Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Nutrition during the early life cycle

Early childhood body mass index trajectory and overweight/obesity risk differed by maternal weight status

European Journal of Clinical Nutrition volume 76, pages 450–455 (2022)Cite this article

Subjects

Abstract

Objectives

To evaluate the associations of maternal prepregnancy body mass index (pp-BMI) and gestational weight gain (GWG) with the childhood BMI z-score (BMI-z) trajectories from birth to 2 years old and the risk of overweight/obesity (OWO) at 2 years of age.

Subjects/methods

Mother–child dyads (23,617) were involved in the analysis. They were followed up from early pregnancy to 2 years postpartum with their healthcare data recorded in the Wuhan Maternal and Child Health Management Information System (WMCHMIS). The OWO in children was defined as BMI-z > 1. Linear mixed models (LMM) and unconditional logistic regression were used to evaluate the independent and joint associations of pp-BMI and GWG with the BMI-z trajectory of children per their anthropometric measurements at 0, 1, 3, 6, 9, 12, 18, and 24 months old and the risk of OWO at 2 years of age.

Results

Maternal overweight/obesity and excessive GWG independently and jointly increased the risks of their offspring falling into high BMI-z trajectories of birth to 2 years (p < 0.001). In addition, the children whose mothers were overweight/obese before pregnancy and gained excessive weight during pregnancy independently and jointly increased the OWO risk in children at age 2, with adjusted odds ratios (adjOR) of 1.36 (95% CI, 1.22–1.53), 1.28 (95% CI, 1.18–1.39), and 1.76 (95% CI: 1.52–2.03), respectively.

Conclusions

Maternal prepregnancy overweight/obesity and excessive GWG can independently and jointly increase the risks of their children falling into high BMI-z trajectories from birth to 2 years of age and becoming overweight/obese at age 2. Maternal overweight/obesity and excessive gestational weight should be the prime targets for early obese prevention efforts.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: The independent and joint associations of maternal pp-BMI and GWG with offspring BMI-z trajectories from birth to 2 years.

Similar content being viewed by others

References

  1. Keß A, Spielau U, Beger C, Gausche R, Vogel M, Lipek T, et al. Further stabilization and even decrease in the prevalence rates of overweight and obesity in German children and adolescents from 2005 to 2015: a cross-sectional and trend analysis. Public Health Nutr. 2017;20:3075–83.

    Article  PubMed  Google Scholar 

  2. Flores M, Simonsen SE, Manuck TA, Dyer JM, Turok DK. The “Latina epidemiologic paradox”: contrasting patterns of adverse birth outcomes in U.S.-born and foreign-born Latinas. Women’s Health Issues. 2012;22:e501–7.

    Article  PubMed  Google Scholar 

  3. Ma G. China child obesity report. Beijing: people’s medical publishing house. 2017; p 14.

  4. Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev. 2016;17:56–67.

    Article  CAS  PubMed  Google Scholar 

  5. Ward ZJ, Long MW, Resch SC, Giles CM, Cradock AL, Gortmaker SL. Simulation of growth trajectories of childhood obesity into adulthood. N Engl J Med. 2017;377:2145–53.

    Article  PubMed  Google Scholar 

  6. Geserick M, Vogel M, Gausche R, Lipek T, Spielau U, Keller E, et al. Acceleration of BMI in early childhood and risk of sustained obesity. N Engl J Med. 2018;379:1303–12.

    Article  PubMed  Google Scholar 

  7. Twig G, Yaniv G, Levine H, Leiba A, Goldberger N, Derazne E, et al. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med. 2016;374:2430–40.

    Article  PubMed  Google Scholar 

  8. Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc. 2017;92:251–65.

    Article  PubMed  Google Scholar 

  9. Voerman E, Santos S, Golab BP, Amiano P, Jaddoe VWV. Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: an individual participant data meta-analysis. PLoS Med. 2019;16:e1002744.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Sridhar SB, Darbinian J, Ehrlich SF, Markman MA, Gunderson EP, Ferrara A, et al. Maternal gestational weight gain and offspring risk for childhood overweight or obesity. Am J Obstet Gynecol. 2014;211:259.e1–2598.

    Article  Google Scholar 

  11. Wrotniak BH, Shults J, Butts S, Stettler N. Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort study. Am J Clin Nutr. 2008;87:1818–24.

