Adriëtte Oostvogels

9 General conclusion In this thesis, associations were examined between maternal characteristics and (in particular) maternal pBMI and offspring’s cardiometabolic profile in childhood, with a focus on early pregnancy lipid profile, family history of diabetes and postnatal growth as potential underlying mechanisms in this association. Moreover, maternal ethnicity, socioeconomic status and sex of the child were studies in relation to cardiometabolic profile in childhood. The work presented in this thesis indicates that: 1. High maternal pBMI, an atherogenic early pregnancy lipid profile, both a maternal and paternal family history of diabetes, and accelerated postnatal growth, are all independently associated with an adverse cardiometabolic profile at age 5-6 years. 2. Maternal early pregnancy lipid profile and postnatal growth do not mediate the association between maternal pBMI and offspring’s cardiometabolic profile at age 5-6 years. 3. Accelerated postnatal growth modifies the association between pBMI and cardiometabolic profile at age 5-6 years, with the most detrimental outcomes found in children of overweight mothers with accelerated postnatal weight gain or weight-for-length gain. 4. Children with overweight at age 5-6 years and a lower socioeconomic background have a lower BMI during the first 2 years but increase rapidly in BMI, resulting in a higher BMI at age 7 years, compared to children with overweight at age 5-6 years and a higher socioeconomic background. 5. Maternal overweight has a stronger effect on girls than boys, related to faster postnatal growth and an adverse cardiometabolic profile in childhood. 235 General discussion