Associations Between Gestational Weight Gain and Children's Neurodevelopment at 3 Years of Age

OBJECTIVE: This study aimed to investigate the associations of gestational weight gain (GWG) and GWG trajectory with children's neurodevelopment at age three. METHODS: This prospective analysis included 4177 mother-child pairs from the Jiangsu Birth Cohort. GWG was assessed both as categories (insufficient/optimal/excessive) and trajectories based on repeated prenatal measurements. Children's neurodevelopment at age three was assessed using the Bayley Scales of Infant and Toddler Development, Version-III Screening Test. A Robust Poisson regression model was used to examine the associations of GWG categories and trajectories with children's neurodevelopment. RESULTS: Compared with children of mothers with optimal GWG, those exposed to excessive GWG had 50% higher noncompetent cognitive risk (RR = 1.50), while insufficient GWG increased noncompetent fine motor risk by 30% (RR = 1.30). Notably, the association between insufficient GWG and noncompetent cognitive development was observed only among those with breastfeeding duration ≤ 12 months (RR = 2.07), not among those breastfeeding > 12 months (RR = 0.72). The "Slow-Rapid" GWG trajectory was associated with elevated risks of both noncompetent cognitive development (RR = 2.51) and expressive communication (RR = 1.94). CONCLUSIONS: Excessive GWG, insufficient GWG, and the Slow-Rapid GWG trajectory showed associations with children's noncompetent neurodevelopment. As GWG is a modifiable factor, these findings could inform early intervention for high-risk mother-child dyads.