title: Low and high birth weight and the risk of child attention problems.
abstract: OBJECTIVE
  To study the prospective association between birth weight and attention problems and to explore the role of maternal body mass index (BMI) in this association.
  
  
  METHODS
  In 6015 children of a population-based cohort (Rotterdam, The Netherlands, 2001-2005), information on birth weight was collected and gestational age-adjusted SDS were calculated. At age 6 years, parents assessed attention problems with the Child Behavior Checklist. We used linear regression to study the association of birth weight with attention problem score and examined the modification of this association by maternal early pregnancy BMI.
  
  
  RESULTS
  The observed association between birth weight and attention problem score was curvilinear (adjusted β per birth weight SDS(2): 0.02, 95% CI 0.00; 0.03, P = .008); the turning point equals 3.6 kg at term. In analyses of the extreme tails of the birth weight distribution, the associations with attention problem score disappeared after adjustment for socioeconomic confounders. Maternal early pregnancy BMI moderated the association of child birth weight with attention problem score (P interaction = .007, with curvilinear term in model).
  
  
  CONCLUSIONS
  Higher birth weight was related to less attention problems but from a birth weight of about 3.6 kg or more, a higher birth weight did not reduce the risk of attention problems any further. However, in children of obese mothers (BMI >30 kg/m(2)), high birth weight may increase the risk of attention problems.
authors: The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Nina H
authors: NH
authors: van Mil
authors: Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Régine P M
authors: RP
authors: Steegers-Theunissen
authors: Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Ehsan
authors: E
authors: Motazedi
authors: The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Pauline W
authors: PW
authors: Jansen
authors: The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Vincent W V
authors: VW
authors: Jaddoe
authors: Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Eric A P
authors: EA
authors: Steegers
authors: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Frank C
authors: FC
authors: Verhulst
authors: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: h.tiemeier@erasmusmc.nl.
authors: Henning
authors: H
authors: Tiemeier
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D001724:Birth Weight / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D009035:Mothers; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D011446:Prospective Studies