Maternal Gestational Weight Status and Offspring Physical Growth Status at Birth, Mid‐Childhood and Early Adolescence

Maternal adiposity has been identified as a predictor of child overweight/obesity; however, it remains unclear whether the association changes as the child ages. We aimed to examine the associations between maternal weight status during pregnancy and offspring physical growth from birth to early adolescence using data from a birth cohort study in rural western China. Maternal weight measurements during the first, second and third trimesters were used to calculate body mass index (BMI) and gestational weight gain (GWG) rate, and then were classified following the Institute of Medicine recommendation. Offspring length/height and weight were measured at birth, mid-childhood (age 7-10 years) and early adolescence (age 10-14 years) and converted into z-scores using the INTERGROWTH-21st and WHO standards, respectively. Generalized linear models were applied to examine the associations of maternal BMI and GWG with offspring BMI-for-age and sex (BAZ) and length-/height-for-age and sex z-score (LAZ/HAZ) at birth, mid-childhood and early adolescence, respectively, adjusting for potential confounders. Among 411 mother-offspring pairs (62% boys), higher maternal BMI during the first trimester was associated with increased offspring BAZ at birth (adjusted mean differences [aMD]: 0.07, 95% confidence interval [CI]: 0.001-0.14), mid-childhood (aMD 0.09, 95% CI: 0.05-0.14) and early adolescence (aMD 0.11, 95% CI: 0.05-0.17). Maternal excessive GWG was associated with higher HAZ in early adolescence (aMD 0.44; 95% CI: 0.17-0.69). The strongest point estimate of maternal gestational weight status on offspring physical growth emerged in early adolescence, suggesting the potential age-dependent amplifying impact. Additionally, updated GWG guidelines should consider regional characteristics and long-term offspring growth.