Objective
The objective of the study was to evaluate the association between gestational weight
gain, per the 2009 Institute of Medicine (IOM) recommendations, and offspring overweight/obesity
at 2-5 years of age.
Study Design
This was a prospective cohort study of 4145 women who completed a health survey (2007-2009)
and subsequently delivered a singleton at Kaiser Permanente Northern California (2007-2010).
Childhood overweight/obesity was defined as a body mass index (BMI) z-score of the
85th percentile or greater of the Centers for Disease Control and Prevention child
growth standards. Gestational weight gain was categorized according to the 2009 IOM
recommendations. Logistic regression was used; meeting the IOM recommendations was
the referent.
Results
Exceeding the IOM recommendations was associated with a 46% increase in odds of having
an overweight/obese child (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.17–1.83),
after adjusting for maternal prepregnancy BMI, race/ethnicity, age at delivery, education,
child age, birthweight, gestational age at delivery, gestational diabetes, parity,
infant sex, total metabolic equivalents, and dietary pattern. The OR (95% CI) for
childhood overweight/obesity among women gaining below the IOM recommendations was
1.23 (0.88–1.71). The associations between gaining outside the IOM recommendations
and childhood obesity were stronger among women with a normal prepregnancy BMI (OR,
1.63; 95% CI, 1.03–2.57) (below); OR, 1.79; 95% CI, 1.32–2.43) (exceeded).
Conclusion
Gestational weight gain outside the IOM recommendations is associated with increased
odds of childhood overweight/obesity, independent of several potential confounders
and mediators. Gestational weight gain had a greater impact on childhood overweight/obesity
among normal-weight women, suggesting that the effect may be independent of genetic
predictors of obesity.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Gestational weight gain and risk of gestational diabetes mellitus.Obstet Gynecol. 2010; 115 (597-60)
- Gestational weight gain, macrosomia, and risk of cesarean birth in nondiabetic nulliparas.Obstet Gynecol. 2004; 104: 671-677
- Gestational weight gain and long-term postpartum weight retention: a meta-analysis.Am J Clin Nutr. 2011; 94: 1225-1231
- Pre-pregnancy body mass index and weight gain during pregnancy in relation to preterm delivery subtypes.Acta Obstet Gynecol Scand. 2008; 87: 510-517
- Associations of gestational weight gain with short- and longer-term maternal and child health outcomes.Am J Epidemiol. 2009; 170: 173-180
- Low gestational weight gain and the risk of preterm birth and low birthweight: a systematic review and meta-analyses.Acta Obstet Gynecol Scand. 2011; 90: 935-954
- Weight gain and spontaneous preterm birth: the role of race or ethnicity and previous preterm birth.Obstet Gynecol. 2006; 108: 1448-1455
- The association between pregnancy weight gain and birthweight: a within-family comparison.Lancet. 2010; 376: 984-990
- Gestational weight gain and child adiposity at age 3 years.Am J Obstet Gynecol. 2007; 196: 322-328
- Basics about childhood obesity.Centers for Disease Control and Prevention, Atlanta, GA2012 (Available at: http://www.cdc.gov/obesity/childhood/basics.html. Accessed April 27, 2012.)
- Risks and consequences of childhood and adolescent obesity.Int J Obes Relat Metab Disord. 1999; 23: S2-S11
- Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010.JAMA. 2012; 307: 483-490
- Weight gain during pregnancy: reexamining the guidelines.The National Academic Press, Washington, DC2009
- Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology.Am J Public Health. 1992; 82: 703-710
- Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study.JAMA. 2001; 285: 2370-2375
- Increasing prevalence of gestational diabetes mellitus: a public health perspective.Diabetes Care. 2007; 30: S141-S146
- An increase in the incidence of gestational diabetes mellitus: Northern California, 1991-2000.Obstet Gynecol. 2004; 103: 526-533
- CDC growth charts.National Center for Health Statistics, Hyattsville, MD2005
- Modern Epidemiology.2nd ed. Lippincott-Raven Publishers, Philadelphia1998
- The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations.J Pers Soc Psychol. 1986; 51: 1173-1182
- Gestational weight gain in accordance to the IOM/NRC criteria and the risk for childhood overweight: a meta-analysis.Pediatr Obes. 2013; 8: 218-224
- Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort study.Am J Clin Nutr. 2008; 87: 1818-1824
- Excess gestational weight gain is associated with child adiposity among mothers with normal and overweight prepregnancy weight status.J Nutr. 2012; 142: 1851-1858
- Independent relation of maternal prenatal factors to early childhood obesity in the offspring.Obstet Gynecol. 2013; 121: 115-121
- Optimizing weight gain in pregnancy to prevent obesity in women and children.Diabetes Obes Metab. 2012; 14: 195-203
- Obesity in young men after famine exposure in utero and early infancy.N Engl J Med. 1976; 295: 349-353
- Predicting obesity in young adulthood from childhood and parental obesity.N Engl J Med. 1997; 337: 869-873
- Estimation of newborn risk for child or adolescent obesity: lessons from longitudinal birth cohorts.PLoS One. 2012; 7: e49919
- Development of food preferences.Annu Rev Nutr. 1999; 19: 41-62
- Parent-child relationship of physical activity patterns and obesity.Int J Obes Relat Metab Disord. 1999; 23: 1262-1268
- Neonatal body composition according to the revised institute of medicine recommendations for maternal weight gain.J Clin Endocrinol Metab. 2012; 97: 3648-3654
- Being big or growing fast: systematic review of size and growth in infancy and later obesity.BMJ. 2005; 331: 929
- Validity of self-reported pregravid weight.Ann Epidemiol. 1992; 2: 715-721
- Relationship of self-reported prepregnant weight and weight gain during pregnancy to maternal body habitus and age.J Am Diet Assoc. 1992; 92: 85-87
Article info
Publication history
Published online: April 14, 2014
Accepted:
February 26,
2014
Received in revised form:
January 31,
2014
Received:
October 13,
2013
Footnotes
This research was supported by a research grant (R40MC21515) from the Health Resources and Services Administration (M.M.H.).
The authors report no conflict of interest.
Cite this article as: Sridhar SB, Darbinian J, Ehrlich SF, et al. Maternal gestational weight gain and offspring risk for childhood overweight or obesity. Am J Obstet Gynecol 2014;211:259.e1-8.
Identification
Copyright
© 2014 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