    Article  CAS  PubMed  Google Scholar 

  12. Aris IM, Chen LW, Tint MT, Pang WW, Soh SE, Saw SM, et al. Body mass index trajectories in the first two years and subsequent childhood cardio-metabolic outcomes: a prospective multi-ethnic Asian cohort study. Sci Rep. 2017;7:8424.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Buscot MJ, Thomson RJ, Juonala M, Sabin MA, Burgner DP, Lehtimäki T, et al. BMI trajectories associated with resolution of elevated youth BMI and incident adult obesity. Pediatrics. 2018;141:e20172003.

    Article  PubMed  Google Scholar 

  14. Roy SM, Chesi A, Mentch F, Xiao R, Chiavacci R, Mitchell JA, et al. Body mass index (BMI) trajectories in infancy differ by population ancestry and may presage disparities in early childhood obesity. J Clin Endocrinol Metab. 2015;100:1551–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Montazeri P, Vrijheid M, Martinez D, Basterrechea M, Fernandez‐Somoano A, Guxens M, et al. Maternal metabolic health parameters during pregnancy in relation to early childhood BMI trajectories. Obesity. 2018;26:588–96.

    Article  CAS  PubMed  Google Scholar 

  16. Hu Z, Tylavsky FA, Han JC, Kocak M, Fowke JH, Davis R, et al. Maternal metabolic factors during pregnancy predict early childhood growth trajectories and obesity risk: the CANDLE Study. Int J Obes. 2019;43:1914–22.

    Article  Google Scholar 

  17. Yang S, Peng A, Sheng W, Jing W, Zhao J, Zhang Y, et al. Pre-pregnancy body mass index, gestational weight gain, and birth weight: a cohort study in China. PLoS ONE. 2015;10:e0130101.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Chen CM. Overview of obesity in Mainland China. Obes Rev. 2008;9:14–21.

    Article  PubMed  Google Scholar 

  19. Institute of Medicine. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington: National Academies Press. 2009; p 2.

  20. Baumgartner J, Smuts CM, Aeberli I, Malan L, Tjalsma H, Zimmermann MB. Overweight impairs efficacy of iron supplementation in iron-deficient South African children: a randomized controlled intervention. Int J Obes. 2013;37:24–30.

    Article  CAS  Google Scholar 

  21. Yang S, Mei H, Mei H, Yang Y, Li N, Tan Y, et al. Risks of maternal pre-pregnancy overweight/obesity, excessive gestational weight gain, and bottle-feeding in infancy rapid weight gain: evidence from a cohort study in China. Sci China Life Sci. 2019;62:1580–9.

    Article  PubMed  Google Scholar 

  22. Liu P, Xu L, Wang Y, Zhang Y, Du Y, Sun Y, et al. Association between perinatal outcomes and maternal pre-pregnancy body mass index. Obes Rev. 2016;17:1091–102.

    Article  CAS  PubMed  Google Scholar 

  23. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307:491–7.

    Article  PubMed  Google Scholar 

  24. Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ. 2017;356:j1.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Deputy NP, Sharma AJ, Kim SY, Hinkle SN. Prevalence and characteristics associated with gestational weight gain adequacy. Obstet Gynecol. 2015;125:773–81.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Liu J, Gallagher AE, Carta CM, Torres ME, Moran R, Wilcox S. Racial differences in gestational weight gain and pregnancy-related hypertension. Ann Epidemiol. 2014;24:441–7.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Gaillard R, Santos S, Duijts L, Felix JF. Childhood health consequences of maternal obesity during pregnancy: a narrative review. Ann Nutr Metab. 2016;69:171–80.

    Article  CAS  PubMed  Google Scholar 

  28. Godfrey KM, Reynolds RM, Prescott SL, Nyirenda M, Jaddoe VWV, Eriksson JG, et al. Influence of maternal obesity on the long-term health of offspring. Lancet Diabetes Endocrinol. 2017;5:53–64.

    Article  PubMed  Google Scholar 

  29. Maes HH, Neale MC, Eaves LJ. Genetic and environmental factors in relative body weight and human adiposity. Behav Genet. 1997;27:325–51.

    Article  CAS  PubMed  Google Scholar 

  30. Poston L. Maternal obesity, gestational weight gain and diet as determinants of offspring long term health. Best Pr Res Clin Endocrinol Metab. 2012;26:627–39.

