期刊
ACADEMIC PEDIATRICS
卷 14, 期 5, 页码 463-470出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.acap.2014.05.005
关键词
infants; mothers; obesity; pediatric; pregnancy; weight gain
类别
资金
- Academic Pediatric Association
- Maternal-Child Health Bureau
- National Heart, Lung, and Blood Institute [U01 HL03620-03]
- Eunice Kennedy Shriver National Institute of Child Health and Development
- Office of Behavioral and Social Sciences Research
- CTSA award from the National Center for Advancing Translational Sciences [UL1TR000445]
- Vanderbilt University [5T32HD060554-05]
- NCATS/National Institutes of Health [UL1 TR000445]
- [P30DK092986]
OBJECTIVE: To quantify the combined effect of maternal pre-pregnancy obesity and maternal gestational weight gain (GWG) on the shape of infant growth throughout the first year of life. METHODS: A retrospective cohort of mother-child dyads with children born between January 2007 and May 2012 was identified in a linked electronic medical record. Data were abstracted to define the primary exposures of maternal prepregnancy body mass index (BMI) and GWG, and the primary outcome of infant growth trajectory. RESULTS: We included 499 mother-child dyads. The average maternal age was 28.2 years; 55% of mothers were overweight or obese before pregnancy, and 42% of mothers had excess GWG, as defined by the Institute of Medicine. Maternal prepregnancy BM1 (P < .001) and the interaction between prepregnancy BMI and maternal GWG (P = .02) showed significant association with infant growth trajectory through the first year of life after controlling for breast-feeding and other covariates, while GWG alone did not reach statistical significance (P = .38). Among infants of mothers with excess GWG, a prepregnancy BMI of 40 k g/m(2) versus 25 kg/m(2) resulted in a 13.6% (95% confidence interval 5.8, 21.5; P < .001) increase in 3-month infant weight/length percentile that persisted at 12 months (8.4%, 95% confidence interval 0.2, 16.5; P = .04). CONCLUSIONS: The combined effect of excess maternal GWG and prepregnancy obesity resulted in higher infant birth weight, rapid weight gain in the first 3 months of life, with a sustained weight elevation throughout the first year of life. These findings highlight the importance of the preconception and prenatal periods for pediatric obesity prevention.
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