title: Maternal pre-pregnancy overweight and obesity, and child neuropsychological development: two Southern European birth cohort studies.
abstract: BACKGROUND
  Maternal pre-pregnancy obesity may be associated with impaired infant neuropsychological development; however, there are few studies and it is unclear if reported associations are due to intrauterine mechanisms.
  
  
  METHODS
  We assessed whether maternal pre-pregnancy overweight and obesity were associated with cognitive and psychomotor development scores (mean 100 ± 15) of children aged 11-22 months in two birth cohorts: Environment and Childhood (INMA, Spain; n = 1967) and Mother-Child (RHEA, Greece: n = 412). Paternal body mass index (BMI) was used as a negative control exposure.
  
  
  RESULTS
  The percentage of overweight and obese mothers was 18% and 8%, respectively, in INMA and 20% and 11% in RHEA, respectively. Maternal pre-pregnancy obesity was associated with reduced infant cognitive development scores in both INMA (score reduction: -2.72; 95% CI: -5.35, -0.10) and RHEA (score reduction: -3.71; 95% CI: -8.45, 1.02), after adjusting for socioeconomic variables and paternal BMI. There was evidence in both cohorts of a dose-response relationship with continuous maternal BMI. Paternal overweight/obesity was not associated with infant cognitive development. Associations with psychomotor scores were not consistent between cohorts, and were stronger for paternal than maternal BMI in RHEA.
  
  
  CONCLUSIONS
  This study in two birth cohorts with moderately high obesity prevalence suggests that maternal pre-pregnancy obesity is associated with reduced child cognitive development at early ages. This association appears more likely to be due to maternal than shared family and social mechanisms, but further research is needed to disentangle a direct intrauterine effect from other maternal confounding factors.
authors.affiliation: Centre for Research in Environmental Epidemiology, 08003 Barcelona, Catalonia, Spain. mcasas@creal.cat
authors.forename: Maribel
authors.initials: M
authors.lastname: Casas
authors.forename: Leda
authors.initials: L
authors.lastname: Chatzi
authors.forename: Anne-Elie
authors.initials: AE
authors.lastname: Carsin
authors.forename: Pilar
authors.initials: P
authors.lastname: Amiano
authors.forename: Mònica
authors.initials: M
authors.lastname: Guxens
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.forename: Katerina
authors.initials: K
authors.lastname: Koutra
authors.forename: Nerea
authors.initials: N
authors.lastname: Lertxundi
authors.forename: Mario
authors.initials: M
authors.lastname: Murcia
authors.forename: Marisa
authors.initials: M
authors.lastname: Rebagliato
authors.forename: Isolina
authors.initials: I
authors.lastname: Riaño
authors.forename: Clara L
authors.initials: CL
authors.lastname: Rodríguez-Bernal
authors.forename: Theano
authors.initials: T
authors.lastname: Roumeliotaki
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
authors.forename: Michelle
authors.initials: M
authors.lastname: Mendez
authors.forename: Martine
authors.initials: M
authors.lastname: Vrijheid
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002657:Child Development / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D011247:Pregnancy; D015995:Prevalence; D011597:Psychomotor Performance; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires