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Paternal BMI in the preconception period, and the association with child zBMI



Rapid growth and excess weight in early childhood are associated with obesity risk. While maternal preconception BMI has been identified as a potential risk factor, the role of paternal preconception BMI is less clear.


To examine the association between paternal preconception BMI and age- and sex-standardized WHO BMI z-score (zBMI) growth rates, zBMI, and weight status, in 0- to 10-year-old children. To determine whether these associations differed by child sex and maternal preconception weight status.


A longitudinal cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!). Children (n = 218) underwent repeated measures of height and weight from birth to 10 years old. Piecewise linear mixed models were used to assess the association between paternal preconception BMI and child zBMI growth rates (zBMI SD units/month) between 0, 4, 30, 48 and 120 months of age. Linear mixed models were used to examine the association with child zBMI, and logistic generalized estimation equations (GEE) were used to assess the association with child weight status. Child sex and maternal preconception weight status were tested as effect modifiers.


Paternal preconception BMI was associated with child zBMI growth rate, mean zBMI and weight status in boys, but not girls. A 5 kg/m2 higher paternal preconception BMI was associated with approximately 0.01 zBMI SD unit/month higher growth rate for boys born to mothers with preconception overweight. Higher paternal BMI was associated with higher mean zBMI and increased odds of overweight and obesity in boys, with greater effects seen when mothers had preconception overweight compared to normal weight.


Paternal preconception BMI was associated with child zBMI growth rate, zBMI and weight status in boys, with greater effects when the biological mother had preconception overweight or obesity. Further understanding of sex differences in paternal preconception weight effects in children is needed.

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Fig. 1: Flow chart of participant inclusion and exclusion criteria.
Fig. 2: Predicted zBMI growth trajectories (95%CIs) by paternal preconception BMI, for child sex and maternal preconception weight status strata.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available as we do not have REB approval for data sharing.


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Authors and Affiliations




JLM, and CSB: designed and led the TARGet Kids! cohort study; LNA led TARGet Kids! cohort study; ACD, CKS, DLO, JLM, CLD, and CSB: designed the present analysis; ACD and CKS: analyzed the data; ACD and CSB: wrote the manuscript; CSB: had primary responsibility for final content. All authors read and approved the final manuscript.

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Correspondence to Arin C. Deveci.

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CSB reported receiving research funding from the Canadian Institute for Health Research, Heart and Stroke Foundation of Canada, Physician Services Inc, The Edwin S.H. Leong Centre for Healthy Children, University of Toronto and Hospital for Sick Children, Centre for Addictions and Mental Health, Ontario Child Health Support Unit (OCHSU) Impact Child Health Award, and a Walmart Community Grant through the SickKids Foundation for a study on food insecurity in the inpatient hospital setting. The other authors had no conflicts of interest relevant to this article to disclose. The funding agencies had no role in the design and conduct of the study, the collection, management, analysis and interpretation of the data, or the preparation, review and approval of the manuscript.

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Deveci, A.C., Keown-Stoneman, C.D.G., Maguire, J.L. et al. Paternal BMI in the preconception period, and the association with child zBMI. Int J Obes 47, 280–287 (2023).

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