Association between trimester-specific gestational weight gain and childhood obesity at 5 years of age: results from Shanghai obesity cohort.

Background: It is still unclear if and at which trimester gestational weight gain is related to childhood adiposity. Thus we aimed to evaluate the association between trimester-specific gestational weight gain and body-fat compositions in Chinese children.

Methods: Maternal gestational weight were measured by trained nurses every 2 to 4 weeks from the first prenatal care, and body-fat compositions of 407 children from the Shanghai Obesity Cohort at 5 years of age were measured by nutritionist through bioelectrical impedance analysis. Overweight/obesity of children was defined according to the criteria of International Obesity Task Force. Logistic and linear regression models adjusted for potential confounders were conducted to evaluate the associations of gestational weight gains with childhood obesity and body-fat compositions. Two-sided P-value < 0.05 was considered statistically significant.

Results: Greater gestational weight gain in the 1-trimester was significantly associated with a higher risk of childhood overweight/obesity [OR: 1.40 (95% CI: 1.06, 1.86)], fat mass index [β: 0.25 (95% CI: 0.12, 0.38)], body fat percentage [β: 1.04 (95% CI: 0.43, 1.65)], and waist-to-height ratio [β: 0.005 (95% CI: 0.002, 0.008)]. A positive but nonsignificant association was found between greater 3-trimester gestational weight gain and a higher risk of offspring overweight/obesity, and we speculated that the association between 2-trimester gestational weight gain and offspring overweight/obesity is the "U" type.

Conclusions: Weight gain in the first trimester gestation is positively correlated with the risk of childhood overweight/obesity and with body adiposity distributions of children at 5 years of age. Weight gain should be well controlled and monitored from early pregnancy.