title: Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years.
abstract: Maternal obesity, excessive gestational weight gain (EGWG), gestational diabetes mellitus (GDM) and breastfeeding are four important factors associated with childhood obesity.
  
  
  
  The objective of the study was to assess the interplay among these four factors and their independent contributions to childhood overweight in a cohort with standard clinical care.
  
  
  
  The cohort included 15 710 mother-offspring pairs delivered in 2011. Logistic regression was used to assess associations between maternal exposures and childhood overweight (body mass index >85th percentile) at age 2 years.
  
  
  
  Mothers with pre-pregnancy obesity or overweight were more likely to have EGWG, GDM and less likely to breastfeed ≥6 months. Mothers with GDM had 40-49% lower EGWG rates and similar breastfeeding rates compared with mothers without GDM. Analysis adjusted for exposures and covariates revealed an adjusted odds ratio (95% confidence interval) associated with childhood overweight at age 2 years of 2.34 (2.09-2.62), 1.50 (1.34-1.68), 1.23 (1.12-1.35), 0.95 (0.83-1.10) and 0.76 (0.69-0.83) for maternal obesity, overweight, EGWG, GDM and breastfeeding ≥6 months vs. <6 months, respectively.
  
  
  
  In this large clinical cohort, GDM was not associated with, but maternal pre-pregnancy obesity or overweight and EGWG were independently associated with an increased risk, and breastfeeding ≥6 months was associated with a decreased risk of childhood overweight at age 2 years.
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
authors.forename: Z
authors.initials: Z
authors.lastname: Bider-Canfield
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Martinez
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
authors.forename: W
authors.initials: W
authors.lastname: Yu
authors.affiliation: Consulting & Implementation, Kaiser Permanente Southern California, Pasadena, CA, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Bautista
authors.affiliation: Quality and Risk, Kaiser Permanente Southern California, Pasadena, CA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Brookey
authors.affiliation: Department of Medicine and Diabetes and Obesity Research Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Page
authors.affiliation: Department of Medicine and Diabetes and Obesity Research Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Buchanan
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
authors.forename: A H
authors.initials: AH
authors.lastname: Xiang
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D001942:Breast Feeding / Q000009:adverse effects*; D002675:Child, Preschool; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects; D009035:Mothers; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012189:Retrospective Studies; D015430:Weight Gain
keywords: Breastfeeding; gestational diabetes; gestational weight gain; maternal and childhood obesity