Gestational weight gain in relation to offspring obesity over the life course: a systematic review and bias‐adjusted meta‐analysis

Abstract

Gestational weight gain (GWG) is considered one of the risk factors for future obesity in the offspring. However, the direction and strength of this association at different periods of offspring life is relatively unknown. This study investigates whether excess or inadequate maternal GWG during pregnancy influences the risk of offspring obesity at different stages in life. A systematic review of published articles was undertaken after a comprehensive search of different databases, and extracted data were meta-analysed. To quantify offspring obesity estimates in relation to GWG, we stratified obesity estimates within three life stages of the offspring age: <5 years, 5 to <18 years and 18+ years. Our meta-analysis showed that, compared with offspring of women with adequate GWG, offspring of women who gained inadequate gestational weight were at a decreased risk of obesity (relative risk [RR]: 0.86; 95% confidence interval [CI]: 0.78-0.94), and offspring of women who gained excess weight were at an increased risk of obesity (RR: 1.40; 95% CI: 1.23-1.59). These relationships were similar after stratification by life stage. Findings of this study therefore suggest that excess GWG does influence offspring obesity over the short- and long-term, and should therefore be avoided.

Maternal Gestational and Postdelivery Weight Gain and Child Weight

“…Three meta-analyses were performed on the association between GWG and childhood obesity. [1][2][3] However, the metaanalyses did not take postdelivery weight gain into account, which is shown to contribute to additional development of childhood BMI in our study.…”

“…A mother's gestational weight gain (GWG) is a risk factor for the development of overweight in her child. [1][2][3] However, it is not clear to what extent this effect is due to genetics, 4 a programming effect of maternal GWG on the fetus, 5 or a result of maternal lifestyle that already points toward a shared "obesogenic" environment in the course of childhood. 6 Maternal postdelivery weight gain could well represent this shared "obesogenic" environment.…”

Early in the Life Course: Time for Obesity Prevention

“…Although some evidence suggests that extreme undernutrition during pregnancy may be associated with higher obesity risk in offspring, the more common occurrence is overnutrition during pregnancy (Herring et al 2012). Recent systematic reviews found that excessive GWG was associated with an increased risk for offspring obesity compared to adequate GWG (Lau et al 2014;Mamun Mamun et al 2014;Nehring et al 2013), with an overall pooled odds ratio of 1.4 (Mamun et al 2014;Nehring et al 2013). For example, Perng et al (2014) found that every 5 kilograms of GWG was associated with greater adiposity (measured total fat and trunk fat) and higher leptin in children at ages 6-10 years, independent of maternal prepregnancy BMI.…”

Optimizing Pregnancy for Intergenerational Health Benefits

“…This dysregulation in body composition suggests that an energy surplus in utero acts independent of parental genetics with respect to predisposition for excess weight. In fact, according to recent systematic reviews and meta-analyses, excessive GWG increases the risk of childhood overweight/obesity by 30-40% [9,10], thereby propagating the intergenerational cycle of obesity and the proliferation of chronic disease [5]. This may be due to a host of sociopolitical and physiological factors that promote maternal resource storage, decrements in PA, a loss of metabolic control, and a partitioning of excess energy reserves to the fetus [5,11].…”