Poor maternal nutritional status before and during pregnancy is associated with suspected child developmental delay...

Area of Science:

• Maternal and Child Health
• Developmental Pediatrics
• Nutritional Epidemiology

Background:

• Inadequate pre-pregnancy Body Mass Index (BMI) and gestational weight gain (GWG) are linked to suboptimal child development.
• Understanding these associations is crucial for early intervention and public health strategies.

Purpose of the Study:

• To investigate the association between maternal pre-pregnancy BMI, GWG, and child development at 24 months.
• To explore sex differences in these associations and potential mediation by GWG.

Main Methods:

• Utilized data from the 2015 Pelotas (Brazil) Birth Cohort Study (n=3,776).
• Classified maternal BMI and GWG adequacy using WHO and IOM criteria.
• Assessed child development using the INTER-NDA tool, defining suspected developmental delay (SDD) as <10th percentile.
• Employed linear/logistic regressions and G-formula for mediation analysis.

Main Results:

• Maternal underweight increased odds of SDD in girls across language, motor, and global domains.
• Excessive GWG was associated with SDD in language and cognition for boys.
• Total GWG suppressed the association between pre-pregnancy BMI and global development percentiles.
• Sex differences were noted in developmental outcomes, excluding the motor domain.

Conclusions:

• Maternal underweight and excessive GWG are negatively associated with child development, with distinct effects by sex.
• GWG does not mediate the relationship between pre-pregnancy BMI and global child development.
• Findings highlight the importance of optimizing maternal nutrition for diverse child developmental trajectories.