Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, United States of America.
Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, United States of America.
Neurotoxicol Teratol. 2022 Jan-Feb;89:107049. doi: 10.1016/j.ntt.2021.107049. Epub 2021 Nov 12.
Pre-pregnancy obesity has been linked to childhood neurodevelopmental outcomes, including autism and attention-deficit hyperactivity disorder. The aim of our study was to examine the association between pre-pregnancy body mass index (BMI) and scores on behavioral scales according to both mother and teacher report.
We conducted a longitudinal study of 469 mother-child pairs. Information on pre-pregnancy body mass index (BMI) was collected from standardized maternal interviews conducted after delivery and assessment of childhood behavioral problems was measured at 5-12 years of age according to maternal-report using the Child Behavior Checklist (CBCL) and teacher-report using the Teacher Report Form (TRF). Using normal pre-pregnancy BMI (18.5-24.9 kg/m) as the reference (n = 305), we calculated adjusted mean differences (MD) for t-scores on broadband and syndrome scales of behavior for children of mothers with pre-pregnancy overweight (n = 101) or obese (n = 63) BMI. We also examined associations with scores in the clinical range using risk ratios (RR) and compared results across informants. To account for loss to follow-up between the initial interview and the childhood behavioral assessment, we weighted models using stabilized inverse probability weights.
Pre-pregnancy obesity was associated with a mean increase in child's total behavior problem t-scores according to both mother and teacher report, after adjustment for confounders and weighted for loss to follow-up (MD: 0.7, 95% CI: -2.2, 3.6 on CBCL; MD: 3.1, 95% CI: 0.5, 5.7 on TRF), indicating poorer behavioral outcomes. Comparing the magnitude of associations between mother and teacher-report, mean differences for pre-pregnancy obesity and most behavioral problem scales were larger for teacher-reported outcomes than mother-reported outcomes. Pre-pregnancy obesity was associated with increased risks of externalizing behaviors in the clinical range regardless of informant (CBCL RR: 1.6, 95% CI: 0.8, 3.2 and TRF RR: 1.7, 95% CI: 0.8, 3.5). Pre-pregnancy obesity was also associated with increased risks of internalizing behaviors according to teacher-report (TRF RR: 2.6, 95% CI:1.5, 4.6).
Pre-pregnancy obesity, compared to pre-pregnancy normal weight, is associated with generally higher scores on both mother and teacher reported childhood behavioral assessments, indicating an increased likelihood of behavioral problems.
孕前肥胖与儿童神经发育结果有关，包括自闭症和注意缺陷多动障碍。本研究的目的是根据母亲和教师的报告，检查孕前体重指数（BMI）与行为量表评分之间的关系。
我们对 469 对母婴进行了纵向研究。从产后标准化的母亲访谈中收集了孕前体重指数（BMI）信息，在 5-12 岁时根据母亲报告（使用儿童行为检查表（CBCL））和教师报告（使用教师报告表（TRF））评估儿童的行为问题。以正常孕前 BMI（18.5-24.9kg/m）为参考（n=305），我们计算了母亲孕前超重（n=101）或肥胖（n=63）BMI 儿童的宽带和综合征行为量表的 t 评分的调整平均差异（MD）。我们还使用风险比（RR）检查了与临床范围评分的关系，并比较了不同信息提供者的结果。为了考虑从初始访谈到儿童行为评估之间的随访丢失，我们使用稳定的逆概率权重对模型进行加权。
调整混杂因素和随访丢失后，孕前肥胖与母亲和教师报告的儿童总行为问题 t 评分呈正相关（CBCL：MD：0.7，95%CI：-2.2，3.6；TRF：MD：3.1，95%CI：0.5，5.7），表明行为结果较差。比较母亲和教师报告之间关联的大小，与母亲报告相比，孕前肥胖和大多数行为问题量表的平均差异在教师报告结果中更大。无论信息提供者如何（CBCL RR：1.6，95%CI：0.8，3.2 和 TRF RR：1.7，95%CI：0.8，3.5），孕前肥胖与外部行为的临床范围内的风险增加有关。根据教师报告（TRF RR：2.6，95%CI：1.5，4.6），孕前肥胖也与内部行为的风险增加有关。
与孕前正常体重相比，孕前肥胖与母亲和教师报告的儿童行为评估结果普遍较高有关，表明行为问题的可能性增加。
