Preconception Health Trajectories and Birth Weight in a National Prospective Cohort

Abstract

Purpose This study was designed to assess the relationship between birth weight and prospectively measured trajectories of preconception health across adolescence and young adulthood in a diverse national cohort of young adult women. Methods Data came from Waves I (1994–95), III (2001–02), and IV (2007–08) of the National Longitudinal Study of Adolescent Health. Eligibility was restricted to all the singleton live births (N=3436) to female participants occurring between the Wave III (ages 18–26) and Wave IV (ages 24–32) interviews. Preconception cigarette smoking, overweight/obesity, adequate physical activity, heavy alcohol consumption, and fair/poor self-rated health were measured in adolescence (Wave I) and early adulthood (Wave III) and combined into 4-category variables to capture the timing and sequencing of exposure. The outcome measure, birth weight, was classified as low (<2500 grams), normal (2500–4000 grams), and macrosomic (>4000 grams). Results Multinomial logistic regression results indicated that adult-onset overweight significantly increased the odds of having a macrosomic birth (odds ratio = 1.56; 95% confidence interval, 1.02–2.38). Conclusions This study provides new evidence about the influence of maternal body mass index trajectories on offspring birth weight. Adult-onset overweight/obesity during the transition to adulthood was common in the sample and increased the odds of subsequently delivering a macrosomic infant by 56%. This finding suggests that healthy weight promotion prior to this transition would confer intergenerational benefits, and supports recommendations for preconception care to address overweight/obesity.

Selected Preconception Health Indicators and Birth Weight Disparities in a National Study

“…Although the disparity in preconception overweight/obesity for Blacks and Latinas was evident in our analysis, we could not examine the roles of inadequate weight gain or gestational diabetes with these data. Finally, the overall association between adult-onset overweight/obesity and macrosomia, consistent with previous research (Strutz, Richardson, & Hussey, 2012), was modified by race such that it was stronger for Black women. This finding is complementary to studies of PTB in which strong associations between underweight preconception BMI and PTB were identified for Black women (Hickey, Cliver, McNeal, & Goldenberg, 1997; Simhan & Bodnar, 2006).…”

“…Thus, the relative importance of exposures immediately before conception versus those earlier in life or throughout one’s entire life may be meaningful. There is evidence, for example, that adult-onset overweight—but not persistent overweight in adolescence and adulthood—increases the odds of delivering a macrosomic infant (Strutz, Richardson, & Hussey, 2012). …”

Adolescence and the next generation

“…Antenatal maternal obesity predicts macrosomic birth 109 , later childhood obesity and metabolic disturbance 110,111 , poorer cognitive skills and greater risk of behavioural problems during childhood 112 . Antenatal interventions to prevent these consequences appear to have limited benefits.…”

Preconception Nutrition, Physical Activity, and Birth Outcomes in Adolescent Girls

“…56 A previous analysis of the Add Health data found increased risk of macrosomia only among the infants born to those with adult-onset obesity. 57 …”