Maternal Obesity and Excessive Gestational Weight Gain Are Associated with Components of Child Cognition1–3

Pugh, Sarah; Richardson, Gale A.; Hutcheon, Jennifer A.; Himes, Katherine P.; Brooks, Maria M.; Day, Nancy L.; Bodnar, Lisa M.

doi:10.3945/jn.115.215525

Cited by 81 publications

(89 citation statements)

References 48 publications

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“…Gestational weight gain, pre-pregnancy body mass index and offspring behavior and attention-deficit hyperactivity disorder symptoms. Unpublished manuscript 2015) 32. Unlike domain-specific cognition measurements, academic achievement synthesises how behavioural and cognitive problems impact real-life functioning.…”

Section: Discussionmentioning

confidence: 99%

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Child academic achievement in association with pre-pregnancy obesity and gestational weight gain

Pugh

Hutcheon

Richardson

et al. 2016

J Epidemiol Community Health

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Background Recent data suggest that children of mothers who are obese before pregnancy, or who gain too much weight during pregnancy, may be at an increased risk of cognitive impairments. Methods Mother–infant dyads enrolled in a birth cohort study in Pittsburgh, Pennsylvania (1983–1986), were followed from early pregnancy to 14 years postpartum (n=574). Math, reading and spelling achievements were assessed at ages 6 and 10 years using the Wide Range Achievement Test-Revised, and at age 14 years using the Wechsler Individual Achievement Test Screener. Self-reported total GWG was converted to gestational age-standardised z-scores. Generalised estimating equations were used to estimate the effects of GWG and pre-pregnancy body mass index (BMI) on academic achievement at 6, 10 and 14 years, while adjusting for maternal race, child sex, parity, employment, family income, maternal intelligence, maternal depression, pre-pregnancy BMI (in GWG models only) and the home environment. Results The mean (SD) BMI was 23.4 (5.7) kg/m2 and the mean (SD) GWG reported at delivery was 14.4 (5.9) kg. There was a significant non-linear association between pre-pregnancy BMI and an offspring’s academic achievement. At 6, 10 and 14 years, an offspring’s academic scores were inversely associated with pre-pregnancy BMI beyond 22 kg/m2. High GWG (>1 SD) was associated with approximately 4-point lower reading (adjusted β (adjβ) −3.75, 95% CI −7.1 to −0.4) and spelling scores (adjβ −3.90, 95% CI −7.8 to −0.2), compared with GWG −1 to +1 SD. Conclusions Future studies in larger and socioeconomically diverse populations are needed to confirm maternal weight and weight gain as causal determinants of a child’s academic skills, and whether this effect persists into adulthood.

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Section: Discussionmentioning

confidence: 99%

“…Gestational weight gain, pre-pregnancy body mass index and offspring behavior and attention-deficit hyperactivity disorder symptoms. Unpublished manuscript 2015)32 is important. There is concern that low weight gain, particularly among obese women, may impair an offspring's cognitive function 41.…”

Section: Discussionmentioning

confidence: 99%

Child academic achievement in association with pre-pregnancy obesity and gestational weight gain

Pugh

Hutcheon

Richardson

et al. 2016

J Epidemiol Community Health

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“…Several studies showed that maternal pre-pregnancy obesity is associated with a lower cognitive function in children, but results are not consistent [49][50][51][52][53][54][55][56][57] . Total weight gain during pregnancy seems not be associated with childhood cognitive function [54,56,60] . However, a study among 5,191 mother-offspring pairs of term deliveries from the UK showed small positive associations of maternal weight gain in each trimester of pregnancy with IQ scores at 8 years of age, without remarkable differences in strength of the effect estimates for different periods of maternal weight gain [61] .…”

Section: Childhood Outcomesmentioning

confidence: 98%

Childhood Health Consequences of Maternal Obesity during Pregnancy: A Narrative Review

Gaillard

Santos²,

Duijts

et al. 2016

Ann Nutr Metab

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Background: Obesity is a major public health problem among women of reproductive age. In a narrative review, we examined the influence of maternal obesity during pregnancy on fetal outcomes and childhood adiposity, cardio-metabolic, respiratory and cognitive-related health outcomes. We discuss results from recent studies, the causality and potential underlying mechanisms of observed associations and challenges for future epidemiological studies. Summary: Evidence from observational studies strongly suggests that maternal pre-pregnancy obesity and excessive gestational weight gain are associated with increased risks of fetal pregnancy complications and adverse childhood cardio-metabolic, respiratory and cognitive-related health outcomes. It remains unclear whether these associations are due to intrauterine mechanisms or explained by confounding family-based sociodemographic, lifestyle and genetic factors. The underlying mechanisms have mainly been assessed in animal studies and small human studies, and are yet to be further explored in large human studies. Key Message: Maternal obesity is an important modifiable factor during pregnancy that is associated with a variety of adverse offspring health outcomes. Further studies are needed to explore the causality and underlying mechanisms of the observed associations. Ultimately, preventive strategies focused on reducing maternal obesity and excessive weight gain during pregnancy may reduce common diseases in future generations.

