Lu Zheng, Shadid Iskander L C, Shah Jhill, Carey Vincent J, Laranjo Nancy, O'Connor George T, Zeiger Robert S, Bacharier Leonard, Litonjua Augusto A, Weiss Scott T, Mirzakhani Hooman
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands.
Clin Obes. 2025 May 5:e70021. doi: 10.1111/cob.70021.
While prior studies have linked maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) to birth weight and early childhood obesity, fewer have examined their joint effect on longitudinal growth trajectories, particularly standardized BMI z-scores through school age. We aimed to examine the relationship between maternal pre-pregnancy BMI, GWG and the trajectory of offspring's early-life weight, BMI z-scores and weight percentiles from birth to age 8. Linear mixed models were employed to assess the association between maternal pre-pregnancy BMI, GWG and children's standardized weight-for-age, BMI and length/height-for-age, adjusting for potential confounders. Data were analysed from 806 mother-child pairs from the Vitamin D Antenatal Asthma Reduction Trial, with children followed longitudinally from birth through 8 years of age. Our study demonstrated a significant association between maternal pre-pregnancy BMI and offspring weight-for-age and BMI z-score trajectories (β = .03, 95% confidence interval [CI]: 0.02-0.04 for both; p < .001, respectively). Specifically, children born to mothers with pre-pregnancy BMI of 25-30 kg/m or ≥30 kg/m had significantly higher BMI z-scores (β = .15, 95% CI: 0.02-0.29; p = .03; β = .49, 95% CI: 0.33-0.64; p < .001, respectively) compared to those with normal BMI. Maternal BMI was not significantly associated with the child's length/height. GWG was independently and positively associated with weight-for-age and BMI z-scores (β = .01, 95% CI: 0.002-0.015, p = .01 and β = .01, 95% CI: 0.01-0.02, p < .001, respectively). Excessive GWG was linked to higher offspring weight-for-age and BMI z-scores from birth to 8 years (β = .20, 95% CI: 0.08-0.32; β = .19, 95% CI: 0.08-0.31; p = .001, respectively) compared to guideline-congruent or inadequate GWG. Achieving or maintaining a healthy BMI prior to pregnancy and adhering to GWG guidelines may help mitigate the risk of early childhood overweight or obesity.
虽然先前的研究已将孕前体重指数（BMI）和孕期体重增加（GWG）与出生体重及儿童早期肥胖联系起来，但较少有研究考察它们对纵向生长轨迹的联合影响，尤其是对学龄期标准化BMI z评分的影响。我们旨在研究孕前BMI、GWG与子代出生至8岁早期体重轨迹、BMI z评分及体重百分位数之间的关系。采用线性混合模型评估孕前BMI、GWG与儿童年龄别标准化体重、BMI及年龄别身长/身高之间的关联，并对潜在混杂因素进行校正。分析了维生素D预防哮喘试验中806对母婴的数据，儿童从出生起纵向随访至8岁。我们的研究表明，孕前BMI与子代年龄别体重及BMI z评分轨迹之间存在显著关联（两者的β值均为0.03，95%置信区间[CI]：0.02 - 0.04；p值均<0.001）。具体而言，孕前BMI为25 - 30kg/m²或≥30kg/m²的母亲所生儿童的BMI z评分显著更高（分别为β = 0.15，95%CI：0.02 - 0.29；p = 0.03；β = 0.49，95%CI：0.33 - 0.64；p < 0.001），与BMI正常的母亲所生儿童相比。母亲BMI与儿童的身长/身高无显著关联。GWG与年龄别体重及BMI z评分独立正相关（分别为β = 0.01，95%CI：0.002 - 0.015，p = 0.01；β = 0.01，95%CI：0.01 - 0.02，p < 0.001）。与符合指南或不足的GWG相比，孕期体重过度增加与子代出生至8岁时更高的年龄别体重及BMI z评分相关（分别为β = 0.20，95%CI：0.08 - 0.32；β = 0.19，95%CI：0.08 - 0.31；p = 0.001）。孕前达到或维持健康的BMI并遵循GWG指南可能有助于降低儿童早期超重或肥胖的风险。
