Maternal metabolic factors during pregnancy predict early childhood growth trajectories and obesity risk

the CANDLE Study

Zunsong Hu, Frances Tylavsky, Joan Han, Mehmet Kocak, Jay Fowke, Robert Davis, Kaja Lewinn, Nicole R. Bush, Qi Zhao

Research output: Contribution to journalArticle

Abstract

Background: We investigated the individual and additive effects of three modifiable maternal metabolic factors, including pre-pregnancy overweight/obesity, gestational weight gain (GWG), and gestational diabetes mellitus (GDM), on early childhood growth trajectories and obesity risk. Methods: A total of 1425 mother–offspring dyads (953 black and 472 white) from a longitudinal birth cohort were included in this study. Latent class growth modeling was performed to identify the trajectories of body mass index (BMI) from birth to 4 years in children. Poisson regression models were used to examine the associations between the maternal metabolic risk factors and child BMI trajectories and obesity risk at 4 years. Results: We identified three discrete BMI trajectory groups, characterized as rising-high-BMI (12.6%), moderate-BMI (61.0%), or low-BMI (26.4%) growth. Both maternal pre-pregnancy obesity (adjusted relative risk [adjRR] = 1.96; 95% confidence interval [CI]: 1.36–2.83) and excessive GWG (adjRR = 1.71, 95% CI: 1.13–2.58) were significantly associated with the rising-high-BMI trajectory, as manifested by rapid weight gain during infancy and a stable but high BMI until 4 years. All three maternal metabolic indices were significantly associated with childhood obesity at age 4 years (adjRR for pre-pregnancy obesity = 2.24, 95% CI: 1.62–3.10; adjRR for excessive GWG = 1.46, 95% CI: 1.01–2.09; and adjRR for GDM = 2.14, 95% = 1.47–3.12). In addition, risk of rising-high BMI trajectory or obesity at age 4 years was stronger among mothers with more than one metabolic risk factor. We did not observe any difference in these associations by race. Conclusion: Maternal pre-pregnancy obesity, excessive GWG, and GDM individually and jointly predict rapid growth and obesity at age 4 years in offspring, regardless of race. Interventions targeting maternal obesity and metabolism may prevent or slow the rate of development of childhood obesity.

Original languageEnglish (US)
JournalInternational Journal of Obesity
DOIs
StatePublished - Jan 1 2019

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Body Mass Index
Obesity
Mothers
Pregnancy
Growth
Weight Gain
Gestational Diabetes
Confidence Intervals
Pediatric Obesity
Parturition

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

@article{4dfd4d874941428b88ad0d11c36edcae,
title = "Maternal metabolic factors during pregnancy predict early childhood growth trajectories and obesity risk: the CANDLE Study",
abstract = "Background: We investigated the individual and additive effects of three modifiable maternal metabolic factors, including pre-pregnancy overweight/obesity, gestational weight gain (GWG), and gestational diabetes mellitus (GDM), on early childhood growth trajectories and obesity risk. Methods: A total of 1425 mother–offspring dyads (953 black and 472 white) from a longitudinal birth cohort were included in this study. Latent class growth modeling was performed to identify the trajectories of body mass index (BMI) from birth to 4 years in children. Poisson regression models were used to examine the associations between the maternal metabolic risk factors and child BMI trajectories and obesity risk at 4 years. Results: We identified three discrete BMI trajectory groups, characterized as rising-high-BMI (12.6{\%}), moderate-BMI (61.0{\%}), or low-BMI (26.4{\%}) growth. Both maternal pre-pregnancy obesity (adjusted relative risk [adjRR] = 1.96; 95{\%} confidence interval [CI]: 1.36–2.83) and excessive GWG (adjRR = 1.71, 95{\%} CI: 1.13–2.58) were significantly associated with the rising-high-BMI trajectory, as manifested by rapid weight gain during infancy and a stable but high BMI until 4 years. All three maternal metabolic indices were significantly associated with childhood obesity at age 4 years (adjRR for pre-pregnancy obesity = 2.24, 95{\%} CI: 1.62–3.10; adjRR for excessive GWG = 1.46, 95{\%} CI: 1.01–2.09; and adjRR for GDM = 2.14, 95{\%} = 1.47–3.12). In addition, risk of rising-high BMI trajectory or obesity at age 4 years was stronger among mothers with more than one metabolic risk factor. We did not observe any difference in these associations by race. Conclusion: Maternal pre-pregnancy obesity, excessive GWG, and GDM individually and jointly predict rapid growth and obesity at age 4 years in offspring, regardless of race. Interventions targeting maternal obesity and metabolism may prevent or slow the rate of development of childhood obesity.",
author = "Zunsong Hu and Frances Tylavsky and Joan Han and Mehmet Kocak and Jay Fowke and Robert Davis and Kaja Lewinn and Bush, {Nicole R.} and Qi Zhao",
year = "2019",
month = "1",
day = "1",
doi = "10.1038/s41366-019-0326-z",
language = "English (US)",
journal = "International Journal of Obesity",
issn = "0307-0565",
publisher = "Nature Publishing Group",

