Developmental trajectories of Body Mass Index from infancy to 18 years of age: prenatal determinants and health consequences

Abstract

BackgroundKnowledge on the long-term development of adiposity throughout childhood/adolescence and its prenatal determinants and health sequelae is lacking. We sought to (1) identify trajectories of Body Mass Index (BMI) from 1 to 18 years of age, (2) examine associations of maternal gestational smoking and early pregnancy overweight with offspring BMI trajectories and (3) determine whether BMI trajectories predict health outcomes: asthma, lung function parameters (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio), and blood pressure, at 18 years.MethodsThe Isle of Wight birth cohort, a population-based sample of 1456 infants born between January 1989 and February 1990, was prospectively assessed at ages 1, 2, 4, 10 and 18 years. Group-based trajectory modelling was applied to test for the presence of latent BMI trajectories. Associations were assessed using log-binomial and linear regression models.ResultsFour trajectories of BMI were identified: ‘normal’, ‘early persistent obesity’, ‘delayed overweight’, and ‘early transient overweight’. Risk factors for being in the early persistent obesity trajectory included maternal smoking during pregnancy (RR 2.16, 95% CI 1.02 to 4.68) and early pregnancy overweight (3.16, 1.52 to 6.58). When comparing the early persistent obesity to the normal trajectory, a 2.15-fold (1.33 to 3.49) increased risk of asthma, 3.2% (0.4% to 6.0%) deficit in FEV1/FVC ratio, and elevated systolic 11.3 mm Hg (7.1 to 15.4) and diastolic 12.0 mm Hg (8.9 to 15.1) blood pressure were observed at age 18 years.ConclusionsMaternal prenatal exposures show prolonged effects on offspring's propensity towards overweight-obesity. Distinct morbid BMI trajectories are evident during the first 18 years of life that are associated with higher risk of asthma, reduced FEV1/FVC ratio, and elevated blood pressure.

Developmental trajectories of adiposity from birth until early adulthood and association with cardiometabolic risk factors

“…20,[22][23][24] Adiposity differences between trajectories appeared in the first years of life and there was a low probability (about 10%) of changing trajectory from adolescence onwards (data not shown). These results suggest that the determinants of the two different trajectories are related to early events.…”

“…The direct association between parental BMI and childhood obesity have been extensively addressed and have been also found when analysing the association with BMI trajectories in childhood or youth. [22][23][24][26][27][28] The association between caesarean section and offspring overweight and obesity have been previously described, 29 although some authors have argued that it is not causal, and may be due to uncontrolled confounding. 30,31 Maternal smoking during pregnancy, breastfeeding and complementary feeding were not different according to developmental trajectories.…”

“…22,26 Regarding the association between developmental trajectories and cardiometabolic risk factors in early adulthood, we found that participants from 'Higher BMI growth' trajectory presented a worse cardiometabolic profile, with higher levels of blood pressure, HOMA-IR and triglycerides, and lower levels of HDL-C. To our knowledge few studies have evaluated the effect of paediatric adiposity trajectories on adult cardiometabolic outcomes, since the majority of studies are limited to childhood or adolescence. Ziyab et al 23 have studied BMI trajectories from 1 to 18 years in the Isle of Wight birth cohort, UK, and found that an early persistent obesity trajectory was associated with higher blood pressure at 18 years of age. The West Australian Pregnancy cohort showed three trajectories (birth to age 14) characterized by accelerating adiposity associated with increased risk of prehypertension or hypertension at 17 years of age.…”

Maternal Dietary Patterns during Pregnancy Are Associated with Child Growth in the First 3 Years of Life

“…Such an approach neglects the dynamic changes that occur in growth during early childhood, which could lead to incorrect interpretations of study results (13). To our knowledge, only one study has examined maternal dietary patterns during pregnancy and early childhood growth patterns.…”

The association between parental overweight and obesity before pregnancy and the development of offspring overweight and obesity in childhood, adolescence and young adulthood

“…The odds of children at 8 years being in the persistent trajectory group if they had overweight mothers before pregnancy and overweight fathers were 1.85 (95% CI: 1.37-2.49) and years. They defined the trajectories as normal, early persistent obesity, delayed overweight, and early transient overweight [137]. Maternal early-pregnancy overweight (OR: 3.16 95%CI: 1.52-6.58) was reported as one of the strong independent predictors associated with membership of the early-persistent obesity group of offspring compared to normal-weight mothers.…”