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Weight gain in early years and subsequent body mass index trajectories across birth weight groups: a prospective longitudinal study.

ABSTRACT: BACKGROUND:Rapid weight gain (RWG) in early-life is associated with increased risk of childhood obesity and is common among low-birth weight infants. Few studies have compared body mass index (BMI) trajectories of children experienced RWG to those who did not, across birth weight groups. We investigated the association between RWG in early-life and subsequent BMI trajectory and whether the association differs by birth weight. METHODS:We included term singletons from the UK Millennium Cohort Study (n = 10 637). RWG was defined as an increase in weight z-scores (derived using UK-WHO growth reference) between birth and 3 years >0.67. Mixed-effect fractional polynomial models were applied to examine the association between RWG and BMI trajectories (5-14 years). Models were further adjusted for confounders and stratified by birth weight-for-gestational-age group. RESULTS:Mean BMI trajectories were higher in children who experienced RWG in early-life, compared with their non-RWG counterparts. RWG was associated with higher BMI at five years [by 0.76 kg/m2 (95% CI: 0.67-0.85) in boys and 0.87 kg/m2 (0.76-0.97) in girls]; the difference persisted into adolescence [1.37 kg/m2 (1.17-1.58) and 1.75 kg/m2 (1.52-1.99) at 14 years, respectively]. Differences remained after adjustment and were particularly greater for children born large-for-gestational-age than those born small- and appropriate-for-gestational-age. Mean BMI trajectories for large-for-gestational-age children with RWG exceeded international reference curves for overweight (for obesity at some ages in girls). CONCLUSIONS:RWG was associated with higher BMI trajectories throughout childhood and adolescence, especially in large-for-gestational-age children. Strategies for obesity prevention need to address factors during and before infancy and preventing excessive weight gain among infants who have already had adequate growth in utero.

SUBMITTER: Lu Y

PROVIDER: S-EPMC7183364 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Weight gain in early years and subsequent body mass index trajectories across birth weight groups: a prospective longitudinal study.

Lu Yi Y Pearce Anna A Li Leah L

European journal of public health 20200401 2

<h4>Background</h4>Rapid weight gain (RWG) in early-life is associated with increased risk of childhood obesity and is common among low-birth weight infants. Few studies have compared body mass index (BMI) trajectories of children experienced RWG to those who did not, across birth weight groups. We investigated the association between RWG in early-life and subsequent BMI trajectory and whether the association differs by birth weight.<h4>Methods</h4>We included term singletons from the UK Millenn ...[more]

PMID: 31899482

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Project description:BackgroundGestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies.MethodsWe used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape.ResultsWe observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4-17.4) for underweight women, 14.5 kg (11.5-17.7) for normal weight women, 13.9 kg (10.1-17.9) for overweight women, and 11.2 kg (7.0-15.7), 8.7 kg (4.3-13.4) and 6.3 kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications.ConclusionsGestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.

Dataset Information

Weight gain in early years and subsequent body mass index trajectories across birth weight groups: a prospective longitudinal study.

Publications

Weight gain in early years and subsequent body mass index trajectories across birth weight groups: a prospective longitudinal study.

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