Association of Total and Trimester-Specific Gestational Weight Gain Rate with Early Infancy Weight Status: A Prospective Birth Cohort Study in China.

Jiajin Hu,Ning Ding,Ming Gao,Xiaotong Wei,Deliang Wen,Yanan Ma,Emily Oken,Izzuddin Aris

doi:10.3390/nu11020280

Abstract

Studies to examine the associations of gestational weight gain (GWG) with offspring weight status during infancy are needed, especially among Asian populations. We examined 801 mother–infant pairs from a prospective cohort study in China to assess the associations of total and trimester-specific GWG with early infant weight status. We used linear mixed effects models and linear regression models to examine the longitudinal and time-point associations of GWG rate (kg/week) with infant growth measures (z-scores of body-mass-index (BMIZ), weight-for-age (WFAZ) and length-for-age (LFAZ)) at birth, 1, 3, and 6 months. Greater total GWG rate was associated with higher BMIZ (β:1.34 SD units (95% CI: 0.84, 1.83) per 1 kg/week increase in GWG) and higher WFAZ (β:1.18 SD units (95% CI: 1.01, 2.28)) across the first 6 months of life. GWG rate in the first two trimesters but not in the third trimester was positively associated with infant BMIZ. The association between GWG rate and infant BMIZ was significant at all timepoints and more pronounced in normal weight women and among male infants. In conclusion, greater GWG rate is positively associated with offspring BMIZ in the first 6 months of life, the association is mostly driven by GWG in the first two trimesters.

Highlights

The epidemic of childhood obesity is a global challenge [1]
A previous study in China [28] has examined associations of trimester specific gestational weight gain (GWG) with offspring weight status at birth, further studies are needed to assess this association in Asian populations, where GWG patterns may differ from Western populations [20,29,30]
We examined the longitudinal associations of total and trimester-specific GWG rate with infant sex- and age- specific z-score for body mass index (BMI), weight and length from birth to 6 months using linear mixed effects (LME) models, which takes into account within-subject correlation of repeated measurements and at the same time allows for incomplete outcome measurement [39]

Summary

Introduction

The epidemic of childhood obesity is a global challenge [1]. In China, the prevalence of childhood obesity has doubled over the past few decades [2]. Most previous studies found that early, rather than late GWG, was associated with offspring weight status [14,21,22,23,24,25], other studies have suggested that excessive late weight gain may contribute to offspring risk for obesity [26,27]. Most of these studies were based in Western populations. A previous study in China [28] has examined associations of trimester specific GWG with offspring weight status at birth, further studies are needed to assess this association in Asian populations, where GWG patterns may differ from Western populations [20,29,30]

Methods

Results

Discussion

Conclusion