Columbia: Unhealthy weight gain in pregnancy has been linked with infant size
and body composition but until now little was known about its long-term
association with childhood obesity among low-income and multi-ethnic
youth.
For the first time, researchers at Columbia University’s Mailman School of Public Health
studied the effects of gestational weight gain on childhood obesity
risk among a multi-ethnic urban population. The researchers determined
that excessive pregnancy weight gain was associated with greater overall
and abdominal body fat and obesity in children at age seven. Excessive
pre-pregnancy weight gain was associated with an increased risk of
childhood obesity of approximately 300 percent. Findings are published
online in the journal Maternal & Child Nutrition.
Before pregnancy, 45 percent of the African–American and Dominican
women studied were overweight or obese, and 64 percent of the mothers
gained more weight during pregnancy than recommended by the 2009
Institute of Medicine Guidelines. At age seven, 22 percent of the
children born to the women studied were obese, and on average, 24
percent of their body mass was comprised of fat tissue. The 2009
Institute of Medicine Guidelines for weight gain during pregnancy were
set to optimize prenatal, birth, and possibly longer-term health
outcomes, and recommended that pregnant women gain weight within set
ranges according to their pre-pregnancy body mass index. For example,
it recommends that women in a normal weight range gain 25-35 lbs and
approximately 1 lb per week in the 2nd and 3rd trimester. These
guidelines should be used in conjunction with clinical judgment by
healthcare providers.
“This is the first study to evaluate the long-term effects of
gestational weight gain in a contemporary low-income multi-ethnic urban
population, characterized by a high risk of obesity,” noted Elizabeth
Widen, PhD, RD, postdoctoral fellow at the Mailman School Department of
Epidemiology, the Institute of Human Nutrition, and the New York Obesity
Research Center.
Findings were based on data from the Columbia
Center for Children’s Environmental Health Mothers and Newborns Study in
Northern Manhattan and the South Bronx from 1998 to 2013. There were
727 mothers who self-identified as African–American or Dominican.
Most studies examining longer term effects of pregnancy weight gain
on childhood body size typically only have measures of height and weight
rather than estimates of body fat. Further, there has been little
research on the long-term effects of gestational weight gain on
childhood obesity risk in vulnerable populations.
“Our findings suggest that weight gain in pregnancy above the
Institute’s recommendations is strongly associated with obesity in
childhood,” said
Andrew Rundle, DrPH, associate
professor of Epidemiology.“A stronger focus on helping pregnant women
meet the Institute of Medicine’s targets for healthy weight gain during
pregnancy is needed.”
The researchers controlled for pre-pregnancy body mass index,
maternal education, receipt of public assistance, ability to afford food
in pregnancy, and previous pregnancies. Women were also excluded from
the analysis if the first prenatal visit was after 20 weeks gestation or
if the mother self-reported diabetes, hypertension, known human
immunodeficiency virus status, or use of illicit drugs or cigarettes
during pregnancy. Marital status and infant sex had no effect on
outcomes.
“Some weight gain during pregnancy is normal, but women need to know
that gaining too much weight can put their child at risk for being obese
in childhood and as they get older, which places them at higher risk
for future chronic disease. Because pregnancy weight gain has lasting
implications for childhood health, we need to determine how to support
women to gain a healthy amount of weight in pregnancy,” said Widen.
The
study was supported by the National Institute of Environmental Health
Sciences (NIEHS) and the U.S. Environmental Protection Agency (EPA)
Children’s Environmental Health and Disease Prevention Research Centers
(NIEHS/EPA P01ES09600/R82702701, NIEHS/EPA P01ES09600/RD832141,
NIEHS/EPA P01ES09600/RD834509). The Irving General Clinical Research
Center (RR00645), the National Institute of Diabetes and Digestive and
Kidney Diseases (NIDDK T32DK091227), the Educational Foundation of
America, the John and Wendy Neu Family Foundation, the New York
Community Trust and the Trustees of the Blanchette Hooker Rockefeller
Fund also supported the study.