Early life influences on child weight outcomes in the Study to Explore Early Development

Area of Science:

• Pediatrics
• Public Health
• Developmental Pediatrics

Background:

• Childhood obesity is a significant public health concern with complex etiological factors.
• Understanding the role of maternal pre-pregnancy weight and gestational weight gain in early childhood obesity is crucial for intervention.
• Autism spectrum disorder (ASD) and developmental delays are associated with unique developmental trajectories, including growth patterns.

Purpose of the Study:

• To investigate the associations between maternal pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and rapid infant weight gain with child BMI at 2-5 years.
• To compare these associations across children with ASD, developmental delays, and population controls.

Main Methods:

• A multi-site case-control study, "The Study to Explore Early Development," included children aged 2-5 years.
• Participants were classified as ASD (n=668), developmental delays (n=914), or population controls (n=884).
• Maternal pre-pregnancy BMI, GWG (compared to Institute of Medicine recommendations), and rapid weight gain (change in weight-for-age z-scores >0.67 SD from birth to 6 months) were assessed.

Main Results:

• Mothers with overweight/obesity pre-pregnancy were 2.38 times more likely to have an overweight/obese child.
• Mothers exceeding GWG recommendations were 1.48 times more likely to have an overweight/obese child (P < 0.001).
• Children with ASD exhibited the highest frequency of rapid weight gain (44%) and were 3.47 times more likely to be overweight/obese compared to ASD children without rapid weight gain (P < 0.001).

Conclusions:

• Achieving a healthy maternal pre-pregnancy BMI and appropriate GWG are critical targets for preventing childhood obesity.
• Healthy infant growth patterns are particularly important for children at increased risk for ASD, potentially mitigating obesity risk.