Xinyi Lin1, Izzuddin M Aris1, Mya Thway Tint1, Shu E Soh1, Keith M Godfrey1, George Seow-Heong Yeo1, Kenneth Kwek1, Jerry Kok-Yen Chan1, Peter D Gluckman1, Yap Seng Chong1, Fabian Yap1, Joanna D Holbrook1, Yung Seng Lee1. 1. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (X.L., P.D.G., Y.S.C., J.D.H., Y.S.L.), 117609 Singapore; Department of Paediatrics (I.M.A., S.E.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, 119228 Singapore; Department of Obstetrics and Gynaecology (M.T.T., Y.S.C.), Yong Loo Lin School of Medicine, National University of Singapore, 119228 Singapore; Saw Swee Hock School of Public Health (S.E.S.), National University of Singapore, 117597 Singapore; MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre (K.M.G.), University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD United Kingdom; Department of Maternal Fetal Medicine (G.S.-H.Y., K.K.), KK Women's and Children's Hospital, 229899 Singapore; Department of Reproductive Medicine (J.K.-Y.C.), KK Women's and Children's Hospital, 229899 Singapore; Centre for Human Evolution, Adaptation and Disease (P.D.G.), Liggins Institute, University of Auckland, Auckland, New Zealand; Department of Paediatrics (F.Y.), KK Women's and Children's Hospital, 229899 Singapore; Department of Biochemistry (J.D.H.), National University of Singapore, 117596 Singapore; and Division of Paediatric Endocrinology and Diabetes (Y.S.L.), Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, 119228 Singapore.
Abstract
CONTEXT: Maternal adiposity and overnutrition, both before and during pregnancy, plays a key role in the subsequent development of obesity and metabolic outcomes in offspring. OBJECTIVE: We explored the hypothesis that maternal adiposity (pre-pregnancy and at 26-28 weeks' gestation) and mid-pregnancy gestational weight gain (GWG) are independently associated with offspring size and adiposity in early childhood, and determined whether these effects are ethnicity dependent. DESIGN: In a prospective mother-offspring cohort study (N = 976, 56% Chinese, 26% Malay, and 18% Indian), we assessed the associations of offspring size (weight, length) and adiposity (subscapular and triceps skinfolds), measured at birth and age 6, 12, 18, and 24 mo, with maternal pre-pregnancy body mass index (ppBMI), mid-pregnancy GWG, and mid-pregnancy four-site skinfold thicknesses (triceps, biceps, subscapular, suprailiac). RESULTS: ppBMI and mid-pregnancy GWG were independently associated with postnatal weight up to 2 y and skinfold thickness at birth. Weight and subscapular and triceps skinfolds at birth increased by 2.56% (95% confidence interval, 1.68-3.45%), 3.85% (2.16-5.57%), and 2.14% (0.54-3.75%), respectively for every SD increase in ppBMI. Similarly, a one-SD increase in GWG increased weight and subscapular and triceps skinfolds at birth by 2.44% (1.66-3.23%), 3.28% (1.75-4.84%), and 3.23% (1.65-4.84%), respectively. ppBMI and mid-pregnancy suprailiac skinfold independently predicted postnatal skinfold adiposity up to 2 years of age, whereas only GWG predicted postnatal length. The associations of GWG with postnatal weight and length were present only among Chinese and Indians, but not Malays (P < .05 for interaction). CONCLUSIONS: ppBMI and GWG are independent modifiable factors for child size and adiposity up to 2 years of age. The associations are ethnic-dependent, and underscore the importance of ethnic specific studies before generalizing the applicability of risk factors reported in other populations.
CONTEXT: Maternal adiposity and overnutrition, both before and during pregnancy, plays a key role in the subsequent development of obesity and metabolic outcomes in offspring. OBJECTIVE: We explored the hypothesis that maternal adiposity (pre-pregnancy and at 26-28 weeks' gestation) and mid-pregnancy gestational weight gain (GWG) are independently associated with offspring size and adiposity in early childhood, and determined whether these effects are ethnicity dependent. DESIGN: In a prospective mother-offspring cohort study (N = 976, 56% Chinese, 26% Malay, and 18% Indian), we assessed the associations of offspring size (weight, length) and adiposity (subscapular and triceps skinfolds), measured at birth and age 6, 12, 18, and 24 mo, with maternal pre-pregnancy body mass index (ppBMI), mid-pregnancy GWG, and mid-pregnancy four-site skinfold thicknesses (triceps, biceps, subscapular, suprailiac). RESULTS: ppBMI and mid-pregnancy GWG were independently associated with postnatal weight up to 2 y and skinfold thickness at birth. Weight and subscapular and triceps skinfolds at birth increased by 2.56% (95% confidence interval, 1.68-3.45%), 3.85% (2.16-5.57%), and 2.14% (0.54-3.75%), respectively for every SD increase in ppBMI. Similarly, a one-SD increase in GWG increased weight and subscapular and triceps skinfolds at birth by 2.44% (1.66-3.23%), 3.28% (1.75-4.84%), and 3.23% (1.65-4.84%), respectively. ppBMI and mid-pregnancy suprailiac skinfold independently predicted postnatal skinfold adiposity up to 2 years of age, whereas only GWG predicted postnatal length. The associations of GWG with postnatal weight and length were present only among Chinese and Indians, but not Malays (P < .05 for interaction). CONCLUSIONS: ppBMI and GWG are independent modifiable factors for child size and adiposity up to 2 years of age. The associations are ethnic-dependent, and underscore the importance of ethnic specific studies before generalizing the applicability of risk factors reported in other populations.
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