Maternal Weight Gain in Pregnancy and Risk of Obesity among Offspring: A Systematic Review

Table 1

Cohort studies on maternal weight gain during pregnancy and offspring’s body weight outcomes.

Authors, year, country, and study design	Sample size and; time period	Child age at; follow-up	Definition of gestational weight gain (GWG)	GWG variable	Child body weight; measure	Confounders adjusted
Li et al. 2007, USA; (mixed) [38]	1,739; (1986–2000)	2–12 years	Self-reported weight before delivery minus self-reported prepregnancy weight	Total GWG (kg); (i) <6.8; (ii) 6.81–11.34; (iii) 11.35–15.88 (ref); (iv) 15.89–20.42; (v) ≥20.43	BMI -score based on measured height and weight; Early-onset OW: BMI ≥95th PCTL persisted from 2 to 8 years; Late-onset OW: BMI ≥95th PCTL starting at 8 years (CDC)	Maternal age, alcohol consumption during pregnancy, education, family net income0 and prepregnancy BMI, and smoking during pregnancy; child’s birth order, birth weight, birth year, breastfeeding, gestational age, race, and sex
Oken et al. 2007, USA; (pros) [25]	1,044; (1999–2002)	3 years	Medical record retrieved last prenatal weight minus self-reported prepregnancy weight	Total GWG (kg); Net GWG (total GWG minus infant birth weight); IOM 1990; (i) Excessive; (ii) Adequate; (iii) Inadequate (ref)	BMI -score based on measured height and weight; OW: BMI ≥95th PCTL (CDC)	Mother’s glucose tolerance, marital status, prepregnancy BMI, SES, smoking, and race; paternal BMI; and child breastfeeding duration, cesarean section, daily television viewing time, fast food and sugar beverage intake, gestational fetal growth, gestational length, and sex
Gillman et al. 2008, USA; (pros) [35]	1,110; (1999–2002)	3 years	Medical record retrieved last prenatal weight minus prepregnancy weight	IOM 1990; (i) Excessive; (ii) Nonexcessive (Ref)	BMI -score based on self-reported height and weight; OW: BMI ≥95th PCTL; (CDC)	Maternal education, prepregnancy BMI, smoking during pregnancy, and SES; child breastfeeding duration, daily sleep during infancy, and race
Oken et al. 2008, USA; (pros) [41]	11,994; (1996–1999)	9–14 years	Self-reported total GWG	Total GWG (lbs); IOM 1990; (i) Excessive; (ii) Adequate (Ref); (iii) Inadequate	BMI -score based on self-reported height and weight; OW: BMI 85th to ≤95th PCTL; OB: BMI >95th PCTL; (CDC)	Maternal age, education, SES, gestational diabetes, marital status, prepregnancy BMI, smoking, and paternal education; and child age in 1996, birth weight, breastfeeding, daily sugar sweetened beverage intake, fried food away from home, gestational age, maturity, hours of TV and video, physical activity, and race
Wrotniak et al. 2008, USA; (pros) [47]	10,226; (1959–1965)	7 years	Weight measured at delivery minus self-reported prepregnancy weight	Total GWG (kg); IOM 1990; (i) Excessive; (ii) Adequate (Ref); (iii) Inadequate	BMI -score based on measured height and weight; OW: BMI ≥95th PCTL; (CDC)	Maternal age, prepregnancy BMI, parity, race, and smoking; child age at 7-year assessment, birth weight, gestational age, and sex
Oken et al. 2009, USA; (pros) [40]	2,012; (1999–2002)	3 years	Medical record retrieved last prenatal weight minus self-reported prepregnancy weight	Rate of GWG (kg/week)	BM -score based on measured height and weight; OB: BMI >95th PCTL; (CDC)	Prepregnancy BMI
Olson et al. 2009, 2010, USA; (pros) [42, 50]	321; (1997-1998)	4 years	Measured weight at last prenatal visit minus first measured weight in the first trimester	Net GWG (kg)	BMI -score based on self-reported height and weight; OW: BMI 85th to <95th PCTL; OB: BMI ≥95th PCTL; (CDC)	Maternal overweight at early pregnancy, SES, smoking during pregnancy, and SES; child birth weight, breastfeeding for at least 6 months, and gestational age
Stuebe et al. 2009, USA; (mixed) [46]	26,506; (1989–2001)	7 years	Self-reported total GWG	Total GWG (lbs); (i) <10; (ii) 10–14; (iii) 15–19 (Ref); (iv) 20–29; (v) 30–40; (vi) >40	BMI based on measured height and weight; OW: BMI ≥25 to <30 kg/m^2; OB: BMI >30 kg/m^2; (CDC)	Maternal age at child birth, prepregnancy BMI, maternal age at child’s birth, nausea and smoking during pregnancy, family history of diabetes, parental BMI and education level, and mother living with father at time of child’s birth; child birth weight and birth order
