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Maternal Prepregnancy Obesity and Offspring Intelligence Quotient at 5 Years: A Multicohort Analysis
Courtney Dow1, Elsa Lorthe1,2,3, Jonathan Y Bernard1
1Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France.
Insights
Maternal obesity before pregnancy is linked to lower child IQ scores by age 5. This association was observed in both full-term and preterm infants, highlighting risks to cognitive development.
Area of Science:
- Pediatric Health
- Developmental Psychology
- Public Health Nutrition
Background:
- The impact of maternal obesity on child cognitive development is not well understood.
- Previous research often overlooked crucial confounders and the unique developmental trajectory of preterm infants.
Purpose of the Study:
- To investigate the association between maternal pre-pregnancy body mass index (BMI) and offspring intelligence quotient (IQ) up to age 5.
- To examine if this relationship differs based on gestational age, particularly in preterm infants.
Main Methods:
- Utilized data from two French birth cohorts: EDEN (all gestational ages) and EPIPAGE-2 (preterm infants).
- Calculated maternal pre-pregnancy BMI using weight and height data.
- Assessed child IQ at approximately 5 years using the Wechsler Preschool and Primary Scale of Intelligence.
- Employed multivariable models adjusted for socioeconomic status and paternal BMI.
Main Results:
- Maternal pre-pregnancy obesity was associated with a decrease of approximately 3 IQ points in children.
- The association was consistent in both cohorts, with specific impacts on verbal IQ in full-term infants and verbal, processing, and reasoning IQ in preterm infants.
- Adjusting for paternal BMI did not alter the observed relationship between maternal obesity and child IQ.
Conclusions:
- Elevated maternal pre-pregnancy BMI is significantly associated with reduced cognitive development in children by age 5.
- The findings underscore the importance of maternal weight management for optimal child neurodevelopment.
Background:
The relationship between maternal obesity and childhood cognitive development remains unclear. Prior studies did not adjust for important confounders, and preterm infants are a developmentally distinct group that remains scarcely examined.
Objectives:
To determine whether maternal prepregnancy body mass index (BMI) is associated with offspring intelligence quotient (IQ) up to 5 years and whether this relationship varies with gestational age.
Methods:
Data from two French birth cohorts, EDEN (all gestational ages) and EPIPAGE-2 (preterm children born between 24 and 34 weeks of gestation), were used for this study. Maternal prepregnancy weight and height were used to calculate prepregnancy BMI. The Wechsler Preschool and Primary Scale of Intelligence was used to assess child IQ around 5 years. Multivariable models were adjusted for confounders, including socioeconomic status and paternal BMI.
Results:
Analytical cohorts included 1100 children from EDEN and 2629 from EPIPAGE-2. Lower intellectual functioning (full-scale IQ < 85) was observed in 8.1% of children in EDEN and 19.6% in EPIPAGE-2. The prevalence of maternal obesity was 13.6% (EDEN) and 21.3% (EPIPAGE-2) among children with lower intellectual functioning compared to 8.9% (EDEN) and 12.9% (EPIPAGE-2) among children with normal intellectual functioning. Maternal prepregnancy obesity was associated with an approximately 3-point decrease in full-scale IQ scores in fully adjusted models (adjusted β -2.8, 95% confidence interval [CI] -5.6, -0.1 and -2.6, 95% CI -4.7, -0.6 in EDEN and EPIPAGE-2, respectively). In EDEN, maternal obesity was associated with lower scores in the verbal IQ domain. Among infants born preterm (EPIPAGE-2), maternal obesity was associated with lower scores in the processing, reasoning, and verbal IQ domains. Adjustment for paternal BMI did not change the magnitude of the relationship with maternal obesity.
Conclusions:
High maternal prepregnancy BMI is associated with child cognitive development around 5 years of age.
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