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Maternal Preconception Body Mass Index and Early Childhood Nutritional Risk
Kate E Braddon1, Charles Dg Keown-Stoneman2, Cindy-Lee Dennis3
1Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Maternal preconception body mass index (BMI) is linked to higher child nutritional risk scores. Focusing on maternal preconception health can improve child nutrition outcomes.
Area of Science:
- Pediatric Nutrition
- Maternal Health
- Public Health
Background:
- Childhood eating behaviors and food preferences may originate before conception.
- The association between maternal preconception body mass index (BMI) and child nutritional risk factors remains unclear.
Purpose of the Study:
- To investigate the relationship between maternal preconception BMI and child nutritional risk.
Main Methods:
- Longitudinal cohort study analyzing data from children aged 18 months to 5 years.
- Maternal preconception BMI was the primary exposure.
- Child nutritional risk was assessed using the parent-reported Nutrition Screening for Every Preschooler/Toddler (NutriSTEP) questionnaire.
Main Results:
- A 1-unit increase in maternal preconception BMI was associated with a 0.09 increase in the NutriSTEP total score.
- This association remained significant for both toddlers and preschoolers.
- Higher maternal BMI correlated with increased child nutritional risk scores.
Conclusions:
- Elevated maternal preconception BMI is associated with slightly higher child nutritional risk.
- The preconception period presents a critical opportunity for interventions to enhance childhood nutrition.
- Study registered on clinicaltrials.gov (NCT01869530).
Background:
Risk factors for problematic child eating behaviors and food preferences are thought to begin during the preconception period. It is unknown if maternal preconception body mass index (BMI) is associated with child nutritional risk factors (eg, poor dietary intake and eating behaviors).
Objectives:
We aimed to determine whether maternal preconception BMI was associated with child nutritional risk.
Methods:
In this longitudinal cohort study, a secondary data analysis of children ages 18 mo to 5 y were recruited from The Applied Research Group for Kids (TARGet Kids!), a primary care practice-based research network in Canada. The primary exposure was maternal preconception BMI. The primary outcome was parent-reported child nutritional risk score, measured using the Nutrition Screening for Every Preschooler/Toddler (NutriSTEP), an age-appropriate validated questionnaire. Fitted linear mixed effects models analyzed associations between maternal preconception BMI and child nutritional risk after adjusting for covariates.
Results:
This study included 4733 children with 8611 repeated NutriSTEP observations obtained between ages 18 mo to 5 y. The mean (standard deviation [SD]) maternal preconception BMI was 23.6 (4.4), where 73.1% of mothers had a BMI ≤24.9 kg/m2, and 26.9% had a BMI ≥25 kg/m2. The mean (SD) NutriSTEP total score was 13.5 (6.2), with 86.6% at low risk (score <21) and 13.4% at high risk (score ≥21). Each 1 unit increase in maternal preconception BMI was associated with a 0.09 increase in NutriSTEP total score (95% confidence interval [CI]: 0.05, 0.12; P ≤ 0.001). After stratification, each 1 unit increase in maternal BMI was associated with a 0.06 increase in mean NutriSTEP total score (95% CI: 0.007, 0.11; P = 0.025) in toddlers and 0.11 increase in mean NutriSTEP total score (95% CI: 0.07, 0.15; P < 0.001) in preschoolers.
Conclusion:
Higher maternal preconception BMI is associated with slightly higher NutriSTEP total scores. This provides evidence that the preconception period may be an important time to focus on for improving childhood nutrition. This study was registered at clinicaltrials.gov as NCT01869530.
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