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“…Overweight and obesity affect 60% of women of childbearing age in the United States (Flegal, Kruszon‐Moran, Carroll, Fryar, & Ogden, ; Ogden, Carroll, Kit, & Flegal, ) and are associated with several adverse health outcomes for mothers and children (Gilmore, Klempel‐Donchenko, & Redman, ; Marchi, Berg, Dencker, Olander, & Begley, ). Recently, maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) have emerged as potentially modifiable risk factors for adverse child cognitive development (Hinkle, Albert, Sjaarda, Grewal, & Grantz, ; Hinkle, Sharma, Kim, & Schieve, ; Hinkle et al, ; Huang et al, ; Jo et al, ; Keim & Pruitt, ; Pugh et al, ; Pugh et al, ; Pugh et al, ). Several non‐mutually exclusive biological mechanisms are postulated to be involved in these associations.…”

Section: Introductionmentioning

confidence: 99%

Prepregnancy overweight and obesity are associated with impaired child neurodevelopment

Widen

Kahn

Cirillo

et al. 2017

Maternal & Child Nutrition

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The authors examined the relationship of prepregnancy body mass index (BMI) and gestational weight gain (GWG) with child neurodevelopment. Mother-child dyads were a subgroup (n = 2,084) of the Child Health and Development Studies from the Oakland, California, area enrolled during pregnancy from 1959 to 1966 and followed at child age 9 years. Linear regression was used to examine associations between prepregnancy BMI, GWG, and standardized Peabody Picture Vocabulary Test and Raven Progressive Matrices scores and to evaluate effect modification of GWG by prepregnancy BMI. Before pregnancy, 77% of women were normal weight, 8%were underweight, 11% were overweight, and 3% were obese. Associations between GWG and child outcomes did not vary by prepregnancy BMI, suggesting no evidence for interaction.In multivariable models, compared to normal prepregnancy BMI, prepregnancy overweight and Gage et al., 2013;Hinkle et al., 2012;Hinkle et al., 2016;Huang et al., 2014;Keim & Pruitt, 2012;Pugh et al., 2015;Pugh et al., 2016a;Pugh et al., 2016b;Tavris & Read, 1982;Torres-Espinola et al., 2015). Finally, several studies only evaluated effects of BMI or GWG alone, and did not evaluate the joint associations between these factors (Basatemur et al., 2013;Brion et al., 2011;Hinkle et al., 2013;Krakowiak et al., 2012;Mann et al., 2013;Neggers et al., 2003;Rodriguez, 2010;Rodriguez et al., 2008;Tanda et al., 2013;Tavris & Read, 1982;Torres-Espinola et al., 2015). Our objective was to determine the relationship of maternal prepregnancy BMI and GWG with child neurodevelopment in midchildhood among mother-child dyads who participated in the Child Health and Development Studies (CHDS). We hypothesized that higher prepregnancy BMI and higher GWG would have negative associations with child cognitive outcomes. We also hypothesized that associations of GWG with child cognitive outcomes would vary by prepregnancy BMI, with stronger negative associations in women with higher BMI. | METHODSThe CHDS is a prospective birth cohort that has been previously

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Maternal Obesity and Excessive Gestational Weight Gain Are Associated with Components of Child Cognition1–3

Abstract: Although GWG may be important for executive function, maternal BMI has a stronger relation than GWG to both offspring intelligence and executive function. Our findings contribute to evidence linking maternal obesity to long-term child outcomes.

Cited by 81 publications

References 48 publications

Child academic achievement in association with pre-pregnancy obesity and gestational weight gain

Child academic achievement in association with pre-pregnancy obesity and gestational weight gain

Childhood Health Consequences of Maternal Obesity during Pregnancy: A Narrative Review

Prepregnancy overweight and obesity are associated with impaired child neurodevelopment

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