Maternal Pre-Pregnancy Nutritional Status and Infant Birth Weight in Relation to 0–2 Year-Growth Trajectory and Adiposity in Term Chinese Newborns with Appropriate Birth Weight-for-Gestational Age

Abstract

Being born with appropriate weight-for-gestational age (AGA, ~80% of newborns) is often considered as low risk for future obesity. This study examined differential growth trajectories in the first two years by considering pre- and peri-natal factors among term-born AGA infants. We prospectively investigated 647 AGA infants and their mothers enrolled during 2012–2013 in Shanghai, China, and obtained repeated anthropometric measures at ages 42 days, 3, 6, 9, and 18 months from postnatal care records, and onsite measurements at age 1 and 2 years (skinfold thickness, mid-upper arm circumference (MUAC)). Birthweight was classified into sex-and gestational age-specific tertiles. Among mothers, 16.3% were overweight/obese (OWO), and 46.2% had excessive gestational weight gain (GWG). The combination of maternal prepregnancy OWO and high birthweight tertile identified a subset of AGA infants with 4.1 mm higher skinfold thickness (95% CI 2.2–5.9), 1.3 cm higher MUAC (0.8–1.7), and 0.89 units higher weight-for-length z-score (0.54, 1.24) at t2 years of age years with adjustment for covariates. Excessive GWG was associated with higher child adiposity measures at 2 years of age. AGA infants manifested differential growth trajectories by the combination of maternal OWO and higher birthweight, suggesting that additional attention is needed for those “at increased risk” of OWO in early intervention.

Association of early-term birth and breastfeeding practices with nutritional outcomes in singleton term infants: a multicenter cross-sectional study

“…For instance, pregnancy-related risk factors, such as gestational hypertension and GDM, have long been a concern for the health of fetuses and infants [ 21 , 22 ]. Birth weight reflects the growth status and outcome of the fetal period, and its impact on short- and long-term health has been confirmed by numerous studies [ 7 , 23 ] Considering the significant variations in growth rates, patterns, and potential nutritional risks among infants with different birth weights, this study not only considered birth weight as a critical covariate but also conducted sensitivity analyses within normal birth weight infants, ensuring more robust and reliable research findings. The timing of complementary foods introduction is considered important, as inappropriate nutritional intake can change infant growth rates, which have been identified as important risk factors for subsequent obesity [ 24 ] Therefore, we also included the timing of complementary foods introduction as one of the models’ covariates in infants aged ≥ 6 months, controlling for its potential effects.…”

“…In addition, previous studies have focused primarily on the factors influencing the growth of high-risk infants, particularly preterm and low birth weight infants [ 5 , 6 ]. There are limited studies that have explored the factors affecting early-life growth in term infants, as they are typically considered “healthy” from birth [ 7 ]. However, given that term infants account for the vast majority of the population (90%) [ 8 ], investigating the factors associated with their growth could make a significant contribution to the overall health status of the population.…”