Maternal weight gain during pregnancy and overweight in Portuguese children.

Objective:The objective of our study was to assess the association between maternal weight gain during pregnancy and childhood overweight.Design:This study was a cross-sectional analysis.Setting:The data were derived from a community-based survey of children from primary schools of Portugal.Subjects:The study was performed in a sample of 6-12-year-old Portuguese school children (2445 girls and 2400 boys; age was 8.5±0.91 years).Measurements:Height and weight were measured according to international standards, and body mass index (BMI) was calculated. The definition of overweight was based on average centiles according to the International Obesity Task Force cutoffs. Children's parents completed a self-administered questionnaire, which provided information on general family background characteristics, maternal weight gain during pregnancy and children's physical activity. The response rate was 70.6%. Children's dietary intake was measured using a 24-h dietary recall. Logistic regression models were fitted to estimate the magnitude of the association between maternal weight gain during pregnancy and overweight in their children, adjusting for confounders (gender, age, birthweight, order of birth, breastfeeding, smoking during pregnancy, physical activity, parental BMI, parental education, calcium to protein ratio and energy intake).Results:The prevalence of overweight (including obesity) was 29% in boys and 33% in girls. The odds favouring overweight (including obesity) increased significantly for those women who gained ⩾16 kg during pregnancy, compared to those with <9 kg , even after adjustment for confounders (crude odds ratio (OR)=1.53, confidence interval (CI) 95% 1.27–1.84, P-trend <0.001; Adjusted OR=1.27, CI 95% 1.01–1.61, P-trend=0.038).Conclusion:Large maternal weight gain during pregnancy (⩾16 kg) was significantly associated with higher risk of overweight in Portuguese children.

[1]  W. Mechelen,et al.  Design of the New Life ( style ) study : a randomised controlled trial to optimise maternal weight development during pregnancy . [ ISRCTN 85313483 ] , 2006 .

[2]  L. Neufeld,et al.  Overweight with concurrent stunting in very young children from rural Mexico: prevalence and associated factors , 2007, European Journal of Clinical Nutrition.

[3]  A. Siega-Riz,et al.  Sociodemographic determinants of added sugar intake in preschoolers 2 to 5 years old. , 2002, Jornal de Pediatria.

[4]  T. Sørensen,et al.  Maternal prepregnant body mass index, duration of breastfeeding, and timing of complementary food introduction are associated with infant weight gain. , 2004, The American journal of clinical nutrition.

[5]  B. Breier,et al.  Prenatal influences on leptin sensitivity and susceptibility to diet-induced obesity. , 2006, The Journal of endocrinology.

[6]  P. Moreira,et al.  Overweight and obesity related to activities in Portuguese children, 7-9 years. , 2007, European journal of public health.

[7]  J. King Maternal obesity, metabolism, and pregnancy outcomes. , 2006, Annual review of nutrition.

[8]  D. Crowell Weight change in the postpartum period. A review of the literature. , 1995, Journal of nurse-midwifery.

[9]  E. Stone,et al.  Adolescents' eating patterns influence their nutrient intakes. , 2001, Journal of the American Dietetic Association.

[10]  S. Cnattingius,et al.  Nutrition and reproduction in women. , 2006, Human reproduction update.

[11]  Nancy R Cook,et al.  Body mass index and the risk of stroke in men. , 2002, Archives of internal medicine.

[12]  Setting Brazil Establishing a standard definition for child overweight and obesity worldwide: international survey. , 2008 .

[13]  J. Pennington Bowes' and Church's Food Values of Portions Commonly Used , 1980 .

[14]  L. Allen,et al.  Position of the American Dietetic Association: nutrition and lifestyle for a healthy pregnancy outcome. , 2002, Journal of the American Dietetic Association.

[15]  S. Amini,et al.  Increased fetal adiposity: a very sensitive marker of abnormal in utero development. , 2003, American journal of obstetrics and gynecology.

[16]  R. Recker,et al.  Calcium intake and body weight. , 2000, The Journal of clinical endocrinology and metabolism.

[17]  S. Rössner,et al.  Interrelationships between weight development and weight retention in subsequent pregnancies: the SPAWN study , 2003, Acta obstetricia et gynecologica Scandinavica.

[18]  C. Padez,et al.  Prevalence of overweight and obesity in 7–9‐year‐old Portuguese children: Trends in body mass index from 1970–2002 , 2004, American journal of human biology : the official journal of the Human Biology Council.

