Trimester of Maternal Gestational Weight Gain and Offspring Body Weight at Birth and Age Five

Abstract

To investigate associations of trimester-specific GWG with fetal birth size and BMI at age 5 years. We examined 3,015 singleton births to women without pregnancy complications from the Child Health and Development Studies prospective cohort with measured weights during pregnancy. We used multivariable regression to examine the associations between total and trimester gestational weight gain (GWG) and birth weight for gestational age and child BMI outcomes, adjusting for maternal age, race/ethnicity, education, marital status, parity, pre-pregnancy body mass index (BMI), and smoking; paternal overweight, gestational age, and infant sex. We explored differences in associations by maternal BMI and infant sex. GWG in all trimesters was significantly and independently associated with birth weight with associations stronger, though not significantly, in the second trimester. First trimester GWG was associated with child BMI outcomes (OR for child overweight = 1.05; 95% CI = 1.02, 1.09). Each kg of first trimester GWG was significantly associated with increased child BMI z-score in women of low (β = 0.099; 95% CI = 0.034, 0.163) and normal (β = 0.028; 95% CI = 0.012, 0.044), but not high pre-pregnancy BMI. GWG in all trimesters was associated with birth weight; only first trimester GWG was associated with child BMI. If replicated, this information could help specify recommendations for maternal GWG and elucidate mechanisms connecting GWG to child BMI.

Late pregnancy reversal from excessive gestational weight gain lowers risk of childhood overweight-A cohort study

“…In previous studies, investigators (8,30,31) found that absolute, week-specific GWG in the first and second trimesters was more relevant for the risk of later overweight in the offspring than week-specific GWG in the third trimester. These findings would suggest that most of the association of GWG on overweight in the offspring is determined in the first two trimesters.…”

Review of Trimester-Specific Gestational Weight Gain and Childhood Adiposity

“…A limita on of the study was that it did not control for certain poten al confounders: gesta onal diabetes mellitus, gene c characteris cs, nausea, diet, or physical ac vity. In addi on, unlike the Fraser et al, Margerison-Zilko found there to be eff ect modifi ca on by pre-pregnancy BMI 7 .…”

“…Only three studies were found in the literature search to have examined whether trimester-specifi c GWG associates with off spring adiposity later in life as their primary or secondary objec ves, two of them being European cohort studies 7,22,23 . Fraser et al examined the importance of IOM guidelines and off spring adiposity directly with Avon Longitudinal Study of Parents and Children (ALSPAC) prospec ve pregnancy cohort in UK 22 .…”

“…Margerison-Zilko et al examined 3,015 singleton births to women without pregnancy complica ons in a more heterogeneous popula on 7 . Based on the US-based Child Health and Development Studies, the study found associa ons between total as well as trimester-specifi c GWG and birth weight for gesta onal age as well as child BMI at age 5, adjus ng for maternal age, race/ethnicity, educa on, marital status, parity, pre-pregnancy body mass index (BMI), and smoking; paternal overweight, gesta onal age, and infant sex.…”

“…As excessive gesta onal weight gain (GWG) has been correlated with childhood and later in life overweight and obesity, the importance of appropriate GWG has gained increasing a en on in recent mes [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] . Mo vated by recent research on the changing characteris cs of the child-bearing popula on, the Ins tute of Medicine (IOM) revised GWG guidelines in 2009 to include a specifi c recommenda on for obese women, This work is licensed under a Creative Commons Attribution 3.0 License.…”