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      Prenatal determinants of physical activity and cardiorespiratory fitness in adolescence – Northern Finland Birth Cohort 1986 study

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          Abstract

          Background

          Lower levels of physical activity and cardiorespiratory fitness are key risk factors of chronic adult diseases. Physical activity and cardiorespiratory fitness are predicted by birth weight, but the underlying parental and pregnancy-related factors remain largely unknown. We examined how prenatal determinants are associated with physical activity and cardiorespiratory fitness in adolescence.

          Methods

          Of the 16-year-old members of the population-based Northern Finland Birth Cohort 1986 (NFBC 1986), 6682 singletons with no major physical disability reported their amount of physical activity outside school hours, and 4706 completed a submaximal cycle ergometer test assessing cardiorespiratory fitness. Physical activity was expressed as metabolic equivalent hours per week (METh/week) and cardiorespiratory fitness as peak oxygen uptake (ml·kg −1·min −1). Prenatal determinants included birth weight, length of gestation, mother’s and father’s body mass index (BMI), maternal gestational diabetes mellitus (GDM), and maternal hypertension and smoking during pregnancy. Data were analyzed by multiple linear regression.

          Results

          A higher birth weight and longer length of gestation predicted lower levels of physical activity and cardiorespiratory fitness at 16 years, although the association between length of gestation and physical activity was inverse U-shaped. Mother’s or father’s overweight or obesity before pregnancy were associated with lower levels of their offspring’s physical activity and fitness in adolescence. Adjusting for maternal pregnancy disorders and the adolescent’s own BMI attenuated the associations with the mother’s but not the father’s overweight/obesity. Furthermore, maternal GDM predicted lower cardiorespiratory fitness.

          Conclusions

          A high birth weight and parental overweight/obesity are associated with lower levels of both physical activity and cardiorespiratory fitness in adolescence, while maternal GDM and longer length of gestation are associated with lower cardiorespiratory fitness. Both long and short lengths of gestation predict low physical activity.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-017-4237-4) contains supplementary material, which is available to authorized users.

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          Most cited references35

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          Growth at Adolescence

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            The role of size at birth and postnatal catch-up growth in determining systolic blood pressure: a systematic review of the literature.

            To conduct a systematic review in order to (i) summarize the relationship between birthweight and blood pressure, following numerous publications in the last 3 years, (ii) assess whether other measures of size at birth are related to blood pressure, and (iii) study the role of postnatal catch-up growth in predicting blood pressure. All papers published between March 1996 and March 2000 that examined the relationship between birth weight and systolic blood pressure were identified and combined with the papers examined in a previous review. More than 444,000 male and female subjects aged 0-84 years of all ages and races. Eighty studies described the relationship of blood pressure with birth weight The majority of the studies in children, adolescents and adults reported that blood pressure fell with increasing birth weight, the size of the effect being approximately 2 mmHg/kg. Head circumference was the only other birth measurement to be most consistently associated with blood pressure, the magnitude of the association being a decrease in blood pressure by approximately 0.5 mmHg/cm. Skeletal and non-skeletal postnatal catch-up growth were positively associated with blood pressure, with the highest blood pressures occurring in individuals of low birth weight but high rates of growth subsequently. Both birth weight and head circumference at birth are inversely related to systolic blood pressure. The relationship is present in adolescence but attenuated compared to both the pre- and post-adolescence periods. Accelerated postnatal growth is also associated with raised blood pressure.
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              Pre-eclampsia is associated with increased risk of stroke in the adult offspring: the Helsinki birth cohort study.

              Women who develop pre-eclampsia in pregnancy are at increased risk of cardiovascular disease. The offspring from pregnancies complicated by pre-eclampsia have higher blood pressures during childhood, but little is known about their long-term health. We hypothesized that pre-eclampsia would lead to an increased risk of cardiovascular disease in the offspring. We traced 6410 babies born in Helsinki, Finland, from 1934 to 1944. We used the mothers' blood pressure levels and the presence of proteinuria during pregnancy to define pre-eclampsia and gestational hypertension without proteinuria according to modern criteria. Two hundred eighty-four of the pregnancies were complicated by pre-eclampsia (120 with nonsevere and 164 with severe disease) and 1592 by gestational hypertension. The crude hazard ratio for all forms of stroke among people whose mothers had pre-eclampsia was 1.9 (1.2 to 3.0; P=0.01); among people whose mothers had gestational hypertension, it was 1.4 (1.0 to 1.8; P=0.03). There was no evidence that these pregnancy disorders were associated with coronary heart disease in the offspring. Pre-eclampsia, in particular severe disease, was associated with a reduced mean head circumference at birth, whereas gestational hypertension was associated with an increased head circumference in relation to body length. People born after pregnancies complicated by pre-eclampsia or gestational hypertension are at increased risk of stroke. The underlying processes may include a local disorder of the blood vessels of the brain as a consequence of either reduced brain growth or impaired brain growth leading to "brain-sparing" responses in utero.
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                Author and article information

                Contributors
                marjaana.tikanmaki@thl.fi
                tuija.tammelin@likes.fi
                marja.vaarasmaki@oulu.fi
                marika.sipola-leppanen@thl.fi
                satu.miettola@thl.fi
                anneli.pouta@thl.fi
                m.jarvelin@imperial.ac.uk
                eero.kajantie@thl.fi
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                20 April 2017
                20 April 2017
                2017
                : 17
                : 346
                Affiliations
                [1 ]ISNI 0000 0001 1013 0499, GRID grid.14758.3f, , Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, ; Oulu and Helsinki, Finland
                [2 ]ISNI 0000 0001 0941 4873, GRID grid.10858.34, Institute of Health Sciences, , University of Oulu, ; Oulu, Finland
                [3 ]LIKES Research Center for Physical Activity and Health, Jyväskylä, Finland
                [4 ]ISNI 0000 0004 4685 4917, GRID grid.412326.0, Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, , Oulu University Hospital and University of Oulu, ; Oulu, Finland
                [5 ]ISNI 0000 0001 1013 0499, GRID grid.14758.3f, , Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, ; Oulu, Finland
                [6 ]ISNI 0000 0001 1013 0499, GRID grid.14758.3f, , Department of Government Services, National Institute for Health and Welfare, ; Helsinki, Finland
                [7 ]ISNI 0000 0001 2113 8111, GRID grid.7445.2, , Department of Epidemiology and Biostatistics, MRC–PHE Centre for Environment & Health, School of Public Health, Imperial College London, ; London, UK
                [8 ]ISNI 0000 0001 0941 4873, GRID grid.10858.34, Center for Life Course Epidemiology, Faculty of Medicine, , University of Oulu, ; Oulu, Finland
                [9 ]ISNI 0000 0001 0941 4873, GRID grid.10858.34, , Biocenter Oulu, ; Oulu, Finland
                [10 ]ISNI 0000 0004 4685 4917, GRID grid.412326.0, , Unit of Primary Care, Oulu University Hospital, ; Oulu, Finland
                [11 ]ISNI 0000 0004 0410 2071, GRID grid.7737.4, Children’s Hospital, Helsinki University Hospital, , University of Helsinki, ; Helsinki, Finland
                Article
                4237
                10.1186/s12889-017-4237-4
                5399469
                28427374
                33536bc4-8e1d-42ba-890a-d97f81cdef26
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 27 September 2016
                : 6 April 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100002341, Suomen Akatemia;
                Award ID: SALVE program for 2009–2012 and grants 127437, 129306,130326, 134791 and 263924
                Award Recipient :
                Funded by: Doctoral Programme for Public Health, University of Tampere
                Funded by: FundRef http://dx.doi.org/10.13039/501100004756, Emil Aaltosen Säätiö;
                Funded by: FundRef http://dx.doi.org/10.13039/501100004966, Fifth Framework Programme;
                Award ID: QLG1-CT-2000-001643
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100005744, Lastentautien Tutkimussäätiö;
                Funded by: Finnish Medical Society, Duodecim
                Funded by: FundRef http://dx.doi.org/10.13039/100010125, Jalmari ja Rauha Ahokkaan Säätiö;
                Funded by: FundRef http://dx.doi.org/10.13039/501100004037, Juho Vainion Säätiö;
                Funded by: The National Graduate School for Clinical Investigation
                Funded by: Novo Nordisk Foundation
                Funded by: FundRef http://dx.doi.org/10.13039/501100004325, Signe ja Ane Gyllenbergin Säätiö;
                Funded by: FundRef http://dx.doi.org/10.13039/501100006306, Sigrid Juséliuksen Säätiö;
                Funded by: FundRef http://dx.doi.org/10.13039/100010114, Yrjö Jahnssonin Säätiö;
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Public health
                exercise,birth weight,length of gestation,preterm birth,gestational diabetes,gestational hypertension,obesity,overweight,smoking during pregnancy,cardiometabolic risk factors

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