Maternal weight in pregnancy and childhood obesity: Links and leverage points

Our objective was to characterize the relationships between maternal weight variables during and after pregnancy, infant weight characteristics at birth, and child weight at age 3 years in a rural, white population‐based sample. More than 20% of the infants weighed more than 4000 grams at birth. At age 3 years, 30.3% of the children were above the 85 th percentile for BMI and 14.4% were above the 95 th percentile. Net gestational weight gain was positively associated (p=0.01) with infant birth weight. Similarly, women gaining more weight during pregnancy than is recommended by the Institute of Medicine (IOM) were 2.6 (95% CI=1.4,3.6) times more likely to deliver an infant weighing 4000 grams or more than were women gaining within the IOM range. There was a trend for these large infants to be at greater risk for overweight (BMI >85 th percentile) at 3 years (p = 0.08). Maternal pre‐pregnancy overweight and obesity were positively associated with child overweight (BMI >95 th percentile) and risk of overweight (p<0.05). Maternal weight retention of ≥ 10 pounds at 1 year postpartum was associated with the child's risk of overweight at 3 years at a level approaching statistical significance (p=0.10). Additional multivariate analyses will clarify the inter‐relationships between maternal and infant weight characteristics and their independent relationships to childhood overweight at 3 years. NIH Grant No. HD 29549