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Int J Obes (Lond). 2009 Jul;33(7):743-52. doi: 10.1038/ijo.2009.101. Epub 2009 Jun 16.

Maternal-recalled gestational weight gain, pre-pregnancy body mass index, and obesity in the daughter.

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Department of Obstetrics, Gynecology and Reproductive Biology, Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.



Emerging evidence suggests that exposures during fetal life affect adult metabolism. We assessed the relationship between recalled maternal pre-pregnancy body mass, gestational weight gain (GWG), and adiposity in the daughter.


Retrospective cohort study among mother-nurse daughter dyads in the Nurses' Health Study II and the Nurses' Mothers' Cohort. Mothers of participants completed questionnaires regarding their nurse daughter in 2001.


26,506 mother-nurse daughter dyads born between 1946 and 1964.


Body mass index (BMI) of the nurse daughter at age 18 and in 2001.


At age 18, 561 (2.1%) daughters were obese (BMI>30), and in 2001, 5442 (22.0%) were obese. Adjusting for covariates, women whose mothers had a recalled pre-pregnancy BMI of 29 had a 6.1-fold increased risk of obesity at age 18 and a 3.4-fold risk of obesity in 2001, compared with women whose mothers had a pre-pregnancy BMI of 21. We found a U-shaped association between recalled GWG and offspring obesity. Compared with a maternal weight gain of 15-19 lb, GWG <10 lb was associated with a significant increase in obesity risk at age 18 (odds ratio (OR) 1.54, 95% confidence interval (CI) 1.02-2.34) and in 2001 (OR 1.27, 95% CI 1.05-1.53). High weight gain (40+lb) was also associated with obesity risk at age 18 (OR 1.81, 95% CI 1.22-2.69) and in 2001 (OR 1.74, 95% CI 1.48-2.04). These associations were stronger among mothers who were overweight before pregnancy (P for interaction=0.03), and they persisted with adjustment for birth weight.


A high recalled pre-pregnancy BMI and extremes of recalled GWG are associated with an increased risk of adolescent and adult obesity in offspring, particularly when the mother is overweight. Pre-pregnancy weight and GWG may be modifiable fetal origins of overweight and obesity in women.

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