title: How pre- and postnatal risk factors modify the effect of rapid weight gain in infancy and early childhood on subsequent fat mass development: results from the Multicenter Allergy Study 90.
abstract: BACKGROUND
  It is unclear which exposures may cause or modify the adverse effect of rapid weight gain on fat mass development in term children whose birth weight is appropriate-for-gestational age (AGA).
  
  
  OBJECTIVE
  To determine which intrauterine or postnatal exposures increase the risk of or modify the effect of rapid weight gain on body fat percentage (BF%) and body mass index (BMI) trajectories between 2 and 6 y of age.
  
  
  METHODS
  Term AGA singletons (n = 370) from the German Multicenter Allergy Study (MAS-90), a longitudinal birth cohort study, with repeated anthropometric measurements until 6 y, and data on breastfeeding status, exposure to smoking during pregnancy, and maternal anthropometric and socioeconomic characteristics were included in this analysis.
  
  
  RESULTS
  A shorter gestation [multivariate-adjusted odds ratio (OR): 5.12; 95% CI: 2.22, 11.82; P = 0.0001], being firstborn (OR: 2.01; 95% CI: 1.10, 3.69; P = 0.02), and having been bottle-fed (OR: 3.02; 95% CI: 1.68, 5.43; P = 0.0002) all significantly increased a child's risk of gaining weight rapidly, whereas a larger BMI at birth was protective (OR: 0.54; 95% CI: 0.38, 0.77; P = 0.0006). Multilevel model analyses showed that rapid growers exposed to tobacco in utero subsequently gained more BF% between 2 and 6 y than did rapid growers who had not been exposed (beta +/- SE: 0.78 +/- 0.28%/y; P = 0.005). Similarly, change in BF% was greater in rapid growers with an overweight mother than in those with a normal-weight mother (1.01 +/- 0.30%/y; P = 0.0007).
  
  
  CONCLUSIONS
  The occurrence of rapid weight gain between birth and 2 y and the magnitude of its effect on BF% development in AGA children is influenced by both intrauterine and postnatal exposures.
authors.affiliation: Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms-Universität Bonn, Dortmund, Germany. karaolis@fke-do.de
authors.forename: Nadina
authors.initials: N
authors.lastname: Karaolis-Danckert
authors.forename: Anette E
authors.initials: AE
authors.lastname: Buyken
authors.forename: Michael
authors.initials: M
authors.lastname: Kulig
authors.forename: Anja
authors.initials: A
authors.lastname: Kroke
authors.forename: Johannes
authors.initials: J
authors.lastname: Forster
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kamin
authors.forename: Antje
authors.initials: A
authors.lastname: Schuster
authors.forename: Claudia
authors.initials: C
authors.lastname: Hornberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Keil
authors.forename: Renate L
authors.initials: RL
authors.lastname: Bergmann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wahn
authors.forename: Susanne
authors.initials: S
authors.lastname: Lau
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D001722:Birth Order; D001724:Birth Weight / Q000502:physiology*; D015992:Body Mass Index; D001903:Bottle Feeding / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D005865:Gestational Age; D006128:Growth; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D015430:Weight Gain / Q000502:physiology*