Protocol of the Snuggle Bug/Acurrucadito Study: a longitudinal study investigating the influences of sleep-wake patterns and gut microbiome development in infancy on rapid weight gain, an early risk factor for obesity

Association of Maternal BMI and Rapid Infant Weight Gain With Childhood Body Size and Composition

OBJECTIVES

Maternal prepregnancy BMI (ppBMI) and an infant's rapid weight gain (RWG) are each associated with increased risk for childhood obesity. We hypothesized that ppBMI and RWG interact to further raise childhood obesity risk.

METHODS

Mother-infant dyads (n = 414) from the Healthy Start Study, an observational prebirth cohort, were included. RWG was defined as a weight-for-age z score increase of ≥0.67 from birth to 3 to 7 months. Body composition was measured by air displacement plethysmography at age 4 to 7 years. General linear regression models were fit to characterize associations between ppBMI, RWG, and their interaction with the outcomes of childhood BMI-for-age z score and percent fat mass (%FM).

RESULTS

A total of 18.6% (n = 77) of offspring experienced RWG. Maternal ppBMI and RWG were both positively associated with offspring BMI z score and %FM. RWG amplified the association between ppBMI and BMI z score, especially among females. Females exposed to maternal obesity and RWG had an average BMI at the 94th percentile (1.50 increase in childhood BMI z score) compared with those exposed to normal ppBMI and no RWG (average childhood BMI at the 51st percentile). RWG had a weaker effect on the association between ppBMI and %FM. Adjustment for breastfeeding status or childhood daily caloric intake did not significantly alter findings.

CONCLUSIONS

Rapid infant weight gain interacts with maternal ppBMI to jointly exacerbate risk of childhood obesity. Pediatric providers should monitor infants for RWG, especially in the context of maternal obesity, to reduce future risk of obesity.

Early rapid weight gain, parental body mass index and the association with an increased waist-to-height ratio at 5 years of age

Background/Objectives

Obesity-related adverse health consequences are closely associated with abdominal obesity. Risk factors for overweight and obesity have been studied but there is a lack of information regarding risk factors for abdominal obesity, especially in the preschool population. The aim of the present study was to examine early life risk factors for an increased waist-to-height ratio (WHtR) in children at five years of age and, in addition, to investigate if these risk factors also were associated with overweight or obesity.

Subjects/Methods

The study population comprised 1,540 children from a population-based longitudinal birth cohort study that included 2,666 Swedish children. The children were included if they had complete growth data for the analyses used in this study. Children were classified as having WHtR standard deviation scores (SDS) ≥ 1 or < 1 at five years of age, according to Swedish reference values, and as having body mass index standard deviation scores (BMI_SDS) for overweight/obesity, or normal weight/underweight according to the International Obesity Task Force criteria. Associations between child-related, socioeconomic status-related, parental health-related and nutrition- and feeding practice-related factors during the first two years and a WHtR_{SDS ≥} 1 or a BMI_SDS for overweight/obesity at five years were investigated with logistic regression analyses.

Results

At five years of age, 15% of the children had WHtR_{SDS ≥} 1 and 11% had overweight or obesity. In multivariable analyses, rapid weight gain (RWG) during 0–6 months (OR: 1.90, 95% CI: 1.23–2.95, p = 0.004), maternal pre-pregnancy BMI (1.06, 1.01–1.11, p = 0.019) and paternal BMI (1.11, 1.01–1.21, p = 0.028) were associated with WHtR_{SDS ≥} 1. RWG during 0–6 months (2.53, 1.53–4.20, p<0.001), 6–12 months (2.82, 1.37–5.79, p = 0.005), and maternal pre-pregnancy BMI (1.11, 1.06–1.17, p<0.001) were associated with overweight or obesity.

Conclusions

Early risk factors, including rapid weight gain, are associated with increased WHtR_SDS and overweight or obesity at 5 years of age. Preventive interventions should target early RWG and parental overweight and obesity.