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Am J Obstet Gynecol. 2015 Apr;212(4):502.e1-14. doi: 10.1016/j.ajog.2014.12.038. Epub 2014 Dec 31.

Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood.

Author information

1
Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece. Electronic address: m.karachaliou@med.uoc.gr.
2
Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.
3
Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Department of Endocrinology, Diabetes Mellitus, and Metabolic Disorders, Faculty of Medicine, University of Crete, Crete, Greece.
4
Department of Clinical Chemistry and Biochemistry, Faculty of Medicine, University of Crete, Crete, Greece.
5
National School of Public Health, Athens, Greece; Center for Research in Environmental Epidemiology, Municipal Institute of Medical Research, and CIBER Epidemiologia y Salud Pública, Barcelona, Spain.
6
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.

Abstract

OBJECTIVE:

The purpose of this study was to investigate the association of trimester-specific gestational weight gain with offspring fetal growth, obesity risk, and cardiometabolic health outcomes from birth to 4 years of age.

STUDY DESIGN:

We conducted the present study with 977 mother-child pairs of the pregnancy cohort "Rhea" study in Crete, Greece. We measured birthweight, body mass index from 6 months to 4 years of age, waist circumference, skinfold thickness, blood pressure, and blood levels of lipids, C-reactive protein, and adipose tissue hormones at 4 years of age. We used multiple linear and log Poisson regression models to examine the association of exposure with continuous or binary outcomes, respectively.

RESULTS:

Greater rate of gestational weight gain in the first trimester of pregnancy (per 200 g/wk) was associated with increased risk of overweight/obesity from 2 years (relative risk [RR], 1.25; 95% confidence interval [CI], 1.09-1.42) to 4 years of age (RR, 1.15; 95% CI, 1.05-1.25), but not with birth size. Each 200 g/wk of weight gain in the first trimester of pregnancy was also associated with greater risk of high waist circumference (RR, 1.13; 95% CI, 1.04-1.23), high sum of skinfold thickness (RR, 1.15; 95% CI, 1.02-1.29), and higher diastolic blood pressure at 4 years of age (β, 0.43 mm Hg; 95% CI, 0.00-0.86). Greater rate of gestational weight gain during the second and third trimesters of pregnancy (per 200 g/wk) was associated with greater risk of large-for-gestational-age neonates (RR, 1.22; 95% CI, 1.02, 1.45) and higher levels of cord blood leptin (ratio of geometric means, 1.08; 95% CI, 1.00-1.17), but not with child anthropometry at later ages.

CONCLUSION:

Timing of gestational weight gain may influence childhood cardiometabolic outcomes differentially.

KEYWORDS:

blood pressure; children; gestational weight gain; obesity; pregnancy cohort

PMID:
25557209
PMCID:
PMC5081180
DOI:
10.1016/j.ajog.2014.12.038
[Indexed for MEDLINE]
Free PMC Article

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