Research
Obstetrics
Gestational weight gain and child adiposity at age 3 years

https://doi.org/10.1016/j.ajog.2006.11.027Get rights and content

Objective

The purpose of this study was to examine the associations of gestational weight gain with child adiposity.

Study Design

Using multivariable regression, we studied associations of total gestational weight gain and weight gain according to 1990 Institute of Medicine guidelines with child outcomes among 1044 mother-child pairs in Project Viva.

Results

Greater weight gain was associated with higher child body mass index z-score (0.13 units per 5 kg [95% CI, 0.08, 0.19]), sum of subscapular and triceps skinfold thicknesses (0.26 mm [95% CI, 0.02, 0.51]), and systolic blood pressure (0.60 mm Hg [95% CI, 0.06, 1.13]). Compared with inadequate weight gain (0.17 units [95% CI, 0.01, 0.33]), women with adequate or excessive weight gain had children with higher body mass index z-scores (0.47 [95% CI, 0.37, 0.57] and 0.52 [95% CI, 0.44, 0.61], respectively) and risk of overweight (odds ratios, 3.77 [95% CI: 1.38, 10.27] and 4.35 [95% CI: 1.69, 11.24]).

Conclusion

New recommendations for gestational weight gain may be required in this era of epidemic obesity.

Section snippets

Population and study design

Study subjects were participants in Project Viva, a prospective cohort study of pregnant women and their children. We previously reported the recruitment protocols.8 Mothers provided informed consent. The human subjects committee of Harvard Pilgrim Health Care approved all study protocols.

Of 2128 women who delivered a live singleton infant, 1585 women enrolled for continuation beyond 6 months after delivery. At the time of this analysis, 1110 children had completed the study visit at age 3

Results

Mean (SD) maternal prepregnancy BMI was 24.6 kg/m2 (5.0), and total gestational weight gain was 15.6 kg (5.4). Approximately one-third (29%) of mothers had a prepregnancy BMI > 26.0 kg/m2. According to the 1990 Institute of Medicine recommendations, 51% of women gained excessive weight, 35% gained adequate weight, and 14% gained inadequate weight (Table 1). Mean (SD) child BMI z-score was 0.45 units (1.01), and 9% of children were overweight (BMI ≥ 95th percentile for age and sex).

On bivariate

Comment

In this prospective study of over 1000 mother-child pairs, we found that mothers with greater gestational weight gain had children with more adiposity at 3 years of age, measured by skinfold thickness as well as by BMI. This association was independent of parental BMI, maternal glucose tolerance, breastfeeding duration, fetal and infant growth, and child behaviors. Children of mothers who gained more weight also had somewhat higher systolic blood pressure, a cardiovascular risk factor related

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  • Cited by (0)

    Supported by grants from the US National Institutes of Health (HD 34568, HL 64925, HL 68041, HD 44807), the Robert Wood Johnson Foundation, Harvard Medical School, and the Harvard Pilgrim Health Care Foundation.

    Preliminary findings were presented at the International Congress of the Society for Developmental Origins of Health and Disease, Toronto, Canada, November 15-16, 2005.

    Cite this article as: Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol 2007;196:322.e1-322.e8.

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