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Low and high birth weight and the risk of child attention problems
Nina H van Mil1, Régine P M Steegers-Theunissen2, Ehsan Motazedi3
1The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands.
Insights
Higher birth weight is linked to fewer attention problems, but this benefit plateaus around 3.6 kg. Maternal obesity may reverse this protective effect, increasing attention problems with higher birth weights.
Area of Science:
- Developmental Psychology
- Pediatric Health
- Epidemiology
Background:
- Birth weight is a critical indicator of fetal development and a potential predictor of later childhood outcomes.
- Attention problems in children are a significant concern, impacting academic and social functioning.
- Maternal factors, such as body mass index (BMI), may influence the relationship between birth weight and child development.
Purpose of the Study:
- To investigate the prospective association between birth weight and attention problems in children.
- To examine whether maternal pre-pregnancy BMI modifies the link between birth weight and attention problems.
Main Methods:
- A population-based cohort study involving 6015 children in Rotterdam, The Netherlands.
- Collection of birth weight data and calculation of standard deviation scores (SDS).
- Assessment of attention problems at age 6 years using the Child Behavior Checklist (CBCL) by parents. Linear regression was used to analyze associations, with maternal BMI as a moderator.
Main Results:
- A curvilinear association was observed between birth weight and attention problem scores, with a turning point around 3.6 kg.
- Extreme birth weights showed no association with attention problems after adjusting for socioeconomic factors.
- Maternal early pregnancy BMI significantly moderated the association between child birth weight and attention problems (P interaction = .007).
Conclusions:
- While higher birth weight is generally associated with fewer attention problems, this protective effect diminishes beyond approximately 3.6 kg.
- In offspring of mothers with obesity (BMI >30 kg/m²), high birth weight may be associated with an increased risk of attention problems.
- Maternal BMI is an important factor to consider when evaluating the impact of birth weight on child attention development.
Objective:
To study the prospective association between birth weight and attention problems and to explore the role of maternal body mass index (BMI) in this association.
Study Design:
In 6015 children of a population-based cohort (Rotterdam, The Netherlands, 2001-2005), information on birth weight was collected and gestational age-adjusted SDS were calculated. At age 6 years, parents assessed attention problems with the Child Behavior Checklist. We used linear regression to study the association of birth weight with attention problem score and examined the modification of this association by maternal early pregnancy BMI.
Results:
The observed association between birth weight and attention problem score was curvilinear (adjusted β per birth weight SDS(2): 0.02, 95% CI 0.00; 0.03, P = .008); the turning point equals 3.6 kg at term. In analyses of the extreme tails of the birth weight distribution, the associations with attention problem score disappeared after adjustment for socioeconomic confounders. Maternal early pregnancy BMI moderated the association of child birth weight with attention problem score (P interaction = .007, with curvilinear term in model).
Conclusions:
Higher birth weight was related to less attention problems but from a birth weight of about 3.6 kg or more, a higher birth weight did not reduce the risk of attention problems any further. However, in children of obese mothers (BMI >30 kg/m(2)), high birth weight may increase the risk of attention problems.
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