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Pre-, Perinatal, and Parental Predictors of Body Mass Index Trajectory Milestones
Izzuddin M Aris1, Sheryl L Rifas-Shiman2, Ling-Jun Li3
1Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Agency for Science, Technology and Research, Singapore Institute for Clinical Sciences, Singapore, Singapore.
Insights
Prenatal and parental factors influence infant body mass index (BMI) trajectories. Identifying these predictors can inform early interventions to prevent childhood obesity.
Area of Science:
- Pediatrics
- Public Health
- Human Growth and Development
Background:
- Childhood obesity is a growing public health concern.
- Understanding early life factors influencing body mass index (BMI) trajectories is crucial for prevention.
- Project Viva is a longitudinal cohort study investigating child health outcomes.
Purpose of the Study:
- To examine associations between pre-, perinatal, and parental factors and the timing and magnitude of body mass index (BMI) peak in infancy and rebound in early childhood.
- To identify modifiable predictors of BMI trajectories in children.
- To inform potential early-life interventions for obesity prevention.
Main Methods:
- Individual BMI trajectories were modeled using mixed-effects models with natural cubic splines in 1681 children from birth to mid-childhood.
- Age and magnitude at BMI peak (infancy) and rebound (early childhood) were estimated.
- Stepwise multivariable regression identified predictors of these BMI trajectory milestones in 1354 children.
Main Results:
- Mean age at BMI peak was 8.4 months and at rebound was 59.8 months.
- Girls exhibited later peak age, earlier rebound age, and lower peak/rebound magnitudes compared to boys.
- Maternal hyperglycemia and pre-eclampsia were linked to later BMI peak; impaired glucose tolerance to lower peak magnitude. Maternal weight gain, smoking, no breastfeeding, parental obesity, and lower maternal education predicted greater BMI at rebound.
Conclusions:
- Modifiable prenatal and parental factors are associated with BMI peak and rebound.
- Early-life interventions targeting identified factors may influence BMI trajectories.
- These interventions hold potential for preventing later-onset obesity.
Objective:
To assess associations of pre-, perinatal, and parental factors with age and magnitude at body mass index (BMI) peak and rebound.
Study Design:
Among 1681 children with BMI data from birth to mid-childhood in Project Viva, we fitted individual BMI trajectories using mixed-effect models with natural cubic spline functions and estimated age and magnitude at peak in infancy and rebound in early childhood. We used stepwise multivariable regression to identify predictors of peak and rebound in the 1354 (63.6%) children with estimable trajectory milestones.
Results:
The mean (SD) of age at BMI peak was 8.4 (2.7) months and at rebound was 59.8 (19.6) months, and the mean (SD) of magnitude at peak was 18.0 (1.4) kg/m2 and at rebound was 15.9 (1.2) kg/m2. Girls had a later age at peak, earlier age at rebound, and lower magnitudes at peak and rebound than boys. Maternal isolated hyperglycemia (vs normoglycemia: β 0.7 months [95% CI 0.2-1.2]) and pre-eclampsia (vs normal blood pressure: 1.6 months [0.8-2.4]) were associated with a later peak, and impaired glucose tolerance (vs normoglycemia: -0.5 kg/m2 [-0.9, -0.1]) was associated with a lower magnitude at peak. Greater maternal first-trimester weight gain, smoking during pregnancy, no breastfeeding, parental obesity, and no university education were associated with greater BMI at rebound.
Conclusions:
We have identified modifiable prenatal and parental predictors of BMI peak in infancy and rebound in childhood. Early-life interventions that address these factors may be effective in changing BMI peak and rebound and potentially preventing later obesity.
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