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Nutrition during the early life cycle

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

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.

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

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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.

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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.

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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).

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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 (2021). https://doi.org/10.1038/s41430-021-00975-6

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