PEACHES

Early detection of obesity risk in children of obese mothers - A project of the Molecular Nutrition Research Group at the Research Centre of the Children's Hospital of Ludwig-Maximilians-Universität München (LMU).

More than one in three women in Bavaria is overweight at the beginning of pregnancy. This quadruples the risk of the child also developing obesity. Half of all children born to these mothers will be overweight or obese as adolescents. The obesity epidemic is a global challenge, but there is a lack of concepts for targeted prevention.

The project aims to recognise the risk of obesity in the offspring of overweight mothers at an early stage.

Between 2010 and 2015, mother-child pairs with a risk constellation were recruited and examined in 24 Bavarian maternity clinics. The examinations include blood tests, physical examinations and a nutritional survey. The test subjects are accompanied as follows:

• Initial examination during pregnancy
• The first examination of the newborn 3 months after birth
• Maternal follow-up examination 3 years after birth
• Follow-up examination of the child around the 5th birthday
• Nutritional counselling
• The child's weight progress and a questionnaire on nutrition are reported back via the paediatricians and families at yearly intervals
• Participation ends at the child's 5th birthday

At the time of birth, a blood sample is taken from the mother to determine her long-term blood glucose level, while an umbilical cord blood test and a buccal swab are carried out on the newborn. In addition, a personal interview is conducted with the mother in the first four to six weeks postpartum to determine her nutritional behaviour during pregnancy and the child's state of health. In addition to anthropometric surveys and a blood sample, a further buccal swab is repeated in a follow-up with the infant after three months. After this, a questionnaire is collected annually, which covers a variety of factors in addition to the child's development, including nutritional and exercise behaviour. Furthermore, examinations are carried out on mother and child to determine a possible cardiometabolic disease risk after a pregnancy with a diabetic and/or obese metabolic condition: consequently, a health check is carried out on the mother three years after the birth and a pre-school follow-up on the child at the age of 5. A primary school follow-up is also planned, in which gene markers and the microbiome of the mother and child will be analysed in addition to anthropometric surveys.

The focus of our research is on:

• Investigating the mechanisms of ‘foetal programming’, a still poorly understood process that is controlled by the mother's metabolic environment and is essential for the development of the foetus and its lifelong health
• Detection of metabolites that may indicate a later risk of obesity in the child
• Monitoring of long-term postpartum complications due to gestational diabetes and/or obesity in both mothers and children

The aim is to develop indicators for the early detection of obesity and establish reliable, early preventive measures.

The study started in 2010 and is scheduled to run until 2027. An extension for long-term observation is planned. Funding comes from resources of the Federal Ministry of Education and Research, the Foundation for Cardiovascular Prevention in Children at the Ludwig Maximilian University of Munich, the Federal Ministry of Nutrition and Agriculture and its Max Rubner-Institute.