Pregnancy Weight Gain and Childhood Body Weight: A Within-Family Comparison

English version České info

Background:
Excessive pregnancy weight gain is associated with obesity in the offspring, but this relationship may be confounded by genetic and other shared influences. We aimed to examine the association of pregnancy weight gain with body mass index (BMI) in the offspring, using a within-family design to minimize confounding.

Methods and Findings:
In this population-based cohort study, we matched records of all live births in Arkansas with state-mandated data on childhood BMI collected in public schools (from August 18, 2003 to June 2, 2011). The cohort included 42,133 women who had more than one singleton pregnancy and their 91,045 offspring. We examined how differences in weight gain that occurred during two or more pregnancies for each woman predicted her children's BMI and odds ratio (OR) of being overweight or obese (BMI≥85th percentile) at a mean age of 11.9 years, using a within-family design. For every additional kg of pregnancy weight gain, childhood BMI increased by 0.0220 (95% CI 0.0134–0.0306, p<0.0001) and the OR of overweight/obesity increased by 1.007 (CI 1.003–1.012, p = 0.0008). Variations in pregnancy weight gain accounted for a 0.43 kg/m² difference in childhood BMI. After adjustment for birth weight, the association of pregnancy weight gain with childhood BMI was attenuated but remained statistically significant (0.0143 kg/m² per kg of pregnancy weight gain, CI 0.0057–0.0229, p = 0.0007).

Conclusions:
High pregnancy weight gain is associated with increased body weight of the offspring in childhood, and this effect is only partially mediated through higher birth weight. Translation of these findings to public health obesity prevention requires additional study.

Please see later in the article for the Editors' Summary

Vyšlo v časopise: Pregnancy Weight Gain and Childhood Body Weight: A Within-Family Comparison. PLoS Med 10(10): e32767. doi:10.1371/journal.pmed.1001521
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001521

Souhrn

Zdroje

1. BarkerDJ, GluckmanPD, GodfreyKM, HardingJE, OwensJA, et al. (1993) Fetal nutrition and cardiovascular disease in adult life. Lancet 341: 938–941.

2. HalesCN, BarkerDJ (1992) Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia 35: 595–601.

3. AdamoKB, FerraroZM, BrettKE (2012) Can we modify the intrauterine environment to halt the intergenerational cycle of obesity? Int J Environ Res Public Health 9: 1263–1307.

4. BarkerDJ (2007) Obesity and early life. Obes Rev 8 Suppl 1: 45–49.

5. EbbelingCB, PawlakDB, LudwigDS (2002) Childhood obesity: public-health crisis, common sense cure. Lancet 360: 473–482.

6. HerringSJ, RoseMZ, SkouterisH, OkenE (2012) Optimizing weight gain in pregnancy to prevent obesity in women and children. Diabetes Obes Metab 14: 195–203.

7. RheeKE, PhelanS, McCafferyJ (2012) Early determinants of obesity: genetic, epigenetic, and in utero influences. Int J Pediatr 2012: 463850.

8. WhitakerRC, DietzWH (1998) Role of the prenatal environment in the development of obesity. J Pediatr 132: 768–776.

9. BayolSA, SimbiBH, SticklandNC (2005) A maternal cafeteria diet during gestation and lactation promotes adiposity and impairs skeletal muscle development and metabolism in rat offspring at weaning. J Physiol 567: 951–961.

10. LevinBE, GovekE (1998) Gestational obesity accentuates obesity in obesity-prone progeny. Am J Physiol 275: R1374–1379.

11. MuhlhauslerBS, AdamCL, FindlayPA, DuffieldJA, McMillenIC (2006) Increased maternal nutrition alters development of the appetite-regulating network in the brain. FASEB J 20: 1257–1259.

12. SamuelssonAM, MatthewsPA, ArgentonM, ChristieMR, McConnellJM, et al. (2008) Diet-induced obesity in female mice leads to offspring hyperphagia, adiposity, hypertension, and insulin resistance: a novel murine model of developmental programming. Hypertension 51: 383–392.

13. CrozierSR, InskipHM, GodfreyKM, CooperC, HarveyNC, et al. (2010) Weight gain in pregnancy and childhood body composition: findings from the Southampton Women's Survey. Am J Clin Nutr 91: 1745–1751.

