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Effects of gestational weight gain on emotional and behavioral problems in children: Results from the CLaB study
Caroline de Barros Gomes1, Cristina Maria Garcia de Lima Parada2, Ana Beatriz Henrique Parenti2
1Post-graduate program in Public Health, São Paulo State University (UNESP), Medical School, Botucatu.
Insights
Maternal gestational weight gain (GWG) impacts child behavior. Insufficient GWG is linked to more behavioral issues, while excessive GWG may protect against internalizing problems in children aged 7-8 years.
Area of Science:
- Perinatal health and child development.
- Maternal health and offspring neurodevelopment.
- Public health and developmental psychology.
Background:
- Gestational weight gain (GWG) is a critical factor in pregnancy, potentially influencing fetal neurodevelopment.
- Childhood emotional and behavioral outcomes may be affected by maternal GWG.
- Understanding this relationship is crucial for prenatal care and early childhood interventions.
Purpose of the Study:
- To investigate the association between maternal GWG categories (insufficient, adequate, excessive) and behavioral problems in children.
- To analyze the prevalence of total, internalizing, and externalizing behavioral problems in 7-8-year-old children.
- To determine if GWG outside recommended ranges impacts child neurodevelopmental outcomes.
Main Methods:
- A cohort study utilizing data from the Botucatu Infant Cohort.
- Maternal GWG was classified based on National Academy of Medicine guidelines.
- Child behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) in a 7-8-year-old cohort, with Poisson regression used for analysis.
Main Results:
- A high prevalence of behavioral problems (36.2%), internalizing problems (37.5%), and externalizing problems (27.5%) was observed.
- Insufficient GWG was associated with a higher prevalence of overall behavioral problems (PR=1.48).
- Excessive GWG showed a protective effect against internalizing problems (PR=0.66) compared to adequate GWG.
Conclusions:
- The high prevalence of behavioral problems underscores a significant public health concern.
- Maternal GWG outside recommended ranges has a nuanced impact on child behavior.
- Insufficient GWG is linked to increased behavioral problems, while excessive GWG may mitigate internalizing issues.
Background:
Gestational weight gain (GWG) may influence child neurodevelopment, with potential effects on emotional and behavioral outcomes. This study investigates the relationship between GWG and behavioral problems in children aged 7-8 years.
Methods:
This cohort study used data from the Botucatu Infant Cohort. The first wave (2015-2016) included 656 newborns and their mothers, with maternal GWG classified as insufficient, adequate, or excessive according to National Academy of Medicine guidelines. The second wave (2023-2024) assessed 394 children aged 7-8 years using the Strengths and Difficulties Questionnaire (SDQ) to identify emotional and behavioral problems (scores ≥17). We used Poisson regression adjusted for confounders to test whether GWG adequacy (insufficient, adequate, or excessive) was associated with total, internalizing (≥8), and externalizing (≥11) behavioral problems.
Results:
Among 309 children with complete data, 36.2% presented scores indicative of behavioral problems on the SDQ; 37.5% showed internalizing problems, and 27.5% exhibited externalizing problems. When adequate GWG was the reference category, prevalence ratios varied but did not reach statistical significance. However, when excessive GWG was the reference, children of mothers with insufficient weight gain had a higher prevalence of behavioral problems (PR = 1.48; 95% CI: 1.02-2.13). In contrast, compared to children whose mothers had adequate weight gain, those whose mothers gained excessive weight had fewer internalizing problems (PR = 0.66; 95% CI: 0.47-0.94).
Conclusion:
The prevalence of behavioral problems assessed by the SDQ was very high, highlighting a significant issue in the study context. However, our hypothesis that GWG outside recommended ranges could influence behavioral problems in children aged 7-8 years was only partially confirmed. Insufficient GWG was associated with overall behavioral problems (SDQ > 17), while excessive GWG appeared protective against internalizing problems. No association was found between GWG and externalizing problems.
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