Predicting Preschooler Obesity at Birth: The Role of Maternal Obesity in Early Pregnancy

Abstract

ABSTRACT. Objective. Knowing risk factors at birth for the development of childhood obesity could help to identify children who are in need of early obesity prevention efforts. The objective of this study was to determine whether children whose mothers were obese in early pregnancy were more likely to be obese at 2 to 4 years of age.Methods. A retrospective cohort study was conducted of 8494 low-income children who were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Ohio and were followed from the first trimester of gestation until 24 to 59 months of age. Measured height and weight data from WIC were linked to birth certificate records for children who were born in the years 1992-1996. Obesity among 2-to 4-yearolds was defined as a body mass index (BMI) >95th percentile for age and gender. Mothers were classified as obese (BMI >30 kg/m 2 ) or nonobese (BMI <30 kg/m 2 ) on the basis of BMI measured in the first trimester of the child's gestation.Results. The prevalence of childhood obesity was 9.5%, 12.5%, and 14.8% at 2, 3, and 4 years of age, respectively, and 30.3% of the children had obese mothers. By 4 years of age, 24.1% of children were obese if their mothers had been obese in the first trimester of pregnancy compared with 9.0% of children whose mothers had been of normal weight (BMI >18.5 and <25 kg/m 2 ). After controlling for the birth weight, birth year, and gender of the children plus the mothers' age, race/ethnicity, education level, marital status, parity, weight gain, and smoking during pregnancy, the relative risk of childhood obesity associated with maternal obesity in the first trimester of pregnancy was 2.0 (95% confidence interval [CI]: 1.7-2.3) at 2 years of age, 2.3 (95% CI: 2.0 -2.6) at 3 years of age, and 2.3 (95% CI: 2.0 -2.6) at 4 years of age.Conclusion. Among low-income children, maternal obesity in early pregnancy more than doubles the risk of obesity at 2 to 4 years of age. In developing strategies to prevent obesity in preschoolers, special attention should be given to newborns with obese mothers. Pediatrics 2004;114:e29 -e36. URL: http://www.pediatrics.org/cgi/ content/full/114/1/e29; obesity, child, mothers, birth weight, pregnancy.ABBREVIATIONS. WIC, Special Supplemental Nutrition Program for Women, Infants, and Children; BMI, body mass index; WHZ, weight-for-height z score; OR, odds ratio.A lthough there are twice as many obese children now as there were 20 years ago, 1 we still know little about the exact cause of this trend or how best to stop it. However, if the trend is to be slowed, then there are several reasons that obesity prevention may be a better approach than obesity treatment and why prevention efforts should begin very early in life. A major reason to begin prevention early is that the prevalence of obesity has increased even among preschoolers, 2-5 many of whom remain obese into adolescence. 6 Furthermore, obesity increases the risk of physiologic, 7 functional, 8 and emotional morbidity 9 in children, and obese ch...

Perinatal predictors of overweight at infancy and preschool childhood: the GENESIS study

“…11,14,27,28 However, only the present study has examined the effect of these parameters simultaneously and during different developmental stages in early years of life (that is, infancy and preschool childhood). Our data revealed a positive relationship between size at birth and overweight at infancy and preschool years.…”

“…[13][14][15] Regarding Greece there are no data with respect to perinatal correlates of overweight during infancy and preschool years. The Growth, Exercise and Nutrition Epidemiological Study In preSchoolers (GENESIS) represents the first large-scale epidemiological study in Greece, attempting among others to evaluate the aforementioned association.…”

Macrosomia is associated with high weight-for-height in children aged 1–3 years in Shanghai, China

“…A case-control study by Takahashi and colleagues 8 suggested that children who were obese at 3 years of age had higher birth weights compared with their normal weight counterparts. In the study of Whitaker, 9 American children with a large birth weight (X90th percentile) had the higher percentages of obese children at 2-4 years of age, which is more apparent in boys than that in girls. A longitudinal study by Parsons et al 10 indicated that the association between higher birth weight and higher levels of BMI may persist into adulthood among the participants of a British birth cohort.…”

“…Maternal prenatal body weight Macrosomia and high weight-for-height Z Yu et al and weight gain was previously reported to influence children's body weight. 9 Understanding the relationship between maternal prenatal nutritional status to children's birth weight and later body weight may help elucidate the natural history of the association between birth weight and body weight during childhood and perhaps in later life. One limitation of this study is that quantitative data on dietary intakes were not available, so we could not assess postnatal dietary differences between the macrosomic and nonmacrosomic infants.…”

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