Epidemiology and Prevention Association of Maternal Weight Gain in Pregnancy With Offspring Obesity and Metabolic and Vascular Traits in Childhood

Background—We sought to examine the association of gestational weight gain (GWG) and prepregnancy weight with offspring adiposity and cardiovascular risk factors. Methods and Results—Data from 5154 (for adiposity and blood pressure) and 3457 (for blood assays) mother-offspring pairs from a UK prospective pregnancy cohort were used. Random-effects multilevel models were used to assess incremental GWG (median and range of repeat weight measures per woman: 10 [1, 17]). Women who exceeded the 2009 Institute of Medicine–recommended GWG were more likely to have offspring with greater body mass index, waist, fat mass, leptin, systolic blood pressure, C-reactive protein, and interleukin-6 levels and lower high-density lipoprotein cholesterol and apolipoprotein A1 levels. Children of women who gained less than the recommended amounts had lower levels of adiposity, but other cardiovascular risk factors tended to be similar in this group to those of offspring of women gaining recommended amounts. When examined in more detail, greater prepregnancy weight was associated with greater offspring adiposity and more adverse cardiovascular risk factors at age 9 years. GWG in early pregnancy (0 to 14 weeks) was positively associated with offspring adiposity across the entire distribution but strengthened in women gaining Ͼ500 g/wk. By contrast, between 14 and 36 weeks, GWG was only associated with offspring adiposity in women gaining Ͼ500 g/wk. GWG between 14 and 36 weeks was positively and linearly associated with adverse lipid and inflammatory profiles, with these associations largely mediated by the associations with offspring adiposity. Conclusions—Greater maternal prepregnancy weight and GWG up to 36 weeks of gestation are associated with greater offspring adiposity and adverse cardiovascular risk factors. Before any GWG recommendations are implemented, the balance of risks and benefits of attempts to control GWG for short-and long-term outcomes in mother and child should be ascertained. A recent systematic review found evidence of associations of maternal prepregnancy weight and greater gestational weight gain (GWG) with a wide range of adverse perinatal health outcomes. 1 Fewer studies have examined the long-term effects of these on offspring health, and this systematic review and the recently revised 2009 US Institute of Medicine (IOM) guidance on GWG identified a need for further high-quality research with long-term offspring outcomes. Several studies have examined associations of GWG with offspring adiposity and have consistently (all but 1 study 3) reported positive associations with offspring body mass index (BMI) in childhood, 4 – 6 adolescence, 7 and adulthood. 8 Other studies have examined …