Childhood Growth Trajectories of Etiological Subgroups of Large for Gestational Age Newborns

Abstract

To evaluate whether large for gestational age (LGA) etiological subgroups have differential growth trajectories during early childhood. Approximately 10,700 infants and their parents were included in the Early Childhood Longitudinal Study-Birth Cohort in 2001-2002. Research staff collected data in 5 waves when participating children were approximately 9 months and 2, 4, 5, and 6 years of age. We analyzed 2950 LGA and appropriate-for-gestational-age (AGA) children with at least 1 growth outcome at ages 9 months, 2 years, and 4 years. We divided 600 LGA newborns into 8 subgroups by maternal overweight or obesity before pregnancy (OW/OB), diabetes mellitus (DM), and excessive gestational weight gain (ExGWG). We used mixed effect regression models to compare trajectories of height (length)-for-age or body mass index (BMI) z scores across LGA subgroups and the AGA reference group. Relative to the reference group, the LGA subgroup with maternal OW/OB and DM but normal gestational weight gain had "continuous high rising" BMI z-score trajectory from 9 months to 4 years and the greatest mean z score at 4 years (2.14 [95% CI, 1.29, 2.98]). The LGA subgroup free of maternal OW/OB, DM, or ExGWG had a similar BMI z-score trajectory ("stable low") from 9 months to 4 years and a similar 4-years mean z score (0.97 [95% CI, 0.75, 1.18] vs 0.72 [95% CI, 0.67, 0.78]) relative to the AGA reference group. The LGA subgroup with co-occurrence of maternal OW/OB and DM had the greatest 4-year BMI, whereas the LGA subgroup free of maternal OW/OB, DM, or ExGWG were tall but lean ("a healthy phenotype").