Gestational weight gain and childhood body mass index across three generations: Results from the 1993 Pelotas (Brazil) Birth Cohort

摘要

Background: Gestational weight gain (GWG) has been associated with the accumulation of body fat in offspring, but little is known about the intergenerational relationship. Objective: To assess the effect of GWG in grandmothers and mothers on the child's body mass index (BMI). Methods: This is a sub-study nested in the 1993 Pelotas (Brazil) Birth Cohort at 22 years follow-up visit. We calculated the BMI-for-age z-score (BAZ) and evaluated overweight (>2 SD in 1 SD for >5 years of age for BAZ). Grandmothers' and mothers' GWG were calculated as the difference between weight in the beginning of pregnancy and the last recorded weight before delivery. We standardized the GWG by adjusting for pre-gestational BMI. We also categorized GWG as adequate, excessive, or insufficient, in accordance with the Institute of Medicine (2009). Linear and logistic regressions stratified by child's age (5 years) were used. Structural equations were modelled to calculate the total, indirect, and direct effects of grandmothers' and mothers' GWG on children's BAZ. Results: Nine hundred and forty-six out of 1113 children evaluated were 5 years of age or under. There was an indirect effect (through maternal birthweight, maternal pre-gestational BMI, maternal GWG, and child birthweight) of grandmother GWG on grandchild BAZ, from 2.01 to 5 years of age [beta = 0.12 _95%CI: 0.04-0.20 (P 5 years of age [beta = 0.34 95%CI: 0.15-0.53 (P < 0.001)]. Conclusions: GWG's effect on BMI does seem to be transmitted across three generations. Managing this will require health education during the gestational period for women and their families.