The Relationship of Maternal Prepregnancy Body Mass Index and Pregnancy Weight Gain to Neurocognitive Function at Age 10 Years among Children Born Extremely Preterm.
To assess the association between maternal prepregnancy body mass index and adequacy of pregnancy weight gain in relation to neurocognitive function in school-aged children born extremely preterm.



Study participants were 535 ten-year-old children enrolled previously in the prospective multicenter Extremely Low Gestational Age Newborns cohort study who were products of singleton pregnancies. Soon after delivery, mothers provided information about prepregnancy weight. Prepregnancy body mass index and adequacy of weight gain were characterized based on this information. Children underwent a neurocognitive evaluation at 10 years of age.



Maternal prepregnancy obesity was associated with increased odds of a lower score for Differential Ability Scales-II Verbal IQ, for Developmental Neuropsychological Assessment-II measures of processing speed and visual fine motor control, and for Wechsler Individual Achievement Test-III Spelling. Children born to mothers who gained an excessive amount of weight were at increased odds of a low score on the Oral and Written Language Scales Oral Expression assessment. Conversely, children whose mother did not gain an adequate amount of weight were at increased odds of a lower score on the Oral and Written Language Scales Oral Expression and Wechsler Individual Achievement Test-III Word Reading assessments.



In this cohort of infants born extremely preterm, maternal obesity was associated with poorer performance on some assessments of neurocognitive function. Our findings are consistent with the observational and experimental literature and suggest that opportunities may exist to mitigate risk through education and behavioral intervention before pregnancy.
Department of Epidemiology and Prevention, Wake Forest University Public Health Sciences, Winston-Salem, NC.
Elizabeth T
ET
Jensen
Department of Health and Life Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
Jelske W
JW
van der Burg
Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC. Electronic address: moshea52@email.unc.edu.
Thomas M
TM
O'Shea
Department of Psychology and Neuroanatomy, Boston University, Boston, MA.
Robert M
RM
Joseph
Neuroepidemiology Unit, Department of Neurology, Boston Children's Hospital, Boston, MA; Department of Neurology, Harvard Medical School, Boston, MA.
Elizabeth N
EN
Allred
Department of Biostatistics, Boston University School of Public Health, Boston, MA.
Tim
T
Heeren
Neuroepidemiology Unit, Department of Neurology, Boston Children's Hospital, Boston, MA; Department of Neurology, Harvard Medical School, Boston, MA.
Alan
A
Leviton
Department of Pediatrics, Boston Medical Center, Boston, MA.
Karl C K
KCK
Kuban
D015992:Body Mass Index; D002648:Child; D002657:Child Development; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D019965:Neurocognitive Disorders / Q000209:etiology*; D009765:Obesity / Q000150:complications*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D015430:Weight Gain
extremely preterm infants; maternal pre-pregnancy BMI; maternal weight gain; neurocognitive function