Adriëtte Oostvogels

14 Chapter 1 Ethnicity and socioeconomic status Both ethnic and socioeconomic disparities in health are commonly reported: ethnic minority women are more often overweight and more often have diabetes mellitus or hypertension. 127-138 This has its consequences for pregnancy, perinatal and offspring health: women of ethnic minority groups or low socioeconomic background are at increased risk of developing pregnancy complications like GDM and/or pregnancy induced hypertension/preeclampsia. 139-141 Moreover, both children of ethnic minority groups and low socioeconomic background tend to have lower birth weight, 142-146 and grow differently compared to children of Dutch origin with a high socioeconomic background. 122,147 This results in a higher prevalence of overweight in children with a non-Dutch origin or low socioeconomic background. 148-154 A stronger emphasis on these high-risk populations in the study of growth to overweight might result in clues for developing interventions and public health strategies to prevent overweight in these children. Research aim and hypotheses The research described in this thesis aims to examine associations of maternal characteristics, particularly maternal pBMI, on offspring’s cardiometabolic profile in early childhood (at age 5-6 years). As presented in this framework it is hypothesised that maternal pBMI affects offspring’s cardiometabolic profile in childhood through 1) an adverse intra-uterine environment, in particular a more atherogenic lipid profile and 2) increased offspring’s postnatal growth. Furthermore, maternal overweight may differentially affect boys and girls, and the growth to overweight may differ by ethnicity and socioeconomic status. Each of the following, more specified hypotheses are tested in this thesis: 1. An adverse cardiometabolic profile at age 5-6 years is the result of maternal overweight before pregnancy, which acts through prenatal exposure to an atherogenic lipid profile. 2. Children with a family history of diabetes on the maternal side of the family are more often overweight and have a more adverse glucose metabolism at age 5-6 years than children with a family history of diabetes on the paternal side of the family. 3. An adverse cardiometabolic profile at age 5-6 years is the result of accelerated postnatal weight, height and BMI gain, which in turn is a consequence of maternal overweight before pregnancy.