14. FraserA, TillingK, Macdonald-WallisC, SattarN, BrionMJ, et al. (2010) Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation 121: 2557–2564.

15. HinkleSN, SharmaAJ, SwanDW, SchieveLA, RamakrishnanU, et al. (2012) Excess gestational weight gain is associated with child adiposity among mothers with normal and overweight prepregnancy weight status. J Nutr 142: 1851–1858.

16. HochnerH, FriedlanderY, Calderon-MargalitR, MeinerV, SagyY, et al. (2012) Associations of maternal prepregnancy body mass index and gestational weight gain with adult offspring cardiometabolic risk factors: the Jerusalem Perinatal Family Follow-up Study. Circulation 125: 1381–1389.

17. LaitinenJ, JaaskelainenA, HartikainenAL, SovioU, VaarasmakiM, et al. (2012) Maternal weight gain during the first half of pregnancy and offspring obesity at 16 years: a prospective cohort study. BJOG 119: 716–723.

18. MamunAA, O'CallaghanM, CallawayL, WilliamsG, NajmanJ, et al. (2009) Associations of gestational weight gain with offspring body mass index and blood pressure at 21 years of age: evidence from a birth cohort study. Circulation 119: 1720–1727.

19. Margerison ZilkoCE, RehkopfD, AbramsB (2010) Association of maternal gestational weight gain with short- and long-term maternal and child health outcomes. Am J Obstet Gynecol 202: e571–578, 574, e571-578.

20. Margerison-ZilkoCE, ShrimaliBP, EskenaziB, LahiffM, LindquistAR, et al. (2012) Trimester of maternal gestational weight gain and offspring body weight at birth and age five. Matern Child Health J 16: 1215–1223.

21. OkenE, Rifas-ShimanSL, FieldAE, FrazierAL, GillmanMW (2008) Maternal gestational weight gain and offspring weight in adolescence. Obstet Gynecol 112: 999–1006.

22. OkenE, TaverasEM, KleinmanKP, Rich-EdwardsJW, GillmanMW (2007) Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol 196: e321–328, 322, e321-328.

23. OlsonCM, StrawdermanMS, DennisonBA (2009) Maternal weight gain during pregnancy and child weight at age 3 years. Matern Child Health J 13: 839–846.

24. Schack-NielsenL, MichaelsenKF, GamborgM, MortensenEL, SorensenTI (2010) Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood. Int J Obes (Lond) 34: 67–74.

25. StuebeAM, FormanMR, MichelsKB (2009) Maternal-recalled gestational weight gain, pre-pregnancy body mass index, and obesity in the daughter. Int J Obes (Lond) 33: 743–752.

26. WhitakerRC (2004) Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics 114: e29–36.

27. WrotniakBH, ShultsJ, ButtsS, StettlerN (2008) Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort study. Am J Clin Nutr 87: 1818–1824.

28. BranumAM, ParkerJD, KeimSA, SchempfAH (2011) Prepregnancy body mass index and gestational weight gain in relation to child body mass index among siblings. Am J Epidemiol 174: 1159–1165.

29. LawlorDA, TimpsonNJ, HarbordRM, LearyS, NessA, et al. (2008) Exploring the developmental overnutrition hypothesis using parental-offspring associations and FTO as an instrumental variable. PLoS Med 5: e33 doi:10.1371/journal.pmed.0050033

30. LawlorDA, LichtensteinP, FraserA, LangstromN (2011) Does maternal weight gain in pregnancy have long-term effects on offspring adiposity? A sibling study in a prospective cohort of 146,894 men from 136,050 families. Am J Clin Nutr 94: 142–148.

31. Davey SmithG, SteerC, LearyS, NessA (2007) Is there an intrauterine influence on obesity? Evidence from parent child associations in the Avon Longitudinal Study of Parents and Children (ALSPAC). Arch Dis Child 92: 876–880.

32. FletenC, NystadW, StigumH, SkjaervenR, LawlorDA, et al. (2012) Parent-offspring body mass index associations in the Norwegian Mother and Child Cohort Study: a family-based approach to studying the role of the intrauterine environment in childhood adiposity. Am J Epidemiol 176: 83–92.

