Abstract
Objective
To quantify the combined effect of maternal prepregnancy obesity and maternal gestational
weight gain (GWG) on the shape of infant growth throughout the first year of life.
Methods
A retrospective cohort of mother–child dyads with children born between January 2007
and May 2012 was identified in a linked electronic medical record. Data were abstracted
to define the primary exposures of maternal prepregnancy body mass index (BMI) and
GWG, and the primary outcome of infant growth trajectory.
Results
We included 499 mother–child dyads. The average maternal age was 28.2 years; 55% of
mothers were overweight or obese before pregnancy, and 42% of mothers had excess GWG,
as defined by the Institute of Medicine. Maternal prepregnancy BMI (P < .001) and the interaction between prepregnancy BMI and maternal GWG (P = .02) showed significant association with infant growth trajectory through the first
year of life after controlling for breast-feeding and other covariates, while GWG
alone did not reach statistical significance (P = .38). Among infants of mothers with excess GWG, a prepregnancy BMI of 40 kg/m2 versus 25 kg/m2 resulted in a 13.6% (95% confidence interval 5.8, 21.5; P < .001) increase in 3-month infant weight/length percentile that persisted at 12
months (8.4%, 95% confidence interval 0.2, 16.5; P = .04).
Conclusions
The combined effect of excess maternal GWG and prepregnancy obesity resulted in higher
infant birth weight, rapid weight gain in the first 3 months of life, with a sustained
weight elevation throughout the first year of life. These findings highlight the importance
of the preconception and prenatal periods for pediatric obesity prevention.
Keywords
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Article info
Publication history
Accepted:
May 12,
2014
Received:
February 6,
2014
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
