{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:39:11Z","timestamp":1792654751094,"version":"4.5.0"},"reference-count":98,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiometabolic complications in pregnancy may alter the intrauterine environment, influence offspring biological ageing and potentially increase the risk of chronic diseases later in life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis aimed to examine associations between diabetes in pregnancy, hypertensive disorders of pregnancy, maternal BMI and metabolic syndrome, and offspring biological ageing markers, including telomere length and DNA methylation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Studies were retrieved from PubMed, EMBASE, Scopus and Web of Science.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection and Data Extraction<\/jats:title>\n                    <jats:p>Study characteristics, exposures and outcomes were independently extracted and summarised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Synthesis<\/jats:title>\n                    <jats:p>Standardised mean differences in telomere length were calculated using Hedges' g, and random effects meta\u2010analysis was applied to pool effect estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 123 studies, 90 assessed DNA methylation, 28 reported telomere length and 5 reported both outcomes. No differences in telomere length were observed in offspring exposed to gestational diabetes (7 studies) or hypertensive disorders (14 studies). Each unit increase in maternal BMI was associated with a 0.27% decrease in offspring telomere length (3 studies). Exposure to cardiometabolic complications was associated with aberrant DNA methylation patterns in genes related to cardiometabolic pathways. Higher mean methylation level was reported in cord blood (2 studies) and placenta (7 studies) following exposure to diabetes and hypertensive disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher maternal BMI was associated with slightly shorter offspring telomeres, while no differences were observed following exposure to gestational diabetes or hypertensive disorders. Altered DNA methylation in cardiometabolic genes suggests epigenetic effects of in utero exposure, although heterogeneity in biospecimens and measurement methods limits definitive conclusions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ppe.70206","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:54:35Z","timestamp":1792652075000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiometabolic Complications in Pregnancy and Biological Ageing in the Offspring: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8558-1718","authenticated-orcid":false,"given":"Eskedar Getie","family":"Mekonnen","sequence":"first","affiliation":[{"name":"College of Health, School of Medicine Adelaide University  Adelaide South Australia Australia"},{"name":"Robinson Research Institute Adelaide University  Adelaide South Australia Australia"},{"name":"South Australian Health and Medical Research Institute (SAHMRI), Lifelong Health Theme  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8431-5338","authenticated-orcid":false,"given":"Tina","family":"Bianco\u2010Miotto","sequence":"additional","affiliation":[{"name":"Robinson Research Institute Adelaide University  Adelaide South Australia Australia"},{"name":"College of Science, School of Agriculture, Food and Wine, Waite Research Institute Adelaide University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9413-6782","authenticated-orcid":false,"given":"Kai","family":"Liu","sequence":"additional","affiliation":[{"name":"College of Health, School of Medicine Adelaide University  Adelaide South Australia Australia"},{"name":"Robinson Research Institute Adelaide University  Adelaide South Australia Australia"},{"name":"South Australian Health and Medical Research Institute (SAHMRI), Lifelong Health Theme  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1515-948X","authenticated-orcid":false,"given":"Jessica A.","family":"Grieger","sequence":"additional","affiliation":[{"name":"College of Health, School of Medicine Adelaide University  Adelaide South Australia Australia"},{"name":"Robinson Research Institute Adelaide University  Adelaide South Australia Australia"},{"name":"South Australian Health and Medical Research Institute (SAHMRI), Lifelong Health Theme  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2020.611929","article-title":"Nutrition and Metabolic Adaptations in Physiological and Complicated Pregnancy: Focus on Obesity and Gestational Diabetes","volume":"11","author":"Parrettini S.","year":"2020","journal-title":"Frontiers in Endocrinology"},{"issue":"2","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"89","DOI":"10.5830\/CVJA-2016-021","article-title":"Physiological Changes in Pregnancy","volume":"27","author":"Soma\u2010Pillay P.","year":"2016","journal-title":"Cardiovascular Journal of Africa"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabres.2021.109050","article-title":"IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group's Criteria","volume":"183","author":"Wang H.","year":"2022","journal-title":"Diabetes Research and Clinical Practice"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","DOI":"10.3389\/fgwh.2025.1533843","article-title":"Global, Regional, and National Trends and Burden of Hypertensive Disorders in Pregnancy Among Women of Childbearing Age From 1990 to 2021","volume":"6","author":"Tang Z.","year":"2025","journal-title":"Frontiers in Global Women's Health"},{"issue":"4","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1038\/s41366-026-02021-6","article-title":"Changes in Body Mass Index Among Pregnant Women During Labor Over Four Decades: A Retrospective Longitudinal Analysis","volume":"50","author":"Ga\u0161parov\u00e1 P.","year":"2026","journal-title":"International Journal of Obesity"},{"issue":"1","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1056\/NEJMra0708473","article-title":"Effect of In Utero and Early\u2010Life Conditions on Adult Health and Disease","volume":"359","author":"Gluckman P. 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