Maternal and Early Childhood Risk Factors for Overweight and Obesity among Low-Income Predominantly Black Children at Age Five Years: A Prospective Cohort Study

Abstract

Objective. To identify maternal and early childhood risk factors for obesity and overweight among children at age 5 in the state of Alabama. Methods. We recruited 740 mothers during early pregnancy from University of Alabama Prenatal Clinics in a prospective cohort study and followed them throughout pregnancy. We followed their children from birth until 5 years of age. The main outcome measure was obesity (BMI for age and sex ≥ 95th percentile) at 5 years of age. We used poisson regression with robust variance estimation to compute risk ratio (RR). Results. At the 5th year of followup, 71 (9.6%) of the children were obese and 85 (11.5%) were overweight (BMI ≥ 85th–<95th percentile). In multivariable analysis, maternal prepregnancy overweight (RR: 2.30, 95% CI: 1.29–4.11) and obesity (RR: 2.53, 95% CI: 1.49–4.31), and child's birth weight >85th percentile (RR: 2.04, 95% CI: 1.13–3.68) were associated with childhood obesity. Maternal prepregnancy BMI, birth weight, and maternal smoking were associated with the child being overweight 1–12 cigarettes/day versus 0 cigarettes/day (RR: 1.40, 95% CI: 1.02–1.91). Conclusion. Children of overweight and obese mothers, and children with higher birth weight, are more likely to be obese and overweight at age 5. Maternal smoking 1–12 cigarettes per day is associated with the child being overweight.

Chemical and non-chemical stressors affecting childhood obesity: a systematic scoping review

“…These studies found an association between maternal prenatal smoking and childhood obesity even after accounting for various confounding factors. 12,16,76,[78][79][80][81][82][83][84][85][86][87][88][89][90][91] Although there is a compelling link between prenatal smoking and childhood obesity, it is not always clear-cut for both genders and all maternal smoking levels. 86,87 One study followed children from 2 to 10 years of age and found that males whose mothers smoked during pregnancy had a lower BMI at age 2 years than those born to non-smoking mothers or had partners who smoked.…”

Maternal tobacco smoke increased visceral adiposity and serum corticosterone levels in adult male rat offspring

“…for these factors, MTS remains an independent risk factor for childhood obesity (2,7,8,17,18). The independent risk of obesity with maternal smoking suggests that MTS programs altered adipocyte physiology, leading to increased adiposity in the progeny.…”

“…Neonatal rat cotinine levels fell well within the range of 200 to 800 ng/ml, indicating an "active smoker" according to ARUP laboratories. Not only does MTS predispose the fetus to IUGR, but it also increases the risk of obesity in childhood (2,7,8,17,18). Certainly, social factors interplay with MTS exposure during pregnancy, such as decreased physical activity, parental education, and socioeconomic status associated with postnatal cigarette exposure.…”

“…While catch-up growth likely impacts the results of increased adiposity seen in this study as well as many other human and animal studies, catch-up growth is necessary for proper neurodevelopmental function and thus critical for the IUGR offspring. Furthermore, when correcting for these factors, MTS remains an independent risk factor for childhood obesity (2,7,8,17,18). The independent risk of obesity with maternal smoking suggests that MTS programs altered adipocyte physiology, leading to increased adiposity in the progeny.…”

The Combined Effect of Infant Birth Weight and Maternal Determinants of Health on the Development of Childhood Obesity: A Systematic Review

“…While the association between birth weight and childhood obesity has been reported results are inconsistent [36]. Further study of the combined effects of mothers' health determinants and infant birth weight on the development of childhood obesity could be helpful in identifying risk factors and effective interventions for prevention [37,38].…”