Increased Gestational Weight Gain is Associated with a Higher Risk of Offspring Adiposity Before Five Years of Age: A Population-Based Cohort Study

Abstract

Objective

We aim to investigate the influence of weight gain during pregnancy on the risk of offspring adiposity before five years old.

Methods

We retrospectively collected health information from the Tianjin mother-child cohort. Offspring outcome was BMI Z-score and prevalence of childhood adiposity from 0.5–5 years old. Gestational weight gain was analyzed using continuous and categorical variables evaluated by the IOM guidelines. Multivariate analysis adjusted maternal age, prepregnancy BMI, maternal height, smoking, cesarean section, gestational age at birth, birth weight, birth length, and mode of infant feeding during 0–6 months.

Results

Gestational weight gain contributed to offspring’s BMI Z-score from 1–5 years old, and the effect was most obvious in the first half of pregnancy (multivariate analysis, at 1, 2, 2.5, 3, 4, and 5 years of age: β 0.011, 95% CI 0.008–0.014; β 0.017, 95% CI 0.015–0.020; β 0.005, 95%CI 0.002-0.008; β 0.018, 95% CI 0.015–0.021; β 0.014, 95% CI 0.009–0.020; β 0.013, 95% CI 0.005–0.021). Excessive weight gain was associated with a higher prevalence of offspring adiposity before five years, even if prepregnancy BMI is normal. Multivariate regression analysis further confirmed that excessive weight gain during the first half of pregnancy significantly increased the risk of childhood obesity at aged one and three (AOR 1.083, 95% CI 1.003–1.169; AOR 1.158, 95% CI 1.036–1.293).

Conclusion

Offspring have a higher risk of preschool adiposity when gestational weight gain was excessive during the first half of pregnancy.

Keywords:

• gestational weight gain
• the first half of pregnancy
• childhood obesity
• retrospective cohort study

Abbreviations

BMI, body mass index; GWG, gestational weight gain; IOM, Institute of Medicine; f-GWG, weight gain during the first half of pregnancy; s-GWG, weight gain during the second half of pregnancy; WHO, World Health Organization; SGA, small for gestational age; LGA, large for gestational age; AGA, appropriate for gestational age; RWG, rapid weight gain.

Ethics Approval and Informed Consent

The study was approved by the Human Subjects Committee of the Tianjin Women’s and Children’s Health Center. Since this was a retrospective analysis of data routinely collected from health information databases. It does not involve sample collection or touching the participants and has almost no risk to the participants. It is objectively impossible to obtain informed consent from the subject. All participant information was kept confidential and anonymous. The Human Subjects Committee of Tianjin Women’s and Children’s Health Center waived the need for informed consent. This study complies with the Declaration of Helsinki.

Acknowledgments

The authors sincerely thank the doctors and nurses in the community hospitals involved in collecting medical information.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declared no conflicts of interest in this work.

Additional information

Funding

This work was funded by Tianjin Key Medical Discipline (Specialty) Construction Project (grant number: TJYXZDXK-075C).