Association Between Maternal Prepregnancy and Pregnancy Body Mass Index and Children's Telomere Length: A Systematic Review and Meta-analysis

Context Telomeres maintain chromosome stability and mark cellular aging, and their shortening with age compromises genomic stability. Objective The purpose of this study was to conduct a meta-analysis of existing evidence to evaluate the relationship between the maternal pregnancy body mass index (BMI) and children's telomere length (TL). Data Source Web of Science, Scopus, and PubMed databases were systematically searched from their inception to August 27, 2023, for pertinent observational studies. Data Extraction The random-effects meta-analysis was conducted on eligible studies that investigated the linear relationship between exposure and the outcomes of interest, utilizing the reported beta-coefficient. Cochran's Q test and I2 statistics were used to assess heterogeneity. Data Analysis A significant association was observed between maternal pregnancy BMI and children's TL (32 studies, pooled effect size [ES]: -0.04; 95% CI: -0.06 to -0.01; I2 = 47.51%, P < .001) and maternal prepregnancy BMI and children's TL at birth (16 studies; pooled ES: -0.05; 95% CI: -0.08 to -0.02; I2 = 53.49%, P < .001). Conclusion The findings indicate an inverse association between maternal prepregnancy BMI and TL in infants, which is evident within the normal to obese BMI range. This underscores the significance of maternal weight status before pregnancy as a determinant of offspring TL. Systematic Review Registration PROSPERO registration no. CRD42023466425.