Archives of Gynecology and Obstetrics

, Volume 289, Issue 2, pp 247–257 | Cite as

Risk of childhood overweight or obesity associated with excessive weight gain during pregnancy: a meta-analysis

  • Hong-Tao Tie
  • Yi-Yin Xia
  • Yong-Sheng Zeng
  • Yong Zhang
  • Chia-Liang Dai
  • Jeff Jianfei Guo
  • Yong ZhaoEmail author



Several investigations have shown that the risk of childhood overweight and obesity may be associated with excessive gestational weight gain (GWG), but the study samples were limited and results were mixed; hence we conducted this meta-analysis to assess the explicit association between them and present evidence.


We searched PubMed, EMbase, Ovid, Web of knowledge and Cochrane library for relevant studies. Bibliographies from retrieved articles were also manually searched. Cohort studies that presented results by OR or RR with 95 % CI for the association of maternal excessive GWG and child overweight/obesity were included. The pooled estimates were calculated by fixed-effect model or random-effect model according to the heterogeneity.


Twelve cohort studies were identified, and the combined OR of excessive GWG and childhood overweight/obesity was 1.33 (95 % CI 1.18–1.50) with evidence of heterogeneity (P = 0.000, I 2 = 71.1 %). Adjustment of maternal BMI, investigation area, age of children, research type, and omission of any single study had little effect on the pooled estimate. After eliminating the effect of publication bias by trim and fill analyses, the result still remained statistically significant (OR 1.21, 95 % CI 1.05–1.40).


This meta-analysis suggests that the risk of childhood overweight/obesity is significantly associated with excessive gestational weight gain.


Excessive gestational weight gain Childhood overweight/obesity Cohort study Meta-analysis 



