title: Maternal Obesity and Excessive Gestational Weight Gain Are Associated with Components of Child Cognition.
abstract: BACKGROUND
  Maternal overweight and obesity affect two-thirds of women of childbearing age and may increase the risk of impaired child cognition.
  
  
  OBJECTIVE
  Our objective was to test the hypothesis that high/low gestational weight gain (GWG) and high/low prepregnancy BMI were associated with offspring intelligence quotient (IQ) and executive function at age 10.
  
  
  METHODS
  Mother-infant dyads (n = 763) enrolled in a birth cohort study were followed from early pregnancy to 10 y postpartum. IQ was assessed by trained examiners with the use of the Stanford Binet Intelligence Scale-4th edition. Executive function was assessed by the number of perseverative errors on the Wisconsin Card Sorting Test and time to complete Part B on the Trail Making Test. Self-reported total GWG was converted to gestational-age-standardized GWG z score. Multivariable linear regression and negative binomial regression were used to estimate independent and joint effects of GWG and BMI on outcomes while adjusting for covariates.
  
  
  RESULTS
  At enrollment, the majority of women in the Maternal Health Practices and Child Development cohort were unmarried and unemployed, and more than one-half reported their race as black. The mean ± SD GWG z score was -0.5 ± 1.8, and 27% of women had a pregravid BMI ≥ 25. The median (IQR) number of perseverative errors was 23 (17, 29), the mean ± SD time on Part B was 103 ± 42.6 s, and 44% of children had a low average IQ (≤ 89). Maternal obesity was associated with 3.2 lower IQ points (95% CI: -5.6, -0.8) and a slower time to complete the executive function scale Part B (adjusted β: 12.7 s; 95% CI: 2.8, 23 s) compared with offspring of normal-weight mothers. Offspring of mothers whose GWG was >+1 SD, compared with -1 to +1 SD, performed 15 s slower on the executive function task (95% CI: 1.8, 28 s). There was no association between GWG z score and offspring composite IQ score (adjusted β: -0.32; 95% CI: -0.72, 0.10). Prepregnancy BMI did not modify these associations.
  
  
  CONCLUSIONS
  Although GWG may be important for executive function, maternal BMI has a stronger relation than GWG to both offspring intelligence and executive function. Our findings contribute to evidence linking maternal obesity to long-term child outcomes.
authors.affiliation: Department of Epidemiology and lbodnar@pitt.edu.
authors.forename: Sarah J
authors.identifier: http://orcid.org/0000-0003-4347-2561
authors.initials: SJ
authors.lastname: Pugh
authors.affiliation: Department of Epidemiology and Department of Psychiatry.
authors.forename: Gale A
authors.initials: GA
authors.lastname: Richardson
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada; and.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Hutcheon
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, and Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Katherine P
authors.initials: KP
authors.lastname: Himes
authors.affiliation: Department of Epidemiology and Department of Biostatistics, Graduate School of Public Health.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Brooks
authors.affiliation: Department of Epidemiology and Department of Psychiatry, Clinical and Translational Science Institute, School of Medicine, and Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA;
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Day
authors.affiliation: Department of Epidemiology and Department of Obstetrics, Gynecology, and Reproductive Sciences, and Magee-Womens Research Institute, Pittsburgh, PA lbodnar@pitt.edu.
authors.forename: Lisa M
authors.identifier: http://orcid.org/0000-0001-9427-5467
authors.initials: LM
authors.lastname: Bodnar
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002657:Child Development; D003071:Cognition; D003072:Cognition Disorders / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007360:Intelligence; D016014:Linear Models; D008137:Longitudinal Studies; D009035:Mothers; D015999:Multivariate Analysis; D009765:Obesity / Q000503:physiopathology*; D050177:Overweight / Q000503:physiopathology; D011247:Pregnancy; D012959:Socioeconomic Factors; D015430:Weight Gain
keywords: body mass index; child; cognition; gestational weight gain; intelligence; obesity