Maternal Weight Gain During Pregnancy and Child Weight at Age 3 Years

  • Christine M. Olson
  • Myla S. Strawderman
  • Barbara A. Dennison


Objectives To determine the importance of pregnancy weight gain as a predictor of overweight (Body Mass Index [BMI] >85th percentile) in offspring at age 3 years and if its influence varies by maternal BMI. Methods Chi-square and logistic regression analyses were conducted on a sample of 208 mother-child pairs from an earlier observational cohort study on postpartum weight retention. Results In the final reduced regression model, maternal early pregnancy BMI was positively and significantly associated with overweight in offspring, as were birth weight above the sample median of 3,600 g and maternal smoking during pregnancy (P ≤ 0.01). In addition, a significant interaction was found between maternal BMI and gestational weight gain (P = 0.03). The risk of offspring overweight that is associated with 5 excess pounds of net pregnancy weight gain increases with maternal BMI. Conclusions Excess pregnancy weight gain is associated with increased risk of child overweight at age 3 years and its impact is greater among high and obese BMI women than it is in normal BMI women. Reducing maternal BMI in the preconception period in overweight women and preventing excessive weight gain in pregnancy for all women appear to be appropriate strategies to address the childhood obesity epidemic.


Pregnancy Weight gain Child Preschool Obesity Body mass index (BMI) 



The funding for the collection of the data for the Bassett Mothers Health Project was provided by the National Institute of Child Health and Human Development (Grant No. HD 29549). The audit of the children’s medical records was conducted by Lydia Gedmintas at Bassett Healthcare.


