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Updated: Jun 10, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Excessive Gestational Weight Gain, Independent of Body Mass Index, Is Associated With Child Fat Mass Index at Age 2
Margaret Ballard1, Jessica L Saben2, Rebecca A Krukowski3
1Arkansas Children's Nutrition Center, Little Rock, Arkansas.
Insights
Excessive gestational weight gain (eGWG) is linked to higher child adiposity at age 2. Pregnant individuals with eGWG often have a history of dieting and low motivation to follow weight gain guidelines.
Area of Science:
- Maternal and Child Health
- Obesity Research
- Pregnancy Complications
Background:
- Excessive gestational weight gain (eGWG) elevates risks for pregnancy complications and future obesity in both mothers and children.
- The independent impact of eGWG on child adiposity at 2 years, controlling for maternal BMI and covariates, remains unclear.
- Identifying characteristics of individuals with eGWG is crucial for developing targeted interventions.
Purpose of the Study:
- To determine the association between eGWG and child adiposity at age 2, independent of maternal BMI and other covariates.
- To describe the characteristics of pregnant individuals experiencing eGWG during their second pregnancy.
Main Methods:
- Secondary analysis of 221 pregnant individuals and their children aged 2 years from the Growing Life, Optimizing Wellness study.
- Participants were recruited in Arkansas, were secundigravida, had a BMI of 18.5-35, were over 20 years old, and conceived without assistance.
- Child adiposity was measured by fat mass index using quantitative nuclear magnetic resonance imaging; multivariable regression and correlation analyses were employed.
Main Results:
- eGWG was positively associated with child adiposity at age 2, independent of maternal BMI (β = .503, P = .03).
- Individuals with eGWG in their second pregnancy showed higher odds of prior eGWG (OR 7.5), dieting behavior (OR 14.3), and low motivation (OR 11.2).
- eGWG rates decreased in the second pregnancy compared to the first, with varying reductions across BMI groups.
Conclusions:
- eGWG in pregnant individuals is associated with increased child adiposity at 2 years.
- Low motivation, prior dieting, and previous eGWG characterize individuals experiencing eGWG in a second pregnancy.
- Future interventions targeting eGWG should focus on individuals with these identified characteristics.
Background:
Excessive gestational weight gain (eGWG) increases risk for pregnancy complications and future obesity for pregnant persons and children. Yet, it is unclear whether eGWG leads to higher child adiposity at 2 years, independent of the pregnant person's body mass index (BMI) while considering important covariates. Moreover, understanding the characteristics of pregnant persons experiencing eGWG will help design future targeted interventions.
Objective:
The objectives of the analyses were to assess the association between eGWG and childhood adiposity at age 2 years, while controlling for pregnant persons' BMI and other important covariates and to describe the characteristics of pregnant persons who experience eGWG during their second pregnancy.
Design:
This is a secondary analysis of 221 pregnant persons and their children aged 2 years who were enrolled in the Growing Life, Optimizing Wellness longitudinal observational study.
Participants/Setting:
Participants were recruited between 2011 and 2014 in central Arkansas. Participants were secundigravida persons with BMI 18.5 to 35, older than age 20 years, and who conceived without assistance.
Main Outcome Measures:
The main outcome measure was fat mass index of children aged 2 years measured by quantitative nuclear magnetic resonance imaging. Secondary outcomes included first pregnancy GWG, dietary and physical activity characteristics between pregnancies, second pregnancy nausea levels, and motivation level to adhere to the GWG guidelines.
Statistical Analysis Performed:
Multivariable regression analyses were used to examine the associations between GWG and childhood fat mass index at age 2 years. Pearson correlations and Wilcoxon rank sum tests were used to identify the characteristics of pregnant persons who experienced eGWG.
Results:
Pregnant persons' eGWG (β = .503; P = .03) was positively associated with child adiposity at age 2 years independent of maternal BMI (P = 0.3). Pregnant persons who experienced eGWG during their second pregnancy had greater odds of eGWG during first pregnancies (odds ratio 7.5; P < .001), dieting behavior (odds ratio 14.3; P = .02), and low motivation to adhere to the GWG guidelines (odds ratio 11.2; P = .009). Fewer participants had eGWG during their second pregnancy (52.5%) compared with their first pregnancy (66.8%), which was different by BMI groups (BMI 18.5 to 24.9: 23.6% decrease in participants who gained eGWG, BMI 25 to 29.9: 20.0% decrease, and BMI ≥ 30: 37.9% decrease).
Conclusions:
eGWG among pregnant persons is associated with child adiposity at age 2 years. Pregnant persons who experienced eGWG during their second pregnancy reported low motivation to gain weight within guidelines, eGWG in first pregnancy, and reported prior dieting behavior. Future research focusing on patients with these characteristics may increase success of interventions designed to limit eGWG.
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