}

TY - JOUR

T1 - Maternal metabolic factors during pregnancy predict early childhood growth trajectories and obesity risk

T2 - the CANDLE Study

AU - Hu, Zunsong

AU - Tylavsky, Frances

AU - Han, Joan

AU - Kocak, Mehmet

AU - Fowke, Jay

AU - Davis, Robert

AU - Lewinn, Kaja

AU - Bush, Nicole R.

AU - Zhao, Qi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: We investigated the individual and additive effects of three modifiable maternal metabolic factors, including pre-pregnancy overweight/obesity, gestational weight gain (GWG), and gestational diabetes mellitus (GDM), on early childhood growth trajectories and obesity risk. Methods: A total of 1425 mother–offspring dyads (953 black and 472 white) from a longitudinal birth cohort were included in this study. Latent class growth modeling was performed to identify the trajectories of body mass index (BMI) from birth to 4 years in children. Poisson regression models were used to examine the associations between the maternal metabolic risk factors and child BMI trajectories and obesity risk at 4 years. Results: We identified three discrete BMI trajectory groups, characterized as rising-high-BMI (12.6%), moderate-BMI (61.0%), or low-BMI (26.4%) growth. Both maternal pre-pregnancy obesity (adjusted relative risk [adjRR] = 1.96; 95% confidence interval [CI]: 1.36–2.83) and excessive GWG (adjRR = 1.71, 95% CI: 1.13–2.58) were significantly associated with the rising-high-BMI trajectory, as manifested by rapid weight gain during infancy and a stable but high BMI until 4 years. All three maternal metabolic indices were significantly associated with childhood obesity at age 4 years (adjRR for pre-pregnancy obesity = 2.24, 95% CI: 1.62–3.10; adjRR for excessive GWG = 1.46, 95% CI: 1.01–2.09; and adjRR for GDM = 2.14, 95% = 1.47–3.12). In addition, risk of rising-high BMI trajectory or obesity at age 4 years was stronger among mothers with more than one metabolic risk factor. We did not observe any difference in these associations by race. Conclusion: Maternal pre-pregnancy obesity, excessive GWG, and GDM individually and jointly predict rapid growth and obesity at age 4 years in offspring, regardless of race. Interventions targeting maternal obesity and metabolism may prevent or slow the rate of development of childhood obesity.

AB - Background: We investigated the individual and additive effects of three modifiable maternal metabolic factors, including pre-pregnancy overweight/obesity, gestational weight gain (GWG), and gestational diabetes mellitus (GDM), on early childhood growth trajectories and obesity risk. Methods: A total of 1425 mother–offspring dyads (953 black and 472 white) from a longitudinal birth cohort were included in this study. Latent class growth modeling was performed to identify the trajectories of body mass index (BMI) from birth to 4 years in children. Poisson regression models were used to examine the associations between the maternal metabolic risk factors and child BMI trajectories and obesity risk at 4 years. Results: We identified three discrete BMI trajectory groups, characterized as rising-high-BMI (12.6%), moderate-BMI (61.0%), or low-BMI (26.4%) growth. Both maternal pre-pregnancy obesity (adjusted relative risk [adjRR] = 1.96; 95% confidence interval [CI]: 1.36–2.83) and excessive GWG (adjRR = 1.71, 95% CI: 1.13–2.58) were significantly associated with the rising-high-BMI trajectory, as manifested by rapid weight gain during infancy and a stable but high BMI until 4 years. All three maternal metabolic indices were significantly associated with childhood obesity at age 4 years (adjRR for pre-pregnancy obesity = 2.24, 95% CI: 1.62–3.10; adjRR for excessive GWG = 1.46, 95% CI: 1.01–2.09; and adjRR for GDM = 2.14, 95% = 1.47–3.12). In addition, risk of rising-high BMI trajectory or obesity at age 4 years was stronger among mothers with more than one metabolic risk factor. We did not observe any difference in these associations by race. Conclusion: Maternal pre-pregnancy obesity, excessive GWG, and GDM individually and jointly predict rapid growth and obesity at age 4 years in offspring, regardless of race. Interventions targeting maternal obesity and metabolism may prevent or slow the rate of development of childhood obesity.

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