  1. 1.
    Ogden, C. L., Carroll, M. D., Curtin, L. R., McDowell, M. A., Tabak, C. J., & Flegal, K. M. (2006). Prevalence of overweight and obesity in the United States, 1999–2004. Journal of the American Medical Association, 295, 1549–1555. doi: 10.1001/jama.295.13.1549.PubMedCrossRefGoogle Scholar
  2. 2.
    Krebs, N. F., Baker, R. D., Greer, F. R., Heyman, M. B., Jaksic, T., Lifshitz, F., et al. (2003). Prevention of pediatric overweight and obesity. Pediatrics, 112(2), 424–430. doi: 10.1542/peds.112.2.424.PubMedCrossRefGoogle Scholar
  3. 3.
    Nader, P. R., O’Brien, M., Houts, R., Bradley, R., Belsky, J., Crosnoe, R., Susman, E. J., & The National Institute of Child Health and Human Development Early Child Care Network. (2006). Identifying risk for obesity in early childhood. Pediatrics, 118, e594–e601. doi: 10.1542/peds.2005-2801.Google Scholar
  4. 4.
    Whitaker, R. C., & Dietz, W. H. (1998). Role of the prenatal environment in the development of obesity. The Journal of Pediatrics, 132, 768–776. doi: 10.1016/S0022-3476(98)70302-6.PubMedCrossRefGoogle Scholar
  5. 5.
    Oken, E., & Gillman, M. W. (2003). Fetal origins of obesity. Obesity Research, 11, 496–506. doi: 10.1038/oby.2003.69.PubMedCrossRefGoogle Scholar
  6. 6.
    Lawlor, D. A., & Chaturvedi, N. (2006). Treatment and prevention of obesity—are there critical periods for intervention? International Journal of Epidemiology, 35, 3–9. doi: 10.1093/ije/dyi309.PubMedCrossRefGoogle Scholar
  7. 7.
    Whitaker, R. C. (2004). Predicting preschooler obesity at birth: The role of maternal obesity in early pregnancy. Pediatrics, 114, e29–e36. doi: 10.1542/peds.114.1.e29.PubMedCrossRefGoogle Scholar
  8. 8.
    Salsberry, P. J., & Reagan, P. B. (2005). Dynamics of early childhood overweight. Pediatrics, 116, 1329–1338. doi: 10.1542/peds.2004-2583.PubMedCrossRefGoogle Scholar
  9. 9.
    Oken, E., Taveras, E. M., Kleinman, K. P., Rich-Edwards, J. W., & Gillman, M. W. (2007). Gestational weight gain and child adiposity at age 3 years. American Journal of Obstetrics and Gynecology, 196, 322.e1–322.e8.CrossRefGoogle Scholar
  10. 10.
    Moreira, P., Padez, C., Mourão-Carvalhal, I., & Rosado, V. (2007). Maternal weight gain during pregnancy and overweight in Portuguese children. International Journal of Obesity, 31, 608–614. doi: 10.1038/sj.ijo.0803582.PubMedCrossRefGoogle Scholar
  11. 11.
    Sharma, A. J., Cogswell, M. E., & Grummer-Strawn, L. M. (2005). The association between pregnancy weight gain and childhood overweight is modified by mother’s pre-pregnancy BMI. Pediatric Research, 58, 1038. doi: 10.1203/00006450-200510000-00042. abstract.CrossRefGoogle Scholar
  12. 12.
    Olson, C. M., & Strawderman, M. S. (2003). Modifiable behavioral factors in a biopsychosocial model predict inadequate and excessive gestational weight gain. Journal of the American Dietetic Association, 103, 48–54. doi: 10.1053/jada.2003.50001.PubMedCrossRefGoogle Scholar
  13. 13.
    Stotland, N. E., Cheng, Y. W., Hopkins, L. M., & Caughey, A. B. (2006). Gestational weight gain and adverse neonatal outcome among term infants. Obstetrics and Gynecology, 108(3 Pt1), 635–643.PubMedGoogle Scholar
  14. 14.
    Wells, C. S., Schwalberg, R., Noonan, G., & Gabor, V. (2006). Factors influencing inadequate and excessive weight gain in pregnancy: Colorado, 2000–2002. Maternal and Child Health Journal, 10(1), 55–62. doi: 10.1007/s10995-005-0034-2.PubMedCrossRefGoogle Scholar
  15. 15.
    Lederman, S. A., Alfasi, G., & Deckelbaum, R. J. (2002). Pregnancy-associated obesity in black women in New York City. Maternal and Child Health Journal, 6(1), 37–42. doi: 10.1023/A:1014364116513.PubMedCrossRefGoogle Scholar
  16. 16.
    Olson, C. M., Strawderman, M. S., & Reed, R. G. (2004). Efficacy of an intervention to prevent excessive gestational weight gain. American Journal of Obstetrics and Gynecology, 191, 530–536. doi: 10.1016/j.ajog.2004.01.027.PubMedCrossRefGoogle Scholar
  17. 17.
    Polley, B. A., Wing, R. R., & Sims, C. J. (2002). Randomized controlled trial to prevent excessive weight gain in pregnant women. International Journal of Obesity, 26, 1494–1502. doi: 10.1038/sj.ijo.0802130.PubMedCrossRefGoogle Scholar
  18. 18.
