title: Effects of trimester-specific and total gestational weight gain on children's anthropometrics.
abstract: BACKGROUND
  Gestational weight gain (GWG) has been shown to be a risk factor for overweight in offspring.Aim of this study was to quantify the contributions of trimester-specific and total GWG on offspring's BMI and waist circumference (WC). This is of interest for the design of interventions targeted at women showing a high GWG in early pregnancy.
  
  
  METHODS
  In a retrospective cohort study data on GWG (total and by trimester, exposure), a number of potential confounders, and children's BMI z-scores and WC (outcomes) were analyzed using structural equation models to disentangle the trimester-specific direct effects of GWG and indirect effects mediated via total GWG.
  
  
  RESULTS
  7313 mother child pairs with a children's mean age of 5.81 years were analyzed. Total effects (indirect + direct) of GWG (kg/week) on children's BMI z-score and WC (cm) were observed in all trimesters, most prominently in the second. The longitudinal effect of GWG is a composite of trimester-specific direct effects (on BMI: 0.105, 0.255, 0.002, on WC: 0.538, 1.64, 0.308) and total GWG (on BMI 0.608, on WC: 1.03) at the end of pregnancy.
  
  
  CONCLUSIONS
  Both trimester-specific priming and total GWG explained offspring's anthropometrics. The results indicate, that reversal from additional weight gain attained early in pregnancy resulting in normal total GWG at the end of pregnancy might still contribute to a substantial reduction of offspring's BMI and WC.
authors.affiliation: Institute for Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-Universität München, Haydnstr, 5/4, OG, 80336 Munich, Germany. Otmar.Bayer@lrz.uni-muenchen.de.
authors.forename: Otmar
authors.initials: O
authors.lastname: Bayer
authors.forename: Regina
authors.initials: R
authors.lastname: Ensenauer
authors.forename: Ina
authors.initials: I
authors.lastname: Nehring
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
mesh_terms: D000328:Adult; D000886:Anthropometry; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D050177:Overweight / Q000175:diagnosis / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011264:Pregnancy Trimesters; D012189:Retrospective Studies; D018570:Risk Assessment; D055105:Waist Circumference; D015430:Weight Gain / Q000502:physiology*