title: Maternal gestational weight gain and offspring risk for childhood overweight or obesity.
abstract: OBJECTIVE
  The objective of the study was to evaluate the association between gestational weight gain, per the 2009 Institute of Medicine (IOM) recommendations, and offspring overweight/obesity at 2-5 years of age.
  
  
  METHODS
  This was a prospective cohort study of 4145 women who completed a health survey (2007-2009) and subsequently delivered a singleton at Kaiser Permanente Northern California (2007-2010). Childhood overweight/obesity was defined as a body mass index (BMI) z-score of the 85th percentile or greater of the Centers for Disease Control and Prevention child growth standards. Gestational weight gain was categorized according to the 2009 IOM recommendations. Logistic regression was used; meeting the IOM recommendations was the referent.
  
  
  RESULTS
  Exceeding the IOM recommendations was associated with a 46% increase in odds of having an overweight/obese child (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.17-1.83), after adjusting for maternal prepregnancy BMI, race/ethnicity, age at delivery, education, child age, birthweight, gestational age at delivery, gestational diabetes, parity, infant sex, total metabolic equivalents, and dietary pattern. The OR (95% CI) for childhood overweight/obesity among women gaining below the IOM recommendations was 1.23 (0.88-1.71). The associations between gaining outside the IOM recommendations and childhood obesity were stronger among women with a normal prepregnancy BMI (OR, 1.63; 95% CI, 1.03-2.57) (below); OR, 1.79; 95% CI, 1.32-2.43) (exceeded).
  
  
  CONCLUSIONS
  Gestational weight gain outside the IOM recommendations is associated with increased odds of childhood overweight/obesity, independent of several potential confounders and mediators. Gestational weight gain had a greater impact on childhood overweight/obesity among normal-weight women, suggesting that the effect may be independent of genetic predictors of obesity.
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA. Electronic address: sneha.x.sridhar@kp.org.
authors.forename: Sneha B
authors.initials: SB
authors.lastname: Sridhar
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Darbinian
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA.
authors.forename: Samantha F
authors.initials: SF
authors.lastname: Ehrlich
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA.
authors.forename: Margot A
authors.initials: MA
authors.lastname: Markman
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA.
authors.forename: Erica P
authors.initials: EP
authors.lastname: Gunderson
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA.
authors.forename: Assiamira
authors.initials: A
authors.lastname: Ferrara
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA.
authors.forename: Monique M
authors.initials: MM
authors.lastname: Hedderson
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D050177:Overweight / Q000209:etiology*; D063766:Pediatric Obesity / Q000209:etiology*; D011247:Pregnancy; D011446:Prospective Studies; D012306:Risk; D015430:Weight Gain
keywords: childhood obesity; gestational weight gain
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