Multigenerational Cardiometabolic Risk as a Predictor of Birth Outcomes: The Bogalusa Heart Study

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To examine the relationship between generation 1 (grandmaternal) cardiometabolic risk factors and generation 3 (grandchild's) birthweight and gestational age.

Study Design

Mother-daughter pairs in the Bogalusa Heart Study (1973-present) were linked to their children's birth certificates; women were also interviewed about their reproductive histories, creating a 3-generation linkage including 177 generation 1 (grandmothers), 210 generation 2 (mothers), and 424 generation 3 (children). Prepregnancy cardiometabolic risk factors (body mass index [BMI], lipids, glucose) or generation 1 (mean age 16.2 years) and 2 (mean age 11.1 years) were examined as predictors of generation 3 birthweight and gestational age using linear and logistic regression with adjustment for age, race, parity, and other confounders.


Generation 2 higher BMI was associated with higher birthweight (28 g per 1 unit, 95% CI 12-44) and gestational age (0.08 weeks, 95% CI 0.02-0.14) in generation 3, and generation 1 higher BMI was associated with higher birthweight (52 g, 95% CI 34-70) in the generation 2. Generation 1's higher glucose levels were associated with higher birthweight in generation 3 (adjusted beta 111 g, 95% CI 33-189), and triglycerides (adjusted beta −21, 95% CI −43-0) and low-density lipoprotein (adjusted beta −24, 95% CI −48-0) were associated with lower birthweight.


These results suggest the possibility of multigenerational developmental programming of birth outcomes, although mechanisms (whether biological or environmental) are undetermined.

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