Racial differences in the association between maternal prepregnancy obesity and children's behavior problems

Evidence for the adverse effects of prepregnancy obesity on offspring's neurodevelopmental outcomes has begun to emerge. The authors examined the association between prepregnancy obesity and children's behavioral problems and if the association would differ by race.

This observational study used a total of 3395 white (n = 2127) and African-American (n = 1268) children aged 96 to 119 months from the National Longitudinal Survey of Youth. Behavior Problem Index (BPI) total and subscale scores were used to measure children's behavioral problems. The association between maternal prepregnancy obesity and the BPI scores for each racial group was examined using multivariate linear and logistic regressions, controlling for prenatal, child, maternal, and family background factors.

Maternal prepregnancy obesity was independently associated with an increase in the BPI total scores among the white sample only. Among the African-Americans, prepregnancy obesity was not associated with the BPI scores. Subsample analyses using externalizing and internalizing subscales also revealed similar trends. Among the white sample, children born to obese women were more socially disadvantaged than those born to nonobese women, whereas no such trend was observed in children of African-American obese and nonobese women.

The impact of maternal prepregnancy obesity on children's behavioral problems differed by racial groups. Obesity-related metabolic dysregulations during the intrauterine period may not contribute to later children's behavioral problems. Social and psychological factors seem to play key roles in the association between prepregnancy obesity and childhood behavioral problems among whites.