Socioeconomic disadvantage in childhood as a predictor of excessive gestational weight gain and obesity in midlife adulthood.

Benjamin W Chaffee,David H Rehkopf,Alison K Cohen,Barbara Abrams

doi:10.1186/s12982-015-0026-7

Abstract

BackgroundLower childhood socioeconomic position is associated with greater risk of adult obesity among women, but not men. Pregnancy-related weight changes may contribute to this gender difference. The objectives of this study were to determine the associations between: 1. childhood socioeconomic disadvantage and midlife obesity; 2. excessive gestational weight gain (GWG) and midlife obesity; and 3. childhood socioeconomic disadvantage and excessive GWG, among a representative sample of childbearing women.MethodsWe constructed marginal structural models for seven measures of childhood socioeconomic position for 4780 parous women in the United States, using National Longitudinal Survey of Youth (1979–2010) data. Institute of Medicine definitions were used for excessive GWG; body mass index ≥30 at age 40 defined midlife obesity. Analyses were separated by race/ethnicity. Additionally, we estimated controlled direct effects of childhood socioeconomic disadvantage on midlife obesity under a condition of never gaining excessively in pregnancy.ResultsLow parental education, but not other measures of childhood disadvantage, was associated with greater midlife obesity among non-black non-Hispanic women. Among black and Hispanic mothers, childhood socioeconomic disadvantage was not consistently associated with midlife obesity. Excessive GWG was associated with greater midlife obesity in all racial/ethnic groups. Childhood socioeconomic disadvantage was not statistically significantly associated with excessive GWG in any group. Controlled direct effects were not consistently weaker than total effects.ConclusionsChildhood socioeconomic disadvantage was associated with adult obesity, but not with excessive gestational weight gain, and only for certain disadvantage measures among non-black non-Hispanic mothers. Prevention of excessive GWG may benefit all groups through reducing obesity, but excessive GWG does not appear to serve as a mediator between childhood socioeconomic position and adult obesity in women.

Highlights

Lower childhood socioeconomic position is associated with greater risk of adult obesity among women, but not men
Among nonblack Hispanic mothers, low parental education and paternal blue-collar occupation were associated with a higher prevalence of midlife obesity, albeit not statistically significant, while household income
Our results suggest that different aspects of childhood socioeconomic position (SEP) carry different implications for obesity in midlife, which may vary by race/ethnicity

Summary

Introduction

Lower childhood socioeconomic position is associated with greater risk of adult obesity among women, but not men. Excessive gestational weight gain (GWG) and midlife obesity; and 3. An observed gender nonconformity in obesity differences by SEP raises questions as to what weight-related risk factors. No previous studies have considered the association between childhood SEP and gestational weight gain or the role of excessive GWG as a possible mediator between childhood SEP and adult obesity. We first aimed to estimate the association between early-life socioeconomic disadvantage and obesity at midlife among parous women in the National Longitudinal Survey of Youth (NLSY) 1979 cohort [6], using multiple of markers of childhood SEP, including parental educational attainment, parental employment, and household income. To examine mediation by excessive GWG between childhood socioeconomic disadvantage and adult obesity, we estimated the childhood SEP-obesity association under a condition in which no woman gains excessively in pregnancy (i.e. controlled direct effect)

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