Insufficient maternal gestational weight gain and infant neurodevelopment at 12 months of age: the Japan Environment and Children’s Study

Abstract

Abnormal maternal gestational weight gain (GWG) increases the risk of obstetric-related complications. This investigation examined the impact of GWG on infant neurodevelopmental abnormalities at 12 months of age using the data of a nationwide Japanese cohort study. Questionnaire data were obtained from the ongoing Japan Environment and Children’s Study cohort study. Maternal GWG was subdivided as below, within, or above the reference values of the Institution of Medicine pregnancy weight guidelines. The Ages and Stages Questionnaire, third edition (ASQ-3) is a parent-reported developmental screening instrument for children across five domains: communication, gross motor, fine motor, problem-solving, and personal–social. Multiple logistic regression analysis was employed to identify correlations between GWG and developmental delay defined as ASQ-3 scores of less than two standard deviations below the mean. A total of 30,694 mothers with singleton live births and partners who completed the questionnaire were analyzed. The prevalence of mothers below, within, and above the GWG guidelines was 60.4% (18,527), 32.1% (9850), and 7.5% (2317), respectively. We recorded 10,943 infants (35.7%) who were outliers in at least one ASQ-3 domain. After controlling for covariates, GWG below established guidelines was associated with a significantly higher risk of developmental delay for the communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09–1.34), gross motor (OR 1.14, 95% CI 1.05–1.24), fine motor (OR 1.13, 95% CI 1.04–1.24), problem-solving (OR 1.09, 95% CI 1.01–1.18), and personal–social (OR 1.15, 95% CI 1.07–1.24) domains.Conclusion: This large survey revealed a possible deleterious effect of insufficient maternal GWG on infant neurodevelopment.Trial registration: The Japan Environment and Children’s Study (JECS) was registered in the UMIN Clinical Trials Registry on January 15, 2018 (number UMIN000030786). What is Known:• Inappropriate maternal gestational weight gain may cause obstetric complications and adverse birth outcomes.• Excess maternal weight gain may result in gestational diabetes, hypertension, eclampsia, caesarean delivery, and macrosomia, while insufficient maternal weight gain has been associated with pre-term birth and small for gestational age. What is New:• This study provides important information on a possible adverse effect of insufficient maternal gestational weight gain on offspring neurodevelopment at 12 months of age.• Our findings indicate a need to reconsider the optimal body mass index and gestational weight gain for women desiring pregnancy.

Nausea and Vomiting during Early Pregnancy among Chinese Women and Its Association with Nutritional Intakes

“…Moreover, studies have shown that insufficient weight gain is associated with a variety of adverse maternal and infant outcomes, such as an increased risk of gestational diabetes [ 20 ] and low birthweight or small-for-gestational-age offspring [ 21 , 22 , 23 ]. Babies born to women with inadequate weight gain had an increased risk of death within their first year of life [ 24 ] and slower neurodevelopment later in life [ 25 ].…”

Associations of maternal pre-pregnancy body mass index and gestational weight gain with risk of offspring neurodevelopment at 2 years: A Chinese birth cohort study

“…Although we were unable to look at connections between the various cognitive domains in this study. Insufficient maternal GWG may harm an infant’s neurodevelopment, according to a large survey conducted in Japan in 2021 ( 32 ). GWG below recommended levels was linked to a significantly higher risk of developmental delay for the domains of communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09–1.34), gross motor (OR 1.14, 95%CI, 1.05–1.24), fine motor (OR 1.13, 95%CI, 1.04–1.24), problem-solving (OR 1.09, 95%CI, 1.01–1.18), and personal-social (OR 1.15, 95%CI, 1.08–1.25) ( 32 ).…”

“…Insufficient maternal GWG may harm an infant’s neurodevelopment, according to a large survey conducted in Japan in 2021 ( 32 ). GWG below recommended levels was linked to a significantly higher risk of developmental delay for the domains of communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09–1.34), gross motor (OR 1.14, 95%CI, 1.05–1.24), fine motor (OR 1.13, 95%CI, 1.04–1.24), problem-solving (OR 1.09, 95%CI, 1.01–1.18), and personal-social (OR 1.15, 95%CI, 1.08–1.25) ( 32 ). Contrary to these research, a correlation between maternal obesity or overweight and a child’s cognitive development was not found in two cohorts of European infants at around 3 years of age ( 32 , 33 ).…”

“…GWG below recommended levels was linked to a significantly higher risk of developmental delay for the domains of communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09–1.34), gross motor (OR 1.14, 95%CI, 1.05–1.24), fine motor (OR 1.13, 95%CI, 1.04–1.24), problem-solving (OR 1.09, 95%CI, 1.01–1.18), and personal-social (OR 1.15, 95%CI, 1.08–1.25) ( 32 ). Contrary to these research, a correlation between maternal obesity or overweight and a child’s cognitive development was not found in two cohorts of European infants at around 3 years of age ( 32 , 33 ). That study had a drawback, though, in that the evaluation of newborns’ cognitive ability was dependent on subjective maternal reports as opposed to impartial tests.…”

Non-Linear and Sex-Specific Effect of Maternal Pre-Pregnancy BMI on Emotional and Behavioral Development of Preschool Children: A Population-Based Cohort Study

“…Women with higher pre-pregnancy BMI may be likely to gain more weight during pregnancy than indicators issued by Institute of Medicine (IOM) guidelines [ 50 ]. We lack data on GWG, which is also associated with children’s neurodevelopment [ 51 ]. Meanwhile, the C-ABCS was the first cohort we have established in Anhui province, we did not collect maternal waist circumference and other measures of body fat.…”