    Hinton, P. S., & Olson, C. M. (2001). Predictors of pregnancy-associated change in physical activity in a rural white population. Maternal and Child Health Journal, 5, 7–14. doi: 10.1023/A:1011315616694.PubMedCrossRefGoogle Scholar
  19. 19.
    Kendall, A., Olson, C. M., & Frongillo, E. A., Jr. (2001). Evaluation of psychosocial measures for understanding weight-related behaviors in pregnant women. Annals of Behavioral Medicine, 23, 50–58. doi: 10.1207/S15324796ABM2301_8.PubMedCrossRefGoogle Scholar
  20. 20.
    Olson, C. M., Strawderman, M. S., Hinton, P. S., & Pearson, T. A. (2003). Gestational weight gain and postpartum behaviors associated with weight change from early pregnancy to 1 y postpartum. International Journal of Obesity, 27, 117–127. doi: 10.1038/sj.ijo.0802156.PubMedCrossRefGoogle Scholar
  21. 21.
    Institute of Medicine. (1992). Nutrition during pregnancy and lactation. An implementation guide. Washington, DC: National Academy Press.Google Scholar
  22. 22.
    Li, C., Goran, M. I., Kaur, H., Nollen, N., & Ahluwalia, J. S. (2007). Developmental trajectories of overweight during childhood: Role of early life factors. Obesity (Silver Spring, Md.), 15(3), 760–771. doi: 10.1038/oby.2007.585.CrossRefGoogle Scholar
  23. 23.
    Wrotniak, B. H., Shults, J., Butts, S., & Stettler, N. (2008). Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort study. The American Journal of Clinical Nutrition, 87, 1818–1824.PubMedGoogle Scholar
  24. 24.
    Huang, J. S., Lee, T. A., & Lu, M. C. (2007). Prenatal programming of childhood overweight and obesity. Maternal and Child Health Journal, 11, 461–473. doi: 10.1007/s10995-006-0141-8.PubMedCrossRefGoogle Scholar
  25. 25.
    Oken, E., Levitan, E. B., & Gillman, M. W. (2008). Maternal smoking during pregnancy and child overweight: Systematic review and meta-analysis. International Journal of Obesity, 32, 201–210. doi: 10.1038/sj.ijo.0803760.PubMedCrossRefGoogle Scholar
  26. 26.
    Leary, S. D., Smith, G. D., Rogers, I. S., Reilly, J. J., Wells, J. C. K., & Ness, A. R. (2006). Smoking during pregnancy and offspring fat and lean mass in childhood. Obesity (Silver Spring, Md.), 14(12), 2284–2293. doi: 10.1038/oby.2006.268.CrossRefGoogle Scholar
  27. 27.
    Harder, T., Bergmann, R., Kallischnigg, G., & Plagemann, A. (2005). Duration of breastfeeding and risk of overweight: A meta-analysis. American Journal of Epidemiology, 162, 397–403. doi: 10.1093/aje/kwi222.PubMedCrossRefGoogle Scholar
  28. 28.
    Arenz, A., Rückerl, R., Koletzko, B., & von Kries, R. (2004). Breast-feeding and childhood obesity - a systematic review. International Journal of Obesity, 28, 1247–1256. doi: 10.1038/sj.ijo.0802758.PubMedCrossRefGoogle Scholar
  29. 29.
    Ryan, A. S. (2007). Breastfeeding and the risk of childhood obesity. Collegium Antropologicum, 31(1), 19–28.PubMedGoogle Scholar
  30. 30.
    Kramer, M. S., Matush, L., Vanilovich, I., Platt, R. W., Bogdanovich, N., Sevkovskaya, Z., et al. (2007). Effects of prolonged and exclusive breastfeeding on child height, weight, adiposity and blood pressure at age 6.5 y: Evidence from a large randomized trial. The American Journal of Clinical Nutrition, 86, 1717–1721.PubMedGoogle Scholar
  31. 31.
    National Research Council and Institute of Medicine. (2007). Influence of pregnancy weight on maternal and child health workshop report. Washington, DC: The National Academies Press.Google Scholar
  32. 32.
    Committee on Obstetric Practice. (2005). Obesity in pregnancy. Obstetrics and Gynecology, 106, 671–675.Google Scholar
  33. 33.
    Claesson, I.-M., Sydsjö, G., Brynhildsen, J., Cedergren, M., Jeppsson, A., Nyström, F., & Sydsjö, J. A. (2007). Weight gain restriction for obese pregnant women: A case-control intervention study. BJOG. doi: 10.1111/j.1471-0528.2007.01531.x.
  34. 34.
    Wolff, S., Legarth, J., Vangsgaard, K., Toubro, S., & Astrup, A. (2008). A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. International Journal of Obesity. doi: 10.1038/sj.ijo.0803710.

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Christine M. Olson
    • 1
  • Myla S. Strawderman
    • 1
  • Barbara A. Dennison
    • 2
  1. 1.Division of Nutritional SciencesCornell UniversityIthacaUSA
  2. 2.Research InstituteBassett HealthcareCooperstownUSA

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