Maternal Weight Trajectories from Pre-Pregnancy through Postpartum and Childhood Obesity Risk at 24 Months of Age: A Group-Based Trajectory Modeling Analysis

Authors

Taniqua T. Ingol, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
Sarah E. Anderson, Division of Epidemiology, College of Public Health, The Ohio State University, USA
Joseph Rausch, Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, USA; Department of Pediatrics, College of Medicine, The Ohio State University, USA
Rebecca Andridge, Division of Biostatistics, College of Public Health, The Ohio State University, USA
Bharathi J. Zvara, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
Sarah A. Keim, Division of Epidemiology, College of Public Health, The Ohio State University, USA; Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, USA; Department of Pediatrics, College of Medicine, The Ohio State University, USAFollow

Abstract

Background: High pre-pregnancy BMI, excessive gestational weight gain, and postpartum weight retention are modifiable risk factors for childhood obesity, but are often studied singly, limiting understanding of their combined impact. Our objective was to characterize maternal weight trajectories across pregnancy until 18 months’ postpartum and examine associations with child overweight or obesity. Methods: We analyzed data from 299 mother-child dyads enrolled in the Play & Grow study (Ohio, USA). Mother’s weight and height were measured at study enrollment at 18 months’ postpartum. Pre-pregnancy weight and height and weight at delivery were obtained through linkage to birth certificate data. Group-based trajectory modeling was used to characterize maternal weight trajectories using BMI values at pre-pregnancy, delivery, and postpartum. Modified Poisson regression was used to assess associations between maternal BMI trajectories and child overweight or obesity (sex and age-specific WHO BMI z-score ≥ 2) at age 24 months. Results: Approximately 46% of the mothers identified as non-white and 12% smoked. Three maternal BMI trajectories were identified: “Normal then increase and modest decrease” (57%, n=171), “Class 1 Obesity then increase and plateau” (32%, n=95), and “Class 3 Obesity then increase and plateau” (11%, n=33). Effect estimates comparing the latter two groups to the normal group suggested a moderately increased risk of child overweight or obesity which was inconsistently attenuated upon adjustment for confounders (e.g., adjusted risk ratio for “Class 3 Obesity then increase and plateau” =1.32, 95% confidence interval: 0.58, 3.00). All confidence intervals were wide and included null. Conclusion: Excess weight before, during, and after pregnancy may collectively impact childhood obesity. Additional studies are needed because these results were imprecise.

Recommended Citation

Ingol, Taniqua T.; Anderson, Sarah E.; Rausch, Joseph; Andridge, Rebecca; Zvara, Bharathi J.; and Keim, Sarah A. (2025) "Maternal Weight Trajectories from Pre-Pregnancy through Postpartum and Childhood Obesity Risk at 24 Months of Age: A Group-Based Trajectory Modeling Analysis," Journal of Child Science: Vol. 15: Iss. 1, Article 7.
DOI: https://doi.org/10.53391/2474-5871.1006
Available at: https://jcs.researchcommons.org/journal/vol15/iss1/7