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Background <p>The association between birthweight and cardiometabolic risk factors in offspring remains incompletely elucidated. Clarifying this relationship is crucial for understanding the origins of developmental disorders and identifying early risk factors. This systematic review and meta-analysis aimed to assess the association of birthweight with anthropometric nutritional status and blood pressure in offspring, and secondarily to evaluate its association with lipid and glucose metabolism.</p> Methods <p>PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to September 30, 2025. Data were extracted using a standardized form, which included the title, first author, publication year, country, baseline characteristics of participants, exposure variables, grouping method, and outcome measures. The quality of the included studies was assessed using the Newcastle-Ottawa Scale(NOS). Primary endpoints (obesity, overweight, and blood pressure) were pooled and reported as odds ratios (OR) with 95% confidence intervals. A fixed-effects model was used when between-study heterogeneity was low (<i>I²</i>&lt;50%); otherwise, a DerSimonian-Laird random-effects model was used.</p> Results <p>A total of 33 cohort studies involving 8,241,597 children were included. High birthweight (≥ 4,000&#xa0;g) was associated with a higher odds of obesity (OR = 1.62, 95% CI: 1.33–1.95; <i>I²</i>=96.9%) and overweight (OR = 1.51, 95% CI: 1.22–1.86; <i>I²</i>=77.5%). Conversely, low BW (&lt; 2,500&#xa0;g) was associated with a lower odds of obesity (OR = 0.76, 95% CI: 0.71–0.81; <i>I²</i>=0.0%) and overweight (OR = 0.79, 95% CI: 0.71–0.89; <i>I²</i>=0.0%). Birthweight was negatively associated with systolic blood pressure (SBP) (OR = 0.63, 95% CI: 0.42–0.94; <i>I²</i>=4.2%), although no association was observed between birthweight and diastolic blood pressure (DBP).</p> Conclusion <p>High birthweight was associated with a higher likelihood of developing obesity and overweight during childhood and adolescence, while birthweight was negatively correlated with SBP.</p> Trial registration <p>CRD42024565031.</p>

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Birthweight and cardiometabolic risk factors in offspring: A systematic review and meta-analysis of cohort studies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月7日

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  • Chengbi Zhu,
  • Yali Ding,
  • Li Chen,
  • Siming Zhai,
  • Yaqun Li

摘要

Background

The association between birthweight and cardiometabolic risk factors in offspring remains incompletely elucidated. Clarifying this relationship is crucial for understanding the origins of developmental disorders and identifying early risk factors. This systematic review and meta-analysis aimed to assess the association of birthweight with anthropometric nutritional status and blood pressure in offspring, and secondarily to evaluate its association with lipid and glucose metabolism.

Methods

PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to September 30, 2025. Data were extracted using a standardized form, which included the title, first author, publication year, country, baseline characteristics of participants, exposure variables, grouping method, and outcome measures. The quality of the included studies was assessed using the Newcastle-Ottawa Scale(NOS). Primary endpoints (obesity, overweight, and blood pressure) were pooled and reported as odds ratios (OR) with 95% confidence intervals. A fixed-effects model was used when between-study heterogeneity was low (I²<50%); otherwise, a DerSimonian-Laird random-effects model was used.

Results

A total of 33 cohort studies involving 8,241,597 children were included. High birthweight (≥ 4,000 g) was associated with a higher odds of obesity (OR = 1.62, 95% CI: 1.33–1.95; I²=96.9%) and overweight (OR = 1.51, 95% CI: 1.22–1.86; I²=77.5%). Conversely, low BW (< 2,500 g) was associated with a lower odds of obesity (OR = 0.76, 95% CI: 0.71–0.81; I²=0.0%) and overweight (OR = 0.79, 95% CI: 0.71–0.89; I²=0.0%). Birthweight was negatively associated with systolic blood pressure (SBP) (OR = 0.63, 95% CI: 0.42–0.94; I²=4.2%), although no association was observed between birthweight and diastolic blood pressure (DBP).

Conclusion

High birthweight was associated with a higher likelihood of developing obesity and overweight during childhood and adolescence, while birthweight was negatively correlated with SBP.

Trial registration

CRD42024565031.