1. Children of mothers who gained an excessive amount of weight during pregnancy, as well as those of mothers who gained a high amount of weight in the years following their pregnancy, had a greater risk of being overweight in childhood than children whose mothers gained either an inadequate and adequate amount of weight.
2. Excessive maternal gestational weight gain (GWG) and high weight gain after pregnancy were independently associated with the risk of children being overweight.
Evidence Rating Level: 2 (Good)
Study Rundown: Previous research has demonstrated that maternal GWG is a risk factor for the development of childhood obesity. It is unclear whether or not this association is due to a programming effect on the child or if this is related to the unhealthy environment affecting the child. Authors of the current study sought to determine the combined effect of these 2 factors on a child’s weight up to adolescence. Children from mothers who gained the most weight during pregnancy were more likely to be overweight throughout their childhood. Children whose mothers gained the most weight after delivery had greater increases in weight up to age 14. Children with the highest risk of being overweight at age 14 had mothers who gained excessive weight both during pregnancy and after pregnancy. These findings are limited by self-report of maternal weight and the use of maternal post-pregnancy weight gain as a proxy for an obesogenic environment. Nonetheless, these results should encourage providers to counsel pregnant women about maintaining a healthy weight throughout pregnancy and into the future.
In-Depth [prospective cohort]: A total of 3367 mother and child pairs from a Dutch birth cohort were used for analysis. Each child’s height and weight were recorded at ages 3 months, annually from 1-8 years, and at age 11 and 14 years. GWG was defined as inadequate, adequate, or excessive with gain based on the Institute of Medicine’s recommendations. Maternal weight was self-reported at ages 1, 8, and 14 years, and post-delivery weight gain was classified as low (<0.5 kg/year), moderate (0.5-1 kg/year), and high (≥1 kg/year). Excessive GWG was associated with first pregnancies (p<.0001), maternal smoking (p <.0001), and heavier children at birth (p<.0001). Children of these mothers had increased odds of being overweight throughout childhood (OR 1.20; 95% CI 0.99-1.46). Children of mothers with the highest post-delivery weight gain were more likely to be overweight at age 8 than children whose mothers gained a low or moderate amount of weight (OR 1.41; 95% CI 0.99-2.00). The highest odds of being overweight at age 14 were seen in children of mothers who had excessive GWG as well as high post-delivery weight gain (OR 3.53; 95% CI, 1.70-7.33).
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