Gestational weight gain and subsequent risk of childhood overweight/obesity

Introduction: Gestational weight gain (GWG) has significant health implications for the mother and her infant. Excess GWG is associated with increased birth weight, but whether it has long term consequences for the offspring is less clear. Therefore, we sought to evaluate the impact of GWG on overweight/obesity in children ages 2-4.

Methods: We identified 3,638 mother/child pairs among women who completed a health survey between 2007-2009 and had a subsequent pregnancy delivered as a live birth at Kaiser Permanente Northern California. Children were classified as overweight or obese if their weight met or exceeded the 85th percentile of the 2000 CDC BMI growth charts, based on age and sex. GWG was dichotomized (exceeding versus being at or below the 2009 IOM GWG recommendations).

Results: Half of the cohort was from non-white racial/ethnic groups, 45% were overweight/obese before pregnancy, and 68% exceeded the IOM recommendations. Overall, 18% of children were overweight/obese. Exceeding the IOM recommendations was associated with a 24% increase in risk of having a child who was overweight/obese [RR (95% CI): 1.24 (1.02-1.51)], after adjusting for maternal pre-pregnancy BMI, race/ethnicity, age, education, pregnancy glucose tolerance, and infant gestational age. The association appeared stronger among women who were not overweight/obese before pregnancy [RR (95% CI): 1.43 (1.07-1.90) at BMI <25 versus 1.13 (0.87-1.46) at BMI ≥ 25].

Conclusions: The impact of excess GWG on subsequent childhood overweight/obesity may be stronger among women who were not initially overweight or obese. Lifestyle interventions to help women achieve appropriate GWG may also reduce childhood obesity.