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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References
- Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010.JAMA. 2012; 307: 483-490
- Crossing growth percentiles in infancy and risk of obesity in childhood.Arch Pediatr Adolsc Med. 2011; 165: 993-998
- Upward weight percentile crossing in infancy and early childhood independently predicts fat mass in young adults: the Stockholm Weight Development Study (SWEDES).Am J Clin Nutr. 2006; 83: 324-330
- Timing and tempo of first-year rapid growth in relation to cardiovascular and metabolic risk profile in early adulthood.JAMA. 2009; 301: 2234-2242
- Association of weight gain in infancy and early childhood with metabolic risk in young adults.J Clin Endocrinol Metab. 2007; 92: 98-103
- BJOG. 2012; 119: 716-723
- Trajectories of growth among children who have coronary events as adults.N Engl J Med. 2005; 353: 1802-1809
- Weight status in the first 6 months of life and obesity at 3 years of age.Pediatrics. 2009; 123: 1177-1183
- Weight Gain During Pregnancy: Reexamining the Guidelines.National Research Council; Committee to Reexamine IOM Pregnancy Weight Guidelines, Washington, DC2009
- Child health, developmental plasticity, and epigenetic programming.Endocr Rev. 2011; 32: 159-224
- Lifespan: catch-up growth and obesity in male mice.Nature. 2004; 427: 411-412
- The association between pregnancy weight gain and birthweight: a within-family comparison.Lancet. 2010; 376: 984-990
- Fetal origins of obesity.Obes Res. 2003; 11: 496-506
- Gestational weight gain and child adiposity at age 3 years.Am J Obstet Gynecol. 2007; 196: 322.e321-322.e328
- Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis.PLoS One. 2013; 8: e61627
- Obesity, gestational weight gain and preterm birth: a study within the Danish National Birth Cohort.Paediatr Perinat Epidemiol. 2007; 21: 5-14
- Maternal prepregnancy body mass index and gestational weight gain on offspring overweight in early infancy.PLoS One. 2013; 8: e77809
- Research Electronic Data Capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support.J Biomed Inform. 2009; 42: 377-381
- WHO Multicentre Growth Reference Study Group. WHO child growth standards based on length/height, weight and age.Acta Paediatr Suppl. 2006; 450: 76-85
Leroy JL. zscore06: Stata command for the calculation of anthropometric z-scores using the 2006 WHO child growth standards. Available at: http://fmwww.bc.edu/repec/bocode/z/zscore06.hlp. Accessed May 23, 2014.
- Effects of pre-pregnancy obesity, race/ethnicity and prematurity.Matern Child Health J. 2014; 18: 511-517
- Maternal prepregnancy obesity and insulin treatment during pregnancy are independently associated with delayed lactogenesis in women with recent gestational diabetes mellitus.Am J Clin Nutr. 2014; 99: 115-121
- Is the association of breastfeeding with child obesity explained by infant weight change?.Int J Pediatr Obes. 2011; 6: e415-e422
- Pre-pregnancy body mass index, gestational weight gain, and other maternal characteristics in relation to infant birth weight.Matern Child Health J. 2008; 12: 557-567
- Size at birth and early childhood growth in relation to maternal smoking, parity and infant breast-feeding: longitudinal birth cohort study and analysis.Pediatr Res. 2002; 52: 863-867
- Smoking, obesity, and their co-occurrence in the United States: cross sectional analysis.BMJ. 2006; 333: 25-26
- Effects of alcohol use, smoking, and illicit drug use on fetal growth in black infants.J Pediatr. 1994; 124: 757-764
- Hypertension and antihypertensive drugs in pregnancy and perinatal outcomes.Am J Obstet Gynecol. 2013; 208: 301.e301-301.e306
- Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study.Am J Public Health. 2000; 90: 251-257
- Relationship between maternal fasting glucose levels at 4–12 gestational weeks and offspring growth and development in early infancy.Diabetes Res Clin Pract. 2013; 102: 210-217
- The obesity epidemic in the United States—gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis.Epidemiol Rev. 2007; 29: 6-28
- Regression Modeling Strategies: With Applications to Linear Models, Logistic Regression, and Survival Analysis.Springer, New York, NY2001
- A note on the generalized information criterion for choice of a model.Biometrika. 1980; 67: 413-418
- Obesity in young men after famine exposure in utero and early infancy.N Engl J Med. 1976; 295: 349-353
- Maternal prepregnant body mass index, duration of breastfeeding, and timing of complementary food introduction are associated with infant weight gain.Am J Clin Nutr. 2004; 80: 1579-1588
- Excess gestational weight gain is associated with child adiposity among mothers with normal and overweight prepregnancy weight status.J Nutr. 2012; 142: 1851-1858
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.