This study was supported by the National Natural Science Foundation of China (Grant No. 30901189) and China Effective Health Care Network.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Gupta N, Goel K, Shah P, Misra A (2012) Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev 33:48–70PubMedCrossRefGoogle Scholar
  2. 2.
    Ogden CL, Carroll MD, Kit BK, Flegal KM (2012) Prevalence of obesity in the United States, 2009–2010. NCHS Data Brief 82:1–8PubMedGoogle Scholar
  3. 3.
    Kessler J, Koebnick C, Smith N,Adams A (2012) Childhood obesity is associated with increased risk of most lower extremity fractures. Clin Orthop Relat ResGoogle Scholar
  4. 4.
    Matijasevich A, Brion MJ, Menezes AM, Barros AJ, Santos IS et al (2011) Maternal smoking during pregnancy and offspring growth in childhood: 1993 and 2004 Pelotas cohort studies. Arch Dis Child 96:519–525PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Meng LP, Liu AL, Hu X, Zhang Q, Du SM et al (2012) Report on childhood obesity in China (10): association of sleep duration with obesity. Biomed Environ Sci 25:133–140PubMedGoogle Scholar
  6. 6.
    Rodrigues S, Ferris AM, Perez-Escamilla R, Backstrand JR (1998) Obesity among offspring of women with type 1 diabetes. Clin Invest Med 21:258–266PubMedGoogle Scholar
  7. 7.
    Fraser A, Tilling K, Macdonald-Wallis C, Sattar N, Brion MJ et al (2010) Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation 121:2557–2564PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Fuiano N, Rapa A, Monzani A, Pietrobelli A, Diddi G et al (2008) Prevalence and risk factors for overweight and obesity in a population of Italian schoolchildren: a longitudinal study. J Endocrinol Invest 31:979–984PubMedGoogle Scholar
  9. 9.
    Gillman MW, Rifas-Shiman SL, Kleinman K, Oken E, Rich-Edwards JW et al (2008) Developmental origins of childhood overweight: potential public health impact. Obesity (Silver Spring) 16:1651–1656CrossRefGoogle Scholar
  10. 10.
    Jedrychowski W, Maugeri U, Kaim I, Budzyn-Mrozek D, Flak E et al (2011) Impact of excessive gestational weight gain in non-smoking mothers on body fatness in infancy and early childhood. Prospective prebirth cohort study in Cracow. J Physiol Pharmacol 62:55–64PubMedGoogle Scholar
  11. 11.
    Li C, Goran MI, Kaur H, Nollen N, Ahluwalia JS (2007) Developmental trajectories of overweight during childhood: role of early life factors. Obesity (Silver Spring) 15:760–771CrossRefGoogle Scholar
  12. 12.
    Margerison Zilko CE, Rehkopf D, Abrams B (2010) Association of maternal gestational weight gain with short- and long-term maternal and child health outcomes. Am J Obstet Gynecol 202(574):e571–e578Google Scholar
  13. 13.
    Oken E, Rifas-Shiman SL, Field AE, Frazier AL, Gillman MW (2008) Maternal gestational weight gain and offspring weight in adolescence. Obstet Gynecol 112:999–1006PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW (2007) Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol 196(322):e321–e328Google Scholar
  15. 15.
    Rooney BL, Mathiason MA, Schauberger CW (2011) Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort. Matern Child Health J 15:1166–1175PubMedCrossRefGoogle Scholar
  16. 16.
    Stuebe AM, Forman MR, Michels KB (2009) Maternal-recalled gestational weight gain, pre-pregnancy body mass index, and obesity in the daughter. Int J Obes (Lond) 33:743–752CrossRefGoogle Scholar
  17. 17.
    Whitaker RC (2004) Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics 114:e29–e36PubMedCrossRefGoogle Scholar
  18. 18.
    Wrotniak BH, 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. Am J Clin Nutr 87:1818–1824PubMedGoogle Scholar
  19. 19.
    Nehring I, Lehmann S, von Kries R (2012) Gestational weight gain in accordance to the IOM/NRC criteria and the risk for childhood overweight: a meta-analysis. Pediatr ObesGoogle Scholar
  20. 20.
    The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 3rd symposium on systematic reviews: beyond the basics, 2000Google Scholar
  21. 21.
    Barlow SE (2007) Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 120(Suppl 4):S164–S192PubMedCrossRefGoogle Scholar
  22. 22.
    Weight Gain During Pregnancy (2009) Reexamining the guidelines. National Academy of Sciences, Washington DCGoogle Scholar
  23. 23.
    Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA (2011) Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 342:d671PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Zhang J, Yu KF (1998) What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 280:1690–1691PubMedCrossRefGoogle Scholar
  25. 25.
    Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558PubMedCrossRefGoogle Scholar
  26. 26.
    DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188PubMedCrossRefGoogle Scholar
  27. 27.
    Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101PubMedCrossRefGoogle Scholar
  28. 28.
    Egger M, Smith GD, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634PubMedCrossRefGoogle Scholar
  29. 29.
    Moreira P, Padez C, Mourao-Carvalhal I, Rosado V (2007) Maternal weight gain during pregnancy and overweight in Portuguese children. Int J Obes (Lond) 31:608–614CrossRefGoogle Scholar
  30. 30.
    von Kries R, Ensenauer R, Beyerlein A, Amann-Gassner U, Hauner H et al (2010) Gestational weight gain and overweight in children: results from the cross-sectional German KiGGS study. Int J Pediatr ObesGoogle Scholar
  31. 31.
    Beyerlein A, Nehring I, Rzehak P, Heinrich J, Muller MJ et al (2012) Gestational weight gain and body mass index in children: results from three german cohort studies. PLoS One 7:e33205PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Plachta-Danielzik S, Kehden B, Landsberg B, Schaffrath Rosario A, Kurth BM et al (2012) Attributable risks for childhood overweight: evidence for limited effectiveness of prevention. Pediatrics 130:e865–e871PubMedCrossRefGoogle Scholar
  33. 33.
    Taylor S, Tweedie R (1998) Practical estimates of the effect of publication bias in meta-analysis. Australas Epidemiol 5:14–17Google Scholar
  34. 34.
    Whitaker RC, Dietz WH (1998) Role of the prenatal environment in the development of obesity. J Pediatr 132:768–776PubMedCrossRefGoogle Scholar
  35. 35.
    Stamnes Koepp UM, Frost Andersen L, Dahl-Joergensen K, Stigum H, Nass O et al (2012) Maternal pre-pregnant body mass index, maternal weight change and offspring birth-weight. Acta Obstet Gynecol Scand 91:243–249PubMedCrossRefGoogle Scholar
  36. 36.
    Oken E, Gillman MW (2003) Fetal origins of obesity. Obes Res 11:496–506PubMedCrossRefGoogle Scholar
  37. 37.
    Ludwig DS, Currie J (2010) The association between pregnancy weight gain and birth-weight: a within-family comparison. Lancet 376:984–990PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Okosun IS, Liao Y, Rotimi CN, Dever GE, Cooper RS (2000) Impact of birth weight on ethnic variations in subcutaneous and central adiposity in American children aged 5–11 years. A study from the Third National Health and Nutrition Examination Survey. Int J Obes Relat Metab Disord 24:479–484PubMedCrossRefGoogle Scholar
  39. 39.
    Adair LS, Cole TJ (2003) Rapid child growth raises blood pressure in adolescent boys who were thin at birth. Hypertension 41:451–456PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Hong-Tao Tie
    • 1
  • Yi-Yin Xia
    • 2
  • Yong-Sheng Zeng
    • 3
  • Yong Zhang
    • 2
  • Chia-Liang Dai
    • 4
  • Jeff Jianfei Guo
    • 5
  • Yong Zhao
    • 2
    Email author
  1. 1.The First College of Clinical MedicineChongqing Medical UniversityChongqingChina
  2. 2.School of Public Health and ManagementChongqing Medical UniversityChongqingChina
  3. 3.The Second College of Clinical MedicineChongqing Medical UniversityChongqingChina
  4. 4.Health Promotion and Education CincinnatiUniversity of CincinnatiCincinnatiUSA
  5. 5.Division of Pharmacy Practice and Administrative Sciences, College of PharmacyUniversity of CincinnatiCincinnatiUSA

Personalised recommendations