Maternal and Child Health Journal

, Volume 15, Issue 8, pp 1166–1175 | Cite as

Predictors of Obesity in Childhood, Adolescence, and Adulthood in a Birth Cohort

  • Brenda L. Rooney
  • Michelle A. Mathiason
  • Charles W. Schauberger
Article

Abstract

To determine how characteristics of pregnancy, birth, and early infancy are related to offspring obesity at three critical developmental periods. Mothers were followed through pregnancy and 10–15 years after. Offspring data were obtained through medical record review. Maternal and offspring characteristics were examined to predict obesity in childhood (ages 4–5 years), adolescence (ages 9–14 years), and early adulthood (ages 19–20 years). The original cohort included 802 children born to 795 women. Children who were twins, who had died, or whose mothers had died were excluded (n = 25). Medical records of 68.5% of the remaining 777 children documented a height and weight at childhood, adolescence, or early adulthood. Relative risks (RRs) to predict obesity at early adulthood were 12.3 for childhood and 45.1 at adolescence. RRs were also significant to predict obesity at early adulthood between the mother’s obesity at prepregnancy (RR = 6.4), 4–5 years postpregnancy (RR = 6.3), and 10–15 years postpregnancy (RR = 6.2). Excluding these variables from the multivariate models and adjusting by gender, birth insurance, and mother’s marital status at delivery, the best model to predict obesity at childhood included birth weight, weight gain in infancy, and delivery type. At adolescence, it included maternal pregnancy smoking status, gestational weight gain, and weight gain in infancy, and in early adulthood, included maternal pregnancy smoking status, gestational weight gain, and birth weight. Maternal pregnancy smoking status, gestational weight gain, and weight gain in infancy have long-term effects on offspring. Maternal obesity is the strongest predictor of obesity at all times studied.

Keywords

Pregnancy Weight gain Childhood Adolescence Early adult obesity Body mass index (BMI) 

Notes

Acknowledgments

This study was funded by support from the Gundersen Lutheran Medical Foundation.

