Gestational Weight Gain Patterns May Influence Childhood Growth Patterns

Beth Widen, PhD

Research into the impact of weight gain during pregnancy suggests rapid weight gain in the first and final months could influence the body composition trajectories in children.

An analysis of 300 mother-child dyads with regular follow-up from 5-14 years old, the University of Texas at Austin-led study found weight change in pregnancy was associated with what investigators called a “profound effect” on patterns of their children’s BMI, waist circumference, and body fat percentage changes during childhood and early adolescence.

“We wanted to understand whether different weight change patterns during pregnancy impacted the child’s growth over time or the child’s potential to develop excess fat tissue,” said Beth Widen, PhD, assistant professor of nutritional sciences at UT Austin, in a statement. “For boys, we didn’t really see that much of a difference in their patterns of weight and body size over time. But for girls, we saw some striking differences. This tells us there are differences between the sexes in this area of child growth.”

An analysis of data from the Columbia Center for Children’s Environmental Health (CCCEH) Mothers and Newborns Study, the current study was funded by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and other organizations. A prospective birth cohort study beginning in 1998, CCCEH Mothers and Newborns Study enrolled 727 mother-child dyads Dominican and African American during the third trimester from a pair of prenatal in Northern Manhattan and the South Bronx, New York.

Eligibility criteria for CCCEH Mothers and Newborns Study included having data from a first prenatal visit occurring before 20 weeks’ gestation, being 18-35 years of age, and no self-reported diabetes, hypertension, HIV, drug use, or smoking during pregnancy. Participants underwent an initial visit during the third trimester that included assessments of marital status, parity, maternal education, age, and self-reported prepregnancy weight and maternal height. As part of CCCEH Mothers and Newborns Study, up to 7 child height and weight measurements were obtained at standard study visits occuring at ages 5, 7, 9, and 11 and at other project visits at age ranges of 8.5-12 years, 9.2-14 years, and 11.3-14.5 years.

Of the 727 originally enrolled in CCCEH Mothers and Newborns cohort, 337 were included in the maternal weight and child size trajectories analysis. Exclusion criteria for the analysis included missing prepregnancy weight or BMI measurements, less than 4 gestational weight gain measurements, missing child size outcome data, and preterm birth.

Of those included in the study, 49.3% of mothers were African American and 50.7% were Dominican. The mothers in the study had a mean age of 24.9±0.3 years at enrollment and the mean gestational age at delivery was 39.5±0.1 weeks. Of the women included in the study, 54% had a normal weight prepregnancy BMI, 23.1% had prepregnancy overweight and 22.8% had prepregnancy obesity.

A joint latent class model identified 4 distinct patterns of gestational weight gain. The first group lost weight during the first trimester followed by moderate weight gains during the second and rapid gains during the third, the second group experienced slow weight gain across all three trimesters, the third group saw slow weight gain during the first trimester and moderate weight gain through the end of pregnancy, and the final group experienced rapid weight gain during the first trimester followed by slow weight gain during the second and moderate weight gain during the third.

Results of the investigators' analyses suggested girls born to mothers who experienced rapid weight gain during the first trimester had the highest estimates for BMI-Z scores, waist circumference, and percentage body fat, with increases in these values over time. Among boys, those born to mothers with slow then moderate weight gain had the highest BMI-Z scores and body fat percentage in early adolescence, but no significant difference was observed for waist circumference compared to those with mothers who experienced weight loss followed by moderate and rapid gains or those with mothers who experienced slow weight gain throughout pregnancy.

Investigators pointed out greater differences in gestational weight gain and body composition trajectory patterns were observed for girls than boys, with the most notable difference by sex observed among those born the mothers with rapid weight gain during the first trimester of pregnancy.

“This study shows us that there may be sex differences in child body composition based on what they are exposed to in utero,” Widen said. “But, really, we believe there is only a small portion of pregnancy weight gain that can be consciously changed – specifically among fat tissue – since much of the weight change is necessary to support the pregnancy. It is possible that these findings are just the start of research that can help us further understand risk factors for childhood obesity and may help us develop more individualized weight gain guidelines that support pregnant people.”

This study, “Gestational weight change and childhood body composition trajectories from pregnancy to early adolescence,” was published in Obesity.