    Article  Google Scholar 

  31. Ruager-Martin R, Hyde MJ, Modi N. Maternal obesity and infant outcomes. Early Hum Dev. 2010;86:715–22.

    Article  PubMed  Google Scholar 

  32. Reynolds RM. Childhood obesity: the impact of maternal obesity on childhood obesity. Berlin, Heidelberg: Springer; 2011.

  33. Robinson SM, Godfrey KM. Feeding practices in pregnancy and infancy: relationship with the development of overweight and obesity in childhood. Int J Obes. 2008;32:S4–10.

    Article  Google Scholar 

  34. Scaglioni S, Arrizza C, Vecchi F, Tedeschi S. Determinants of children’s eating behavior. Am J Clin Nutr. 2011;94:2006S–11S.

    Article  CAS  PubMed  Google Scholar 

  35. Meyer DM, Brei C, Stecher L, Much D, Brunner S, Hauner H. Leptin in maternal plasma and cord blood as a predictor of offspring adiposity at 5 years: a follow-up study. Obesity. 2018;26:279–83.

    Article  CAS  PubMed  Google Scholar 

  36. Penfold NC, Ozanne SE. Developmental programming by maternal obesity in 2015: Outcomes, mechanisms, and potential interventions. Horm Behav. 2015;76:143–52.

    Article  PubMed  Google Scholar 

  37. Masuyama H, Hiramatsu Y. Effects of a high-fat diet exposure in utero on the metabolic syndrome-like phenomenon in mouse offspring through epigenetic changes in adipocytokine gene expression. Endocrinology. 2012;153:2823–30.

    Article  CAS  PubMed  Google Scholar 

  38. Mühlhäusler BS. Programming of the appetite-regulating neural network: a link between maternal overnutrition and the programming of obesity? J Neuroendocrinol. 2007;19:67–72.

    Article  PubMed  Google Scholar 

  39. Seal N, Broome ME. Prepregnancy body mass index and feeding practices in relation to infants’ growth. J Nurse Pract. 2013;9:10.

    Article  PubMed Central  Google Scholar 

  40. Farajian P, Panagiotakos DB, Risvas G, Malisova O, Zampelas A. Hierarchical analysis of dietary, lifestyle and family environment risk factors for childhood obesity: the GRECO study. Eur J Clin Nutr. 2014;68:1107–12.

    Article  CAS  PubMed  Google Scholar 

  41. Nelson SM, Matthews P, Poston L. Maternal metabolism and obesity: modifiable determinants of pregnancy outcome. Hum Reprod Update. 2010;16:255–75.

    Article  PubMed  Google Scholar 

  42. Karachaliou M, Georgiou V, Roumeliotaki T, Chalkiadaki G, Daraki V, Koinaki S, et al. Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood. Am J Obstet Gynecol. 2015;212:502.e1–14.

    Article  Google Scholar 

  43. Bider-Canfield Z, Martinez MP, Wang X, Yu W, Bautista MP, Brookey J, et al. Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years. Pediatr Obes. 2017;12:171–8.

    Article  CAS  PubMed  Google Scholar 

  44. Robinson SM, Crozier SR, Harvey NC, Barton BD, Law CM, Godfrey KM, et al. Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention. Am J Clin Nutr. 2015;101:368–75.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We extend our sincere thanks to the healthcare staff from the Wuhan Maternal and Child Healthcare Hospital that provided support for data collection. We also greatly appreciate the participants included in this study.

Author information

Authors and Affiliations

  1. Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

    Ruixia Chang, Yuanyuan Zhang, Ke Xu & Jianduan Zhang

  2. Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

    Hong Mei & Shaoping Yang

Authors
  1. Ruixia Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hong Mei
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuanyuan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ke Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shaoping Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jianduan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

RX Chang design the research, interpreted the results, contributed to the discussions, wrote of the manuscript. YY Zhang collected and analyzed the data, revised the manuscript. All authors have reviewed the manuscript and approved the final submitted for publication.

Corresponding authors

Correspondence to Shaoping Yang or Jianduan Zhang.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

This study was approved by the Ethics Committee of Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, and Huazhong University of Science and Technology (No. 2020R025-E01).

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chang, R., Mei, H., Zhang, Y. et al. Early childhood body mass index trajectory and overweight/obesity risk differed by maternal weight status. Eur J Clin Nutr 76, 450–455 (2022). https://doi.org/10.1038/s41430-021-00975-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-021-00975-6

This article is cited by

Search

Advanced search

Quick links