33. KivimakiM, LawlorDA, SmithGD, ElovainioM, JokelaM, et al. (2007) Substantial intergenerational increases in body mass index are not explained by the fetal overnutrition hypothesis: the Cardiovascular Risk in Young Finns Study. Am J Clin Nutr 86: 1509–1514.

34. KnightB, ShieldsBM, HillA, PowellRJ, WrightD, et al. (2007) The impact of maternal glycemia and obesity on early postnatal growth in a nondiabetic Caucasian population. Diabetes Care 30: 777–783.

35. LearyS, Davey SmithG, NessA (2010) No evidence of large differences in mother-daughter and father-son body mass index concordance in a large UK birth cohort. Int J Obes (Lond) 34: 1191–1192.

36. PatelR, MartinRM, KramerMS, OkenE, BogdanovichN, et al. (2011) Familial associations of adiposity: findings from a cross-sectional study of 12,181 parental-offspring trios from Belarus. PLoS ONE 6: e14607 doi:10.1371/journal.pone.0014607

37. LawlorDA, SmithGD, O'CallaghanM, AlatiR, MamunAA, et al. (2007) Epidemiologic evidence for the fetal overnutrition hypothesis: findings from the mater-university study of pregnancy and its outcomes. Am J Epidemiol 165: 418–424.

38. GuenardF, DeshaiesY, CianfloneK, KralJG, MarceauP, et al. (2013) Differential methylation in glucoregulatory genes of offspring born before vs. after maternal gastrointestinal bypass surgery. Proc Natl Acad Sci U S A 110: 11439–1144.

39. LawlorDA, LichtensteinP, LangstromN (2011) Association of maternal diabetes mellitus in pregnancy with offspring adiposity into early adulthood: sibling study in a prospective cohort of 280,866 men from 248,293 families. Circulation 123: 258–265.

40. LudwigDS, CurrieJ (2010) The association between pregnancy weight gain and birthweight: a within-family comparison. Lancet 376: 984–990.

41. NorthamS, KnappTR (2006) The reliability and validity of birth certificates. J Obstet Gynecol Neonatal Nurs 35: 3–12.

42. BuescherPA, TaylorKP, DavisMH, BowlingJM (1993) The quality of the new birth certificate data: a validation study in North Carolina. Am J Public Health 83: 1163–1165.

43. Dietz PM (2012) Evaluating the 2003 Birth Certificate Data: Preliminary Findings from the PRAMS Data Quality Improvement Project. Available: http://www.cdc.gov/nchs/ppt/nchs2012/SS-19_DIETZ.pdf. Accessed 28 August 2013.

44. JustusMB, RyanKW, RockenbachJ, KatterapalliC, Card-HigginsonP (2007) Lessons learned while implementing a legislated school policy: body mass index assessments among Arkansas's public school students. J Sch Health 77: 706–713.

45. CDC (2011) About BMI for Children and Teens. Available: http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html. Accessed 28 August 2013.

46. Allison PD (2009) Fixed effects regression models. Los Angeles: Sage Publications.

47. Wooldridge JM (2002) Econometric analysis of cross sectional and panel data. Cambridge (Massachusetts): MIT Press.

48. ChamberlainG (1980) Analysis of Covariance with Qualitative Data. Rev Economic Studies 47: 225–238.

49. WhitakerRC, WrightJA, PepeMS, SeidelKD, DietzWH (1997) Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 337: 869–873.

50. WangYC, OrleansCT, GortmakerSL (2012) Reaching the healthy people goals for reducing childhood obesity: closing the energy gap. Am J Prev Med 42: 437–444.

51. DietzPM, CallaghanWM, SharmaAJ (2009) High pregnancy weight gain and risk of excessive fetal growth. Am J Obstet Gynecol 201: e51–56, 51, e51-56.

52. NohrEA, VaethM, BakerJL, SorensenTI, OlsenJ, et al. (2009) Pregnancy outcomes related to gestational weight gain in women defined by their body mass index, parity, height, and smoking status. Am J Clin Nutr 90: 1288–1294.

53. WiseLA, PalmerJR, HeffnerLJ, RosenbergL (2010) Prepregnancy body size, gestational weight gain, and risk of preterm birth in African-American women. Epidemiology 21: 243–252.