title: Maternal obesity, gestational weight gain, and offspring adiposity: the exploring perinatal outcomes among children study.
abstract: OBJECTIVE
  To determine whether adequate vs excessive gestational weight gain (GWG) attenuated the association between maternal obesity and offspring outcomes.
  
  
  METHODS
  Data from 313 mother-child pairs participating in the Exploring Perinatal Outcomes among Children study were used to test this hypothesis. Maternal prepregnancy body mass index (BMI) and weight measures throughout pregnancy were abstracted from electronic medical records. GWG was categorized according to the 2009 Institute of Medicine criteria as adequate or excessive. Offspring outcomes were obtained at a research visit (average age 10.4 years) and included BMI, waist circumference (WC), subcutaneous adipose tissue (SAT) and visceral adipose tissue, high-density lipoprotein cholesterol, and triglyceride levels.
  
  
  RESULTS
  More overweight/obese mothers exceeded the Institute of Medicine GWG recommendations (68%) compared with normal-weight women (50%) (P < .01). Maternal prepregnancy BMI was associated with worse childhood outcomes, particularly among offspring of mothers with excessive GWG (increased BMI [20.34 vs 17.80 kg/m(2)], WC [69.23 vs 62.83 cm], SAT [149.30 vs 90.47 cm(2)], visceral adipose tissue [24.11 vs 17.55 cm(2)], and homeostatic model assessment [52.52 vs 36.69], all P < .001). The effect of maternal prepregnancy BMI on several childhood outcomes was attenuated for offspring of mothers with adequate vs excessive GWG (P < .05 for the interaction between maternal BMI and GWG status on childhood BMI, WC, SAT, and high-density lipoprotein cholesterol).
  
  
  CONCLUSIONS
  Our findings lend support for pregnancy interventions aiming at controlling GWG to prevent childhood obesity.
authors.affiliation: Department of Pediatrics, Colorado School of Medicine, University of Colorado Denver, Denver, CO. Electronic address: Jill.Kaar@ucdenver.edu.
authors.forename: Jill L
authors.initials: JL
authors.lastname: Kaar
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Denver, CO.
authors.forename: Tessa
authors.initials: T
authors.lastname: Crume
authors.affiliation: Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver, Denver, CO.
authors.forename: John T
authors.initials: JT
authors.lastname: Brinton
authors.affiliation: Institute for Health Research, Kaiser Permanente of Colorado, Denver, CO.
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Bischoff
authors.affiliation: Department of Perinatology, Kaiser Permanente of Colorado, Denver, CO.
authors.forename: Robert
authors.initials: R
authors.lastname: McDuffie
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Denver, CO.
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011446:Prospective Studies; D050151:Subcutaneous Fat; D055105:Waist Circumference; D015430:Weight Gain
chemical_list: D008076:Cholesterol, HDL