Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
Acta Obstet Gynecol Scand. 2024 Nov;103(11):2171-2182. doi: 10.1111/aogs.14961. Epub 2024 Sep 4.
Childhood obesity is associated with maternal obesity, but the link to gestational weight gain (GWG) is not fully elucidated. We examined the relationship between early pregnancy maternal body mass index (BMI) and GWG on early childhood growth.
Data from 30 197 mother-child pairs from Uppsala County Mother and Child Cohort were divided into 15 groups according to maternal BMI and GWG, based on World Health Organization classification and Institute of Medicine guidelines, respectively. Postnatal growth patterns were analyzed with linear mixed regression models within maternal BMI groups. Odds ratios of overweight and obesity at 4 years of age were assessed with logistic regression analyses. We treated children of mothers with normal weight and adequate GWG as the reference group, and all analyses were adjusted for potential confounders.
GWG was associated with infant BMI z-score at birth, independent of potential confounding factors. Independent of GWG, we observed an overall decrease in BMI z-score from 18 months to 5 years in children of mothers who were underweight, while an increase in BMI z-score was seen in children of mothers who were overweight or obese. In children of normal- and overweight mothers, the risk of childhood overweight and obesity was associated with excessive compared to adequate GWG (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] 1.01-1.36 for normal-weight mothers, and aOR 1.25, 95% CI 1.04-1.51 for overweight mothers, respectively). Children of mothers with obesity and excessive GWG had the highest risk of being overweight or obese at 4 years (aOR 2.88, 95% CI 2.40-3.44, and 4.38, 95% CI 3.37-5.67, respectively). Associations did not differ between children of mothers with obesity class 1 and 2-3 when comparing excessive and adequate GWG (aOR 1.33, 95% CI 0.96-1.85, and 1.12, 95% CI 0.74-1.70, respectively).
Maternal GWG affects infant birth size and growth until 18 months, although maternal BMI is more crucial for childhood growth beyond 18 months. Further, children of mothers who are normal- or overweight and experience excessive GWG have an increased risk of obesity at 4 years.
儿童肥胖与母亲肥胖有关，但与妊娠期体重增加（GWG）的联系尚未完全阐明。我们研究了早孕时母亲的身体质量指数（BMI）与 GWG 对幼儿生长的关系。
乌普萨拉县母婴队列的 30197 对母婴数据，根据世界卫生组织的分类和医学研究所的指南，分别按照母亲 BMI 和 GWG 分为 15 组。在母亲 BMI 组内，采用线性混合回归模型分析产后生长模式。采用 logistic 回归分析评估 4 岁时超重和肥胖的比值比。我们将体重正常和 GWG 充足的母亲的孩子视为参考组，所有分析均调整了潜在混杂因素。
GWG 与婴儿出生时的 BMIz 评分有关，独立于潜在的混杂因素。独立于 GWG，我们观察到在体重不足的母亲所生的孩子中，从 18 个月到 5 岁时 BMIz 评分总体下降，而在超重或肥胖的母亲所生的孩子中，BMIz 评分上升。在正常体重和超重母亲的孩子中，与 GWG 充足相比，GWG 过多与儿童超重和肥胖的风险相关（调整后的比值比 [aOR] 1.17，95%置信区间 [CI] 1.01-1.36 对于正常体重的母亲，aOR 1.25，95% CI 1.04-1.51 对于超重的母亲）。肥胖和 GWG 过多的母亲所生的孩子在 4 岁时超重或肥胖的风险最高（aOR 2.88，95% CI 2.40-3.44 和 4.38，95% CI 3.37-5.67）。肥胖 1 类和 2-3 类母亲的 GWG 过多与充足相比，儿童的关联没有差异（aOR 1.33，95% CI 0.96-1.85 和 1.12，95% CI 0.74-1.70）。
GWG 影响婴儿出生时的大小和 18 个月前的生长，但母亲 BMI 对 18 个月后儿童的生长更为重要。此外，体重正常或超重且 GWG 过多的母亲的孩子在 4 岁时肥胖的风险增加。
