#1-14-ACE-36) (PI: KAP) and in part by the National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) R01DK116858 (PIs: KAP, AHX) and the National Institute Of Mental Health of the National Institutes of Health under Award Number F31MH115640 (PI: JMA). A Research Electronic Data Capture, REDCap, database was used for this study, which is supported by the Southern California Clinical and Translational Science Institute (SC CTSI) through NIH UL1TR001855.

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Author notes

  1. These authors contributed equally: Anny H. Xiang, Kathleen A. Page

  2. These authors jointly supervised this work: Anny H. Xiang, Kathleen A. Page

Authors and Affiliations

  1. Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA

    Jasmin M. Alves, Brendan C. Angelo, Alexandra G. Yunker, Shan Luo & Kathleen A. Page

  2. Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA

    Jasmin M. Alves, Brendan C. Angelo, Alexandra G. Yunker, Shan Luo & Kathleen A. Page

  3. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90032, USA

    Jennifer Zink, Britni Ryan Belcher & Megan M. Herting

  4. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91101, USA

    Ting Chow & Anny H. Xiang

  5. Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA

    Kristi Clark

  6. Division of Population Sciences, Department of Medical Oncology, Dana-Farber Institute, Harvard Medical School, Boston, MA, 02215, USA

    Christina M. Dieli-Conwright

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Contributions

KAP and AHX had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis; KAP, SL and AHX contributed to study concept and design; JMA, KAP and AHX drafted the manuscript; All authors critically revised the manuscript for intellectual content; Statistical and neuroimaging analyses were performed by JMA, BCA, JZ, TC, and AHX; MMH, and KC provided content knowledge and feedback for neuroimaging analyses; BRB and CDC provided content knowledge and feedback for physical activity and statistical methodology; KAP and AHX obtained funding; KAP and AHX provided study supervision.

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Correspondence to Kathleen A. Page.

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Alves, J.M., Angelo, B.C., Zink, J. et al. Child physical activity as a modifier of the relationship between prenatal exposure to maternal overweight/obesity and neurocognitive outcomes in offspring. Int J Obes 45, 1310–1320 (2021). https://doi.org/10.1038/s41366-021-00794-6

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