title: Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood.
abstract: OBJECTIVE
  The purpose of this study was to investigate the association of trimester-specific gestational weight gain with offspring fetal growth, obesity risk, and cardiometabolic health outcomes from birth to 4 years of age.
  
  
  METHODS
  We conducted the present study with 977 mother-child pairs of the pregnancy cohort "Rhea" study in Crete, Greece. We measured birthweight, body mass index from 6 months to 4 years of age, waist circumference, skinfold thickness, blood pressure, and blood levels of lipids, C-reactive protein, and adipose tissue hormones at 4 years of age. We used multiple linear and log Poisson regression models to examine the association of exposure with continuous or binary outcomes, respectively.
  
  
  RESULTS
  Greater rate of gestational weight gain in the first trimester of pregnancy (per 200 g/wk) was associated with increased risk of overweight/obesity from 2 years (relative risk [RR], 1.25; 95% confidence interval [CI], 1.09-1.42) to 4 years of age (RR, 1.15; 95% CI, 1.05-1.25), but not with birth size. Each 200 g/wk of weight gain in the first trimester of pregnancy was also associated with greater risk of high waist circumference (RR, 1.13; 95% CI, 1.04-1.23), high sum of skinfold thickness (RR, 1.15; 95% CI, 1.02-1.29), and higher diastolic blood pressure at 4 years of age (β, 0.43 mm Hg; 95% CI, 0.00-0.86). Greater rate of gestational weight gain during the second and third trimesters of pregnancy (per 200 g/wk) was associated with greater risk of large-for-gestational-age neonates (RR, 1.22; 95% CI, 1.02, 1.45) and higher levels of cord blood leptin (ratio of geometric means, 1.08; 95% CI, 1.00-1.17), but not with child anthropometry at later ages.
  
  
  CONCLUSIONS
  Timing of gestational weight gain may influence childhood cardiometabolic outcomes differentially.
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece. Electronic address: m.karachaliou@med.uoc.gr.
authors.forename: Marianna
authors.initials: M
authors.lastname: Karachaliou
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.
authors.forename: Vaggelis
authors.initials: V
authors.lastname: Georgiou
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.
authors.forename: Theano
authors.initials: T
authors.lastname: Roumeliotaki
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Chalkiadaki
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Department of Endocrinology, Diabetes Mellitus, and Metabolic Disorders, Faculty of Medicine, University of Crete, Crete, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Daraki
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.
authors.forename: Stella
authors.initials: S
authors.lastname: Koinaki
authors.affiliation: Department of Clinical Chemistry and Biochemistry, Faculty of Medicine, University of Crete, Crete, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Dermitzaki
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Sarri
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Vassilaki
authors.affiliation: National School of Public Health, Athens, Greece; Center for Research in Environmental Epidemiology, Municipal Institute of Medical Research, and CIBER Epidemiologia y Salud Pública, Barcelona, Spain.
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.
authors.forename: Leda
authors.initials: L
authors.lastname: Chatzi
mesh_terms: D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015992:Body Mass Index; D002675:Child, Preschool; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D020738:Leptin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D015233:Models, Statistical; D063766:Pediatric Obesity / Q000097:blood / Q000209:etiology*; D011247:Pregnancy; D011264:Pregnancy Trimesters / Q000502:physiology*; D011297:Prenatal Exposure Delayed Effects / Q000097:blood / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D012885:Skinfold Thickness; D055105:Waist Circumference; D015430:Weight Gain / Q000502:physiology*
chemical_list: D015415:Biomarkers; D020738:Leptin; D008055:Lipids
keywords: blood pressure; children; gestational weight gain; obesity; pregnancy cohort