Predictors of Obesity in Childhood, Adolescence, and Adulthood in a Birth Cohort

Abstract

To determine how characteristics of pregnancy, birth, and early infancy are related to offspring obesity at three critical developmental periods. Mothers were followed through pregnancy and 10-15 years after. Offspring data were obtained through medical record review. Maternal and offspring characteristics were examined to predict obesity in childhood (ages 4-5 years), adolescence (ages 9-14 years), and early adulthood (ages 19-20 years). The original cohort included 802 children born to 795 women. Children who were twins, who had died, or whose mothers had died were excluded (n=25). Medical records of 68.5% of the remaining 777 children documented a height and weight at childhood, adolescence, or early adulthood. Relative risks (RRs) to predict obesity at early adulthood were 12.3 for childhood and 45.1 at adolescence. RRs were also significant to predict obesity at early adulthood between the mother's obesity at prepregnancy (RR=6.4), 4-5 years postpregnancy (RR=6.3), and 10-15 years postpregnancy (RR=6.2). Excluding these variables from the multivariate models and adjusting by gender, birth insurance, and mother's marital status at delivery, the best model to predict obesity at childhood included birth weight, weight gain in infancy, and delivery type. At adolescence, it included maternal pregnancy smoking status, gestational weight gain, and weight gain in infancy, and in early adulthood, included maternal pregnancy smoking status, gestational weight gain, and birth weight. Maternal pregnancy smoking status, gestational weight gain, and weight gain in infancy have long-term effects on offspring. Maternal obesity is the strongest predictor of obesity at all times studied.

Birth weight and childhood obesity: a 12-country study

“…Some studies have assessed the association between low birth weight and the risk of childhood obesity, and the results are controversial 7,8,10,[12][13][14][15][16][17][18] Several studies have found that low birth weight was associated with a reduced risk of childhood obesity. 15,[17][18][19] However, other studies have indicated no association, 7,12,14 or an increased risk of obesity with low birth weight. 10,13 The present study was underpowered to identify any association between low birth weight and children obesity.…”

“…Most past studies have found a significant and positive association between birth weight and childhood obesity risk. [7][8][9][10][11][12][13][14][15][16][17][18][19] A population-based cohort study from Denmark indicated an increased risk of overweight for children 6-13 years of age with birth weight ⩾ 4.0 kg compared with those with birth weight between 3.0 and 3.49 kg. 12 Another Chinese birth cohort found that children with higher birth weight ⩾ 3500 g had an increased odds of childhood overweight at 3-6 years of age compared with those having birth weight of 3000-3249 g. 15 A meta-analysis of 66 studies from 26 countries demonstrated that high birth weight (44000 g) was positively associated with increased odds of childhood overweight (OR 1.66; 95% CI: 1.55-1.77) compared with normal birth weight (2500-4000 g).…”

“…[4][5][6] Several studies have indicated that high birth weight is associated with an increased risk of childhood obesity. [7][8][9][10][11][12][13][14][15][16][17][18][19] However, few studies have examined the extent to which birth weight is associated with obesity in young school children in high-, middle-and low-income countries. Moreover, the association between low birth weight and the risk of childhood obesity is controversial.…”

Researchers’ position statement on tackling obesity in pregnancy: the International Weight Management in Pregnancy (i‐WIP) collaboration pleads for public health intervention

“…14,15 Importantly, the problem is transgenerational, with adverse effects on infant birthweight as well as childhood and adult obesity. 16 Over the last decade, the International Weight Management in Pregnancy (i-WIP) collaborative network, which is made up of 36 principal investigators from 17 countries, has evaluated various interventions based on diet and physical activity to improve clinical outcomes. 17 Collectively, experienced researchers, clinicians, nutritionists, dieticians, physiotherapists, exercise physiologists, midwives, nurses, and consumers in our field have come to the conclusion that to make substantive improvements to the health of the mother and future generations, the approach needs to be expanded beyond the gestational period.…”

Birthweight, body composition, and motor performance in 7‐ to 10‐year‐old children

“…The present study reinforces the great deal of importance that has been focused on the influence of BMI and fat mass on motor performance tests. 10,26,34 These results can be confounded by other variables such as physical activity levels, for example.To study the associations among birthweight, body composition, and motor performance without overestimating the influence of birthweight and unduly selective emphasis on particular results, the present study used multiple linear regression models of increasing complexity. It was shown that the expectations of mean changes in the handgrip strength and 20-meter sprint time per 1g increase in birthweight in children are independent of current height, BMI, FFM, and % body fat.…”