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      Maternal obesity in pregnancy impacts offspring cardiometabolic health: Systematic review and meta‐analysis of animal studies

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          Summary

          Obesity before and during pregnancy leads to reduced offspring cardiometabolic health. Here, we systematically reviewed animal experimental evidence of maternal obesity before and during pregnancy and offspring anthropometry and cardiometabolic health. We systematically searched Embase and Medline from inception until January 2018. Eligible publications compared offspring of mothers with obesity to mothers with a normal weight. We performed meta‐analyses and subgroup analyses. We also examined methodological quality and publication bias. We screened 2543 publications and included 145 publications ( N = 21 048 animals, five species). Essential methodological details were not reported in the majority of studies. We found evidence of publication bias for birth weight. Offspring of mothers with obesity had higher body weight (standardized mean difference (SMD) 0.76 [95% CI 0.60;0.93]), fat percentage (0.99 [0.64;1.35]), systolic blood pressure (1.33 [0.75;1.91]), triglycerides (0.64 [0.42;0.86], total cholesterol (0.46 [0.18;0.73]), glucose level (0.43 [0.24;0.63]), and insulin level (0.81 [0.61;1.02]) than offspring of control mothers, but similar birth weight. Sex, age, or species did not influence the effect of maternal obesity on offspring's cardiometabolic health. Obesity before and during pregnancy reduces offspring cardiometabolic health in animals. Future intervention studies should investigate whether reducing obesity prior to conception could prevent these detrimental programming effects and improve cardiometabolic health of future generations.

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          Most cited references66

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          Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

          In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.
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            Systematic reviews: synthesis of best evidence for clinical decisions.

            Systematic reviews can help practitioners keep abreast of the medical literature by summarizing large bodies of evidence and helping to explain differences among studies on the same question. A systematic review involves the application of scientific strategies, in ways that limit bias, to the assembly, critical appraisal, and synthesis of all relevant studies that address a specific clinical question. A meta-analysis is a type of systematic review that uses statistical methods to combine and summarize the results of several primary studies. Because the review process itself (like any other type of research) is subject to bias, a useful review requires clear reporting of information obtained using rigorous methods. Used increasingly to inform medical decision making, plan future research agendas, and establish clinical policy, systematic reviews may strengthen the link between best research evidence and optimal health care.
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              The global epidemic of obesity: an overview.

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                Author and article information

                Contributors
                s.mintjens@vumc.nl
                Journal
                Obes Rev
                Obes Rev
                10.1111/(ISSN)1467-789X
                OBR
                Obesity Reviews
                John Wiley and Sons Inc. (Hoboken )
                1467-7881
                1467-789X
                11 January 2019
                May 2019
                : 20
                : 5 ( doiID: 10.1111/obr.v20.5 )
                : 675-685
                Affiliations
                [ 1 ] Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Obstetrics and Gynecology, Amsterdam Public Health Research Institute, Amsterdam Reproduction and Development Research Institute Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands
                [ 2 ] Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pediatrics, Department of Obstetrics and Gynecology Amsterdam Public Health Research Institute, Amsterdam Reproduction and Development Research Institute Amsterdam The Netherlands
                [ 3 ] Department of Obstetrics and Gynecology, Amsterdam Public Health Research Institute, Amsterdam Reproduction and Development Research Institute Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands
                [ 4 ] Department of Obstetrics and Gynecology, Amsterdam Reproduction and Development Research Institute Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands
                [ 5 ] MRC Metabolic Diseases Unit and Metabolic Research Laboratories University of Cambridge Cambridge UK
                [ 6 ] Department of Research Support—Medical Library Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands
                [ 7 ] Department for Health Evidence Unit SYRCLE, Department of Anesthesiology Radboud University Medical Center Nijmegen The Netherlands
                [ 8 ] Emma Children's Hospital, Amsterdam UMC University of Amsterdam, Pediatric Cardiology Amsterdam The Netherlands
                Author notes
                [*] [* ] Correspondence

                S. Mintjens, MD, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pediatrics, Department of Obstetrics and Gynecology, Amsterdam Public Health Research Institute, Amsterdam Reproduction and Development Research Institute, de Boelelaan 1118, Amsterdam, The Netherlands.

                Email: s.mintjens@ 123456vumc.nl

                M. D. Menting and S. Mintjens contributed equally to this article. A. W. van Deutekom and R. C. Painter also contributed equally to this article. [Correction added on 28 February 2019, after first online publication: This disclaimer is added in this version.]

                Author information
                https://orcid.org/0000-0002-8018-3921
                Article
                OBR12817 OBR-08-18-3548.R1
                10.1111/obr.12817
                6849816
                30633422
                18988b27-e081-4864-a626-3f4ce653c1bb
                © 2019 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 25 August 2018
                : 19 October 2018
                : 06 November 2018
                Page count
                Figures: 3, Tables: 0, Pages: 11, Words: 4948
                Funding
                Funded by: Dutch Heart Foundation , open-funder-registry 10.13039/501100002996;
                Award ID: 21013T085
                Funded by: Netherlands Organization for Health Research and Development , open-funder-registry 10.13039/501100001826;
                Award ID: 114024105
                Funded by: DynaHealth H2020
                Award ID: 633595
                Categories
                Epigenetics/Obesity Comorbidity
                Epigenetics/Obesity Comorbidity
                Custom metadata
                2.0
                May 2019
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.1 mode:remove_FC converted:12.11.2019

                Medicine
                cardiometabolic health,obesity,pregnancy,systematic review
                Medicine
                cardiometabolic health, obesity, pregnancy, systematic review

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