Pre-Gestational Obesity and Gestational Weight Gain as Predictors of Childhood Obesity

Area of Science:

• Pediatric Endocrinology
• Maternal-Fetal Medicine
• Public Health Nutrition

Background:

• Childhood obesity is a growing global health concern with long-term implications.
• Maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are recognized as critical factors influencing offspring's adiposity.
• Understanding these associations is crucial for developing effective prevention strategies.

Purpose of the Study:

• To investigate the relationship between pre-gestational BMI, GWG, and the risk of overweight, obesity, and adiposity in children up to seven years of age.
• To identify independent predictors of childhood adiposity within a prospective cohort.
• To inform public health interventions aimed at mitigating childhood obesity.

Main Methods:

• Analysis of 751 mother-child pairs from the PROGRESS cohort in Mexico City.
• Classification of pre-gestational BMI (normal, overweight, obesity) and GWG (inadequate, adequate, excessive) based on WHO and IOM guidelines.
• Assessment of children's anthropometry and adiposity at 4-5 and 6-7 years using BMI z-scores and waist circumference; employed a generalized structural equation model (GSEM).

Main Results:

• Nearly half (49.3%) of women experienced excessive GWG, and 19.8% had inadequate GWG.
• Pre-gestational overweight and obesity were associated with higher likelihoods of excessive GWG.
• Excessive GWG directly predicted overweight plus abdominal obesity (OW+AO) at 4-5 years, while pre-gestational obesity predicted OW+AO at 6-7 years.

Conclusions:

• Pre-gestational obesity and excessive GWG are significant, independent predictors of childhood obesity.
• Early life interventions targeting maternal weight before and during pregnancy are essential for preventing long-term offspring adiposity.
• Findings highlight the critical role of maternal health in shaping child metabolic outcomes.