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Adiposity and cardiovascular outcomes in three-year-old children of participants in UPBEAT, an RCT of a complex intervention in pregnant women with obesity

Research output: Contribution to journalArticlepeer-review

on behalf of the UPBEAT consortium

Original languageEnglish
Article numbere12725
JournalPediatric Obesity
Issue number3
Accepted/In press7 Aug 2020
PublishedMar 2021

Bibliographical note

Funding Information: Supported by the European Union's 7th Framework Programme (FP7/2007‐2013), project EarlyNutrition; grant agreement no. 289346 and the National Institute for Health Research (NIHR) (UK) Programme Grants for Applied Research Programme (RP‐0407‐10452). The contributions of HLM and DAL are supported by the European Research Council under the European Union's Seventh Framework Programme (FP7/2007‐2013) ERC grant agreement No 669545 (DevelopObese), the US National Institute of Health (R01 DK10324) and the NIHR Biomedical Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol. HLM and DAL work in a Unit that receives support from the UK Medical Research Council (MC_UU_00011/6). Support was also provided by the Chief Scientist Office Scotland, Guy's and St Thomas' Charity and Tommy's Charity (Registered charity no. 1060508). KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the European Union (Erasmus+ Capacity‐Building ENeASEA (573651‐EPP‐1‐2016‐1‐DE‐EPPKA2‐CBHE‐JP) and ImpENSA (598488‐EPP‐1‐2018‐1‐DE‐EPPKA2‐CBHE‐JP) projects), the US National Institute On Aging of the National Institutes of Health (Award No. U24AG047867) and the UK ESRC and BBSRC (Award No. ES/M00919X/1). LP, ACF, SLW an ALB are funded by Tommy's Charity and KVD is supported by the British Heart Foundation FS/17/71/32953. PTS is partly funded by King's Health Partners Institute of Women and Children's Health (KHP), Tommy's and by ARC South London (NIHR). DAL is a NIHR Senior Investigator (NF‐0616‐10102), KMG is a NIHR Senior Investigator (NF‐SI‐0515‐10042) and LP is an NIHR Senior Investigator Emeritus (NI‐SI‐0512‐10104). KMG is supported by the NIHR Southampton Biomedical Research Centre. This research was funded/supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London and/or the NIHR Clinical Research Facility. The views expressed are those of the author(s) and not necessarily those of the NHS, KHP, the NIHR or the Department of Health. The funders had no role in study design, data collection, data analysis, data interpretation or writing of the final report. The corresponding author had access to all the data in the study and had final responsibility for the decision to submit for publication. Funding information Publisher Copyright: © 2020 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Background: Maternal obesity is associated with offspring cardiometabolic risk. UPBEAT was a randomised controlled trial of an antenatal diet and physical activity intervention in 1,555 women with obesity. The intervention was associated with lower gestational weight gain, healthier diet and metabolic profile in pregnancy, and reduced infant adiposity at six months.
Objective: We have investigated whether the UPBEAT intervention influenced childhood cardiometabolic outcomes or was associated with sustained improvements in maternal lifestyle 3-years after delivery.
Methods: In UPBEAT mother-child dyads at the 3-year follow-up, we assessed childhood blood pressure, resting pulse rate, and adiposity (body mass index, skinfold thicknesses, body fat, waist and arm circumferences) and maternal diet, physical activity, and anthropometry.
Results: 514 three-year-old children attended the appointment (49% intervention, 51% standard care). There was no difference in the main outcome of interest, subscapular skinfold thickness, between the trial arms (-0.30mm, 95% confidence interval: -0.92, 0.31). However, the intervention was associated with a lower resting pulse rate (-5bpm (-8.41, -1.07)). There was also a non-significant lower odds of overweight/obesity (OR 0.73; 0.50, 1.08). Maternal dietary improvements observed in the UPBEAT trial, including glycaemic load and saturated fat were maintained 3-years postpartum.
Conclusion: This study has demonstrated that an antenatal dietary and physical activity intervention in women with obesity is associated with lower offspring pulse rate and sustained improvement in maternal diet. Whilst larger than previous cohorts, there remains potential for bias from attrition and these findings require validation in future cohorts.

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