References

  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. JAMA: The Journal of the American Medical Association, 295(13), 1549–1555.CrossRefGoogle Scholar
  2. 2.
    Ogden, C. L., Carroll, M. D., Curtin, L. R., Lamb, M. M., & Flegal, K. M. (2010). Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA: The Journal of the American Medical Association, 303(3), 242–249.CrossRefGoogle Scholar
  3. 3.
    Flegal, K. M., Carroll, M. D., Ogden, C. L., & Curtin, L. R. (2010). Prevalence and trends in obesity among US adults, 1999–2008. JAMA: The Journal of the American Medical Association, 303(3), 235–241.CrossRefGoogle Scholar
  4. 4.
    Dietz, W. H. (1998). Childhood weight affects adult morbidity and mortality. The Journal of Nutrition, 128(2 Suppl), 411S–414S.PubMedGoogle Scholar
  5. 5.
    Raman, R. P. (2002). Obesity and health risks. Journal of the American College of Nutrition, 21(2), 134S–139S.PubMedGoogle Scholar
  6. 6.
    He, Q., Ding, Z. Y., Fong, D. Y., & Karlberg, J. (2000). Risk factors of obesity in preschool children in China: A population-based case-control study. International Journal of Obesity and Related Metabolic Disorders: Journal of the International Association for the Study of Obesity, 24(11), 1528–1536.CrossRefGoogle Scholar
  7. 7.
    Hui, L. L., Nelson, E. A., Yu, L. M., Li, A. M., & Fok, T. F. (2003). Risk factors for childhood overweight in 6- to 7-y-old Hong Kong children. International Journal of Obesity and Related Metabolic Disorders: Journal of the International Association for the Study of Obesity, 27(11), 1411–1418.CrossRefGoogle Scholar
  8. 8.
    Li, C., Kaur, H., Choi, W. S., Huang, T. T., Lee, R. E., & Ahluwalia, J. S. (2005). Additive interactions of maternal prepregnancy BMI and breast-feeding on childhood overweight. Obesity Research, 13(2), 362–371.PubMedCrossRefGoogle Scholar
  9. 9.
    Whitaker, R. C. (2004). Predicting preschooler obesity at birth: The role of maternal obesity in early pregnancy. Pediatrics, 114(1), e29–e36.PubMedCrossRefGoogle Scholar
  10. 10.
    Laitinen, J., Power, C., & Jarvelin, M. R. (2001). Family social class, maternal body mass index, childhood body mass index, and age at menarche as predictors of adult obesity. The American Journal of Clinical Nutrition, 74(3), 287–294.PubMedGoogle Scholar
  11. 11.
    Li, L., Law, C., Lo Conte, R., & Power, C. (2009). Intergenerational influences on childhood body mass index: The effect of parental body mass index trajectories. The American Journal of Clinical Nutrition, 89(2), 551–557.PubMedCrossRefGoogle Scholar
  12. 12.
    Case, A., & Paxson, C. (2002). Parental behavior and child health. Health Affairs (Project Hope), 21(2), 164–178.CrossRefGoogle Scholar
  13. 13.
    Dietz, W. H. (1994). Critical periods in childhood for the development of obesity. The American Journal of Clinical Nutrition, 59(5), 955–959.PubMedGoogle Scholar
  14. 14.
    Dorosty, A. R., Emmett, P. M., Cowin, S., & Reilly, J. J. (2000). Factors associated with early adiposity rebound. ALSPAC study team. Pediatrics, 105(5), 1115–1118.PubMedCrossRefGoogle Scholar
  15. 15.
    Stettler, N., Zemel, B. S., Kumanyika, S., & Stallings, V. A. (2002). Infant weight gain and childhood overweight status in a multicenter, cohort study. Pediatrics, 109(2), 194–199.PubMedCrossRefGoogle Scholar
  16. 16.
    He, Q., & Karlberg, J. (2002). Probability of adult overweight and risk change during the BMI rebound period. Obesity Research, 10(3), 135–140.PubMedCrossRefGoogle Scholar
  17. 17.
    Kinra, S., Baumer, J. H., & Davey Smith, G. (2005). Early growth and childhood obesity: A historical cohort study. Archives of Disease in Childhood, 90(11), 1122–1127.PubMedCrossRefGoogle Scholar
  18. 18.
    Taveras, E. M., Rifas-Shiman, S. L., Belfort, M. B., Kleinman, K. P., Oken, E., & Gillman, M. W. (2009). Weight status in the first 6 months of life and obesity at 3 years of age. Pediatrics, 123(4), 1177–1183.PubMedCrossRefGoogle Scholar
  19. 19.
    Gillman, M. W., Rifas-Shiman, S. L., Camargo, C. A., Jr., Berkey, C. S., Frazier, A. L., Rockett, H. R., et al. (2001). Risk of overweight among adolescents who were breastfed as infants. JAMA: The Journal of the American Medical Association, 285(19), 2461–2467.CrossRefGoogle Scholar
  20. 20.
    Hediger, M. L., Overpeck, M. D., Kuczmarski, R. J., & Ruan, W. J. (2001). Association between infant breastfeeding and overweight in young children. JAMA: The Journal of the American Medical Association, 285(19), 2453–2460.CrossRefGoogle Scholar
  21. 21.
    Armstrong, J., Reilly, J. J., & Child Health Information Team. (2002). Breastfeeding and lowering the risk of childhood obesity. Lancet, 359(9322), 2003–2004.PubMedCrossRefGoogle Scholar
  22. 22.
    Kramer, M. S., Matush, L., Bogdanovich, N., Aboud, F., Mazer, B., Fombonne, E., et al. (2009). Health and development outcomes in 6.5-y-old children breastfed exclusively for 3 or 6 mo. The American Journal of Clinical Nutrition, 90(4), 1070–1074.PubMedCrossRefGoogle Scholar
  23. 23.
    Ong, K. K., Preece, M. A., Emmett, P. M., Ahmed, M. L., Dunger, D. B., & ALSPAC Study Team. (2002). Size at birth and early childhood growth in relation to maternal smoking, parity and infant breast-feeding: Longitudinal birth cohort study and analysis. Pediatric Research, 52(6), 863–867.PubMedGoogle Scholar
  24. 24.
    Toschke, A. M., Koletzko, B., Slikker, W., Jr, Hermann, M., & von Kries, R. (2002). Childhood obesity is associated with maternal smoking in pregnancy. European Journal of Pediatrics, 161(8), 445–448.PubMedCrossRefGoogle Scholar
