Pediatric Highlight
International Journal of Obesity (2009) 33, 743–752; doi:10.1038/ijo.2009.101; published online 16 June 2009
Maternal-recalled gestational weight gain, pre-pregnancy body mass index, and obesity in the daughter
A M Stuebe1, M R Forman2 and K B Michels3,4,5
- 1Department of Obstetrics, Gynecology and Reproductive Biology, Division of Maternal–Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- 2Department of Epidemiology, UT MD Anderson Cancer Center, Houston, Texas, USA
- 3Department of Obstetrics, Gynecology, and Reproductive Biology, Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- 4Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medicine School, Boston, Massachusetts, USA
- 5Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
Correspondence: Dr AM Stuebe, Department of Obstetrics and Gynecology, Division of Maternal–Fetal Medicine, School of Medicine, University of North Carolina at Chapel Hill, 3010 Old Clinic Building, CB#7516, Chapel Hill, NC 27599-7516, USA. E-mail: astuebe@med.unc.edu
Received 5 October 2008; Revised 22 April 2009; Accepted 1 May 2009; Published online 16 June 2009.
Abstract
Objective:
Emerging evidence suggests that exposures during fetal life affect adult metabolism. We assessed the relationship between recalled maternal pre-pregnancy body mass, gestational weight gain (GWG), and adiposity in the daughter.
Design:
Retrospective cohort study among mother–nurse daughter dyads in the Nurses' Health Study II and the Nurses' Mothers' Cohort. Mothers of participants completed questionnaires regarding their nurse daughter in 2001.
Participants:
26,506 mother–nurse daughter dyads born between 1946 and 1964.
Main outcome measures:
Body mass index (BMI) of the nurse daughter at age 18 and in 2001.
Results:
At age 18, 561 (2.1%) daughters were obese (BMI>30), and in 2001, 5442 (22.0%) were obese. Adjusting for covariates, women whose mothers had a recalled pre-pregnancy BMI of 29 had a 6.1-fold increased risk of obesity at age 18 and a 3.4-fold risk of obesity in 2001, compared with women whose mothers had a pre-pregnancy BMI of 21. We found a U-shaped association between recalled GWG and offspring obesity. Compared with a maternal weight gain of 15–19 lb, GWG <10 lb was associated with a significant increase in obesity risk at age 18 (odds ratio (OR) 1.54, 95% confidence interval (CI) 1.02–2.34) and in 2001 (OR 1.27, 95% CI 1.05–1.53). High weight gain (40+lb) was also associated with obesity risk at age 18 (OR 1.81, 95% CI 1.22–2.69) and in 2001 (OR 1.74, 95% CI 1.48–2.04). These associations were stronger among mothers who were overweight before pregnancy (P for interaction=0.03), and they persisted with adjustment for birth weight.
Conclusion:
A high recalled pre-pregnancy BMI and extremes of recalled GWG are associated with an increased risk of adolescent and adult obesity in offspring, particularly when the mother is overweight. Pre-pregnancy weight and GWG may be modifiable fetal origins of overweight and obesity in women.
Keywords:
pregnancy, gestational weight gain, prenatal programming, birth weight
