title: Socioeconomic disadvantage in childhood as a predictor of excessive gestational weight gain and obesity in midlife adulthood.
abstract: BACKGROUND
  Lower childhood socioeconomic position is associated with greater risk of adult obesity among women, but not men. Pregnancy-related weight changes may contribute to this gender difference. The objectives of this study were to determine the associations between: 1. childhood socioeconomic disadvantage and midlife obesity; 2. excessive gestational weight gain (GWG) and midlife obesity; and 3. childhood socioeconomic disadvantage and excessive GWG, among a representative sample of childbearing women.
  
  
  METHODS
  We constructed marginal structural models for seven measures of childhood socioeconomic position for 4780 parous women in the United States, using National Longitudinal Survey of Youth (1979-2010) data. Institute of Medicine definitions were used for excessive GWG; body mass index ≥30 at age 40 defined midlife obesity. Analyses were separated by race/ethnicity. Additionally, we estimated controlled direct effects of childhood socioeconomic disadvantage on midlife obesity under a condition of never gaining excessively in pregnancy.
  
  
  RESULTS
  Low parental education, but not other measures of childhood disadvantage, was associated with greater midlife obesity among non-black non-Hispanic women. Among black and Hispanic mothers, childhood socioeconomic disadvantage was not consistently associated with midlife obesity. Excessive GWG was associated with greater midlife obesity in all racial/ethnic groups. Childhood socioeconomic disadvantage was not statistically significantly associated with excessive GWG in any group. Controlled direct effects were not consistently weaker than total effects.
  
  
  CONCLUSIONS
  Childhood socioeconomic disadvantage was associated with adult obesity, but not with excessive gestational weight gain, and only for certain disadvantage measures among non-black non-Hispanic mothers. Prevention of excessive GWG may benefit all groups through reducing obesity, but excessive GWG does not appear to serve as a mediator between childhood socioeconomic position and adult obesity in women.
authors.affiliation: Division of Oral Epidemiology and Dental Public Health, University of California San Francisco, San Francisco, USA.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Chaffee
authors.affiliation: Division of Epidemiology and Division of Community Health and Human Development, School of Public Health, University of California Berkeley, Berkeley, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Abrams
authors.affiliation: Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, USA.
authors.forename: Alison K
authors.initials: AK
authors.lastname: Cohen
authors.affiliation: Division of General Medical Disciplines, Stanford University, Stanford, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Rehkopf
keywords: Gestational weight gain; Obesity; Social class; Socioeconomic factors