title: Associations of maternal BMI and gestational weight gain with neonatal adiposity in the Healthy Start study.
abstract: BACKGROUND
  Maternal obesity and weight gain during pregnancy are risk factors for child obesity. Associations may be attributable to causal effects of the intrauterine environment or genetic and postnatal environmental factors.
  
  
  OBJECTIVE
  We estimated associations of maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) overall and in early pregnancy, midpregnancy, and late pregnancy with neonatal adiposity.
  
  
  METHODS
  Participants were 826 women enrolled in a Colorado prebirth cohort who delivered term infants (2010-2013). GWG to 39 wk of gestation was predicted by using mixed models, and early pregnancy, midpregnancy, and late pregnancy rates of GWG (0-17, 17-27, and 27 wk to delivery) were calculated from repeated weight measures. Neonatal body composition was measured by using air-displacement plethysmography ≤3 d after birth.
  
  
  RESULTS
  Each1-kg/m(2) increase in maternal BMI was associated with increased neonatal fat mass (5.2 g; 95% CI: 3.5, 6.9 g), fat-free mass (7.7 g; 95% CI: 4.5, 10.9 g), and percentage of body fat (0.12%; 95% CI: 0.08%, 0.16%). Each 0.1-kg/wk increase in predicted GWG was associated with increased fat mass (24.0 g; 95% CI: 17.4, 30.5 g), fat-free mass (34.0 g; 95% CI: 21.4, 46.6 g), and percentage of body fat (0.55%; 95% CI: 0.37%, 0.72%). No interaction was detected between BMI and GWG in their effects on neonatal body composition. Early pregnancy, midpregnancy, and late pregnancy rates of GWG were independently associated with fat mass and percentage of body fat. Midpregnancy and late pregnancy GWGs were associated with fat-free mass. An observed GWG that exceeded recommendations was associated with higher neonatal fat mass and fat-free mass but not percentage of body fat relative to adequate GWG.
  
  
  CONCLUSIONS
  Maternal prepregnancy BMI and GWG, including period-specific GWG, were positively and independently associated with neonatal adiposity. Associations of early and midpregnancy weight gain with neonatal adiposity support the hypothesis that greater maternal weight gain during pregnancy, regardless of prepregnancy BMI, is directly related to offspring adiposity at birth. The Healthy Start study was registered as an observational study at clinicaltrials.gov as NCT02273297.
authors: From the Departments of Epidemiology (APS, ALS, CSH, and DD) and Biostatistics and Informatics (JTB and DHG), Colorado School of Public Health, Aurora, CO; the Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO (AML); and the Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (AMS-R).
authors: Anne P
authors: AP
authors: Starling
authors: From the Departments of Epidemiology (APS, ALS, CSH, and DD) and Biostatistics and Informatics (JTB and DHG), Colorado School of Public Health, Aurora, CO; the Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO (AML); and the Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (AMS-R).
authors: John T
authors: JT
authors: Brinton
authors: From the Departments of Epidemiology (APS, ALS, CSH, and DD) and Biostatistics and Informatics (JTB and DHG), Colorado School of Public Health, Aurora, CO; the Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO (AML); and the Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (AMS-R).
authors: Deborah H
authors: DH
authors: Glueck
authors: From the Departments of Epidemiology (APS, ALS, CSH, and DD) and Biostatistics and Informatics (JTB and DHG), Colorado School of Public Health, Aurora, CO; the Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO (AML); and the Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (AMS-R).
authors: Allison L
authors: AL
authors: Shapiro
authors: From the Departments of Epidemiology (APS, ALS, CSH, and DD) and Biostatistics and Informatics (JTB and DHG), Colorado School of Public Health, Aurora, CO; the Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO (AML); and the Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (AMS-R).
authors: Curtis S
authors: CS
authors: Harrod
authors: From the Departments of Epidemiology (APS, ALS, CSH, and DD) and Biostatistics and Informatics (JTB and DHG), Colorado School of Public Health, Aurora, CO; the Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO (AML); and the Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (AMS-R).
authors: Anne M
authors: AM
authors: Lynch
authors: From the Departments of Epidemiology (APS, ALS, CSH, and DD) and Biostatistics and Informatics (JTB and DHG), Colorado School of Public Health, Aurora, CO; the Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO (AML); and the Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (AMS-R).
authors: Anna Maria
authors: AM
authors: Siega-Riz
authors: From the Departments of Epidemiology (APS, ALS, CSH, and DD) and Biostatistics and Informatics (JTB and DHG), Colorado School of Public Health, Aurora, CO; the Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO (AML); and the Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (AMS-R).
authors: Dana
authors: D
authors: Dabelea
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D050154:Adiposity; D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001823:Body Composition; D015992:Body Mass Index; D003120:Colorado; D005260:Female; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000378:metabolism; D010991:Plethysmography; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D015430:Weight Gain; D055815:Young Adult
keywords: adiposity; developmental origins; gestational weight gain; obesity; pregnancy
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