  25. 25.
    Wideroe, M., Vik, T., Jacobsen, G., & Bakketeig, L. S. (2003). Does maternal smoking during pregnancy cause childhood overweight? Paediatric and Perinatal Epidemiology, 17(2), 171–179.PubMedCrossRefGoogle Scholar
  26. 26.
    von Kries, R., Toschke, A. M., Koletzko, B., & Slikker, W., Jr. (2002). Maternal smoking during pregnancy and childhood obesity. American Journal of Epidemiology, 156(10), 954–961.CrossRefGoogle Scholar
  27. 27.
    Salsberry, P. J., & Reagan, P. B. (2005). Dynamics of early childhood overweight. Pediatrics, 116(6), 1329–1338.PubMedCrossRefGoogle Scholar
  28. 28.
    Schauberger, C. W., Rooney, B. L., & Brimer, L. M. (1992). Factors that influence weight loss in the puerperium. Obstetrics and Gynecology, 79(3), 424–429.PubMedCrossRefGoogle Scholar
  29. 29.
    Rooney, B. L., & Schauberger, C. W. (2002). Excess pregnancy weight gain and long-term obesity: One decade later. Obstetrics and Gynecology, 100(2), 245–252.PubMedCrossRefGoogle Scholar
  30. 30.
    Rooney, B. L., Schauberger, C. W., & Mathiason, M. A. (2005). Impact of perinatal weight change on long-term obesity and obesity-related illnesses. Obstetrics and Gynecology, 106(6), 1349–1356.PubMedCrossRefGoogle Scholar
  31. 31.
    Committee on Nutritional Status During Pregnancy and Lactation, Institute of Medicine. (1990). Weight gain. Nutrition during pregnancy (p. 10). Washington, D.C.: National Academy Press.Google Scholar
  32. 32.
    Nader, P. R., O’Brien, M., Houts, R., Bradley, R., Belsky, J., Crosnoe, R., et al. (2006). Identifying risk for obesity in early childhood. Pediatrics, 118(3), e594–e601.PubMedCrossRefGoogle Scholar
  33. 33.
    Guo, S. S., Roche, A. F., Chumlea, W. C., Gardner, J. D., & Siervogel, R. M. (1994). The predictive value of childhood body mass index values for overweight at age 35 y. The American Journal of Clinical Nutrition, 59(4), 810–819.PubMedGoogle Scholar
  34. 34.
    Salbe, A. D., Weyer, C., Lindsay, R. S., Ravussin, E., & Tataranni, P. A. (2002). Assessing risk factors for obesity between childhood and adolescence: Part I. Birth weight, childhood adiposity, parental obesity, insulin, and leptin. Pediatrics, 110(2 Pt 1), 299–306.PubMedCrossRefGoogle Scholar
  35. 35.
    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.CrossRefGoogle Scholar
  36. 36.
    Olson, C. M., Strawderman, M. S., & Dennison, B. A. (2009). Maternal weight gain during pregnancy and child weight at age 3 years. Maternal and Child Health Journal, 13(6), 839–846.PubMedCrossRefGoogle Scholar
  37. 37.
    Oken, E., & Gillman, M. W. (2003). Fetal origins of obesity. Obesity Research, 11(4), 496–506.PubMedCrossRefGoogle Scholar
  38. 38.
    Sorensen, H. T., Sabroe, S., Rothman, K. J., Gillman, M., Fischer, P., & Sorensen, T. I. (1997). Relation between weight and length at birth and body mass index in young adulthood: Cohort study. BMJ (Clinical Research Ed.), 315(7116), 1137.Google Scholar
  39. 39.
    Ong, K. K., & Dunger, D. B. (2002). Perinatal growth failure: The road to obesity, insulin resistance and cardiovascular disease in adults. Best Practice and Research. Clinical Endocrinology and Metabolism, 16(2), 191–207.PubMedCrossRefGoogle Scholar
  40. 40.
    Haas, J. S., Lee, L. B., Kaplan, C. P., Sonneborn, D., Phillips, K. A., & Liang, S. Y. (2003). The association of race, socioeconomic status, and health insurance status with the prevalence of overweight among children and adolescents. American Journal of Public Health, 93(12), 2105–2110.PubMedCrossRefGoogle Scholar
  41. 41.
    Khlat, M., Jusot, F., & Ville, I. (2009). Social origins, early hardship and obesity: A strong association in women, but not in men? Social Science and Medicine(1982), 68(9), 1692–1699.CrossRefGoogle Scholar
  42. 42.
    Kinnunen, T. I., Luoto, R., Gissler, M., & Hemminki, E. (2003). Pregnancy weight gain from 1960s to 2000 in Finland. International Journal of Obesity and Related Metabolic Disorders: Journal of the International Association for the Study of Obesity, 27(12), 1572–1577.CrossRefGoogle Scholar
  43. 43.
    Schieve, L. A., Cogswell, M. E., & Scanlon, K. S. (1998). Trends in pregnancy weight gain within and outside ranges recommended by the Institute of Medicine in a WIC population. Maternal and Child Health Journal, 2(2), 111–116.PubMedCrossRefGoogle Scholar
  44. 44.
    Institute of Medicine, National Research Council Committee to Reexamine IOM Pregnancy Weight Guidelines. (2009). Weight gain during pregnancy: Reexamining the guidelines. Washington, D.C.: The National Academies Press.Google Scholar
  45. 45.
    Gidding, S. S., Dennison, B. A., Birch, L. L., Daniels, S. R., Gillman, M. W., Lichtenstein, A. H., et al. (2005). Dietary recommendations for children and adolescents: A guide for practitioners: Consensus statement from the American Heart Association. Circulation, 112(13), 2061–2075.PubMedCrossRefGoogle Scholar
  46. 46.
    US Preventive Services Task Force. (2010). Screening for obesity in children and adolescents: US preventive services task force recommendation statement. Pediatrics, 125, 361–367.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Brenda L. Rooney
    • 1
  • Michelle A. Mathiason
    • 2
  • Charles W. Schauberger
    • 3
  1. 1.Gundersen Lutheran Health SystemLa CrosseUSA
  2. 2.Gundersen Lutheran Medical FoundationLa CrosseUSA
  3. 3.St Luke’s HospitalCedar RapidsUSA

Personalised recommendations