[19]  J. Wardle,et al.  Weight concerns and eating patterns: a survey of university students in Europe. , 1995, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[20]  M. Hediger,et al.  Gestational Weight Gain, Pregnancy Outcome, and Postpartum Weight Retention , 1995, Obstetrics and gynecology.

[21]  D. Dunger,et al.  Early and late weight gain and the timing of puberty , 2006, Molecular and Cellular Endocrinology.

[22]  J. Brown,et al.  Nutrition and multifetal pregnancy. , 2000, Journal of the American Dietetic Association.

[23]  R. Eastell,et al.  Intrauterine programming of adult body composition. , 2001, The Journal of clinical endocrinology and metabolism.

[24]  Berthold Koletzko,et al.  Maternal smoking during pregnancy and childhood obesity. , 2002, American journal of epidemiology.

[25]  J. Clapp Maternal carbohydrate intake and pregnancy outcome , 2002, Proceedings of the Nutrition Society.

[26]  A. Prentice,et al.  Energy adaptations in human pregnancy: limits and long-term consequences. , 2000, The American journal of clinical nutrition.

[27]  C. Padez,et al.  Prevalence and risk factors for overweight and obesity in Portuguese children , 2005, Acta paediatrica.

[28]  R. Deckelbaum,et al.  Primary and Secondary Preventive Nutrition , 2001, Nutrition and Health.

[29]  Christine L. Williams Can Childhood Obesity Be Prevented , 2005 .

[30]  M. Cogswell,et al.  Trends in Pregnancy Weight Gain Within and Outside Ranges Recommended by the Institute of Medicine in a WIC Population , 1998, Maternal and Child Health Journal.

[31]  M. Susser,et al.  Obesity in young men after famine exposure in utero and early infancy. , 1976, The New England journal of medicine.

[32]  J. T. Cox,et al.  Nutrition during pregnancy. , 2008, Obstetrics and gynecology clinics of North America.

[33]  J. Wong,et al.  Trends in lifestyle cardiovascular risk factors in women: analysis from the Canadian National Population Health Survey. , 2002, International journal of nursing studies.

[34]  S. Taffel,et al.  Pregnancy-related weight gain and retention: implications of the 1990 Institute of Medicine guidelines. , 1993, American journal of public health.

[35]  P. Catalano,et al.  Review article: The short‐ and long‐term implications of maternal obesity on the mother and her offspring , 2006, BJOG : an international journal of obstetrics and gynaecology.

[36]  C. Padez,et al.  Dietary calcium and body mass index in Portuguese children , 2005, European Journal of Clinical Nutrition.

[37]  E. Ellis Cholera in Brockport, N. York , 1833 .

[38]  R. Kuczmarski,et al.  Effects of age on validity of self-reported height, weight, and body mass index: findings from the Third National Health and Nutrition Examination Survey, 1988-1994. , 2001, Journal of the American Dietetic Association.

[39]  M. Mullen,et al.  Childhood and Adolescent Overweight: The Health Professional's Guide to Identification, Treatment, and Prevention , 2003 .

[40]  F Bellisle,et al.  Adiposity rebound in children: a simple indicator for predicting obesity. , 1984, The American journal of clinical nutrition.

[41]  M. Longnecker,et al.  Maternal smoking during pregnancy in relation to child overweight: follow-up to age 8 years. , 2006, International journal of epidemiology.

[42]  L. Dubois,et al.  Family food insufficiency is related to overweight among preschoolers. , 2006, Social science & medicine.

[43]  Pauline M Emmett,et al.  Size at Birth and Early Childhood Growth in Relation to Maternal Smoking, Parity and Infant Breast-Feeding: Longitudinal Birth Cohort Study and Analysis , 2002, Pediatric Research.

[44]  R. Humphreys AN ANALYSIS OF THE MATERNAL AND FOETAL WEIGHT FACTORS IN NORMAL PREGNANCY , 1954, The Journal of obstetrics and gynaecology of the British Empire.

[45]  S. Featherstone,et al.  Association between postnatal catch›up growth and obesity in childhood: prospective cohort study , 2000 .

[46]  P. Moreira,et al.  [Body mass index: sensitivity and specificity]. , 2004, Acta medica portuguesa.