Fraser et al. 2010, UK; (pros) [23]	5,154; (1991-1992)	9 years	Measured weight at last prenatal visit minus measured weight at first prenatal visit	Rates of GWG (g/week); IOM 2009; (i) Excessive; (ii) Adequate (Ref); (iii) Inadequate	BMI based on measured height and weight (IOTF)	Maternal age, delivery mode, parity, prepregnancy BMI, parity, smoking during pregnancy, SES, and GWG in the previous pregnancy; child birth weight and gestational age
Magerison Zilko et al. 2010, USA (retro) [31]	4496 (1972–2000)	2–20 years	Self-reported weight at delivery minus self-reported prepregnancy weight	Total GWG (kg); IOM (2009); (i) Excessive; (ii) Adequate (Ref); (iii) Inadequate	BMI -score based on parent-reported or measured height and weight; OW: BMI ≥85th PCTL; (CDC)	Maternal age, education, poverty status, length of gestation, prepregnancy BMI, and race, smoking during pregnancy; child sex and year of birth; and weighted for sampling proportion
Schack-Nielsen et al. 2010, Denmark; (pros) [44]	4,234 (1959–1961)	1–14 years	Self-reported total GWG	Total GWG (kg); (i) <6; (ii) 6–8; (iii) 9–10; (iv) 11-12; (v) 13–15; (vi) ≥16 kg; The values of 5.5, 7.0, 9.5, 11.5, 14.0, and 16.5 were assigned mid-points to get continuous GWG	BMI -score based on measured height and weight (British 1990 growth chart)	Maternal age, edema during prepregnancy, marital status, SES, and smoking during pregnancy; parental education, prepregnancy BMI, and prematurity; and child birth weight, gestational age, and sex
Andersen et al. 2011, Denmark; (pros) [32]	9,869; (1996–2002)	7 years	Self-reported total GWG	Total GWG; rates of GWG [kg in early (12–20 weeks) and mid-pregnancy (25–32 weeks)]	BMI -score based on parent-reported height and weight (IOTF)	Maternal age, parity, smoking during pregnancy, prepregnancy BMI, SES, and paternal BMI; child age, birth weight, breastfeeding, gestational age, weight at 5 and 12 months, and sex
Branum et al. 2011, USA; (pros) [33]	5,917; (1959–1965)	4 years	Measured weight at last prenatal visit within 3 wk of delivery minus self-reported prepregnancy weight	Total GWG; IOM 1990; (i) Excessive; (ii) Adequate (Ref); (iii) Inadequate	BMI -score based on measured height and weight (CDC)	Maternal age, parity, prepregnancy BMI, race, SES, and smoking; child birth weight, gestational age, and sex
Lawlor et al. 2011, Sweden; (mixed) [37]	14,6894 (1973–2005)	18 years	Measured weight within 12 h after delivery minus the first antenatal clinic assessment (~10 wk gestation)	Net GWG (kg)	BMI based on measured height and weight; (CDC)	Maternal age, education, gestational diabetes, parity, and early-pregnancy BMI; child birth weight, gestational age, and year of birth
Ronney et al. 2011, USA; (retro) [43]	450; (1988)	4-5 years	Measured weight prior to delivery minus self-reported prepregnancy weight	IOM 1990; (i) Excessive; (ii) Adequate (Ref); (iii) Inadequate	BMI -score based on measured height and weight; OB: ≥85th PCTL	Maternal marital status, GWG in first 4 months and smoking, during pregnancy; child insurance status at birth and sex
Ensenauer et al. 2013, Germany; (mixed) [34]	6,837; (2009–2011)	5 years	Measured weight at an average of 38-wk of gestation minus measured prepregnancy weight	Total GWG; IOM 2009; (i) Excessive; (ii) Adequate (Ref); (iii) Inadequate	BMI -score based on measured height and weight; OW: BMI ≥90th PCTL.; OB: BMI ≥97th PCTL (IOTF)	Maternal age and smoking during pregnancy; child age, birth weight, breastfeeding, TV viewing, physical activity, and SES
Hinkle et al. 2012, USA; (mixed) [36]	3,600; (2001–2006)	5 years	Total GWG from birth certificates (81%) plus maternal report (19%) at; 9-month postpartum	Total GWG (kg)	BMI -score based on measured height and weight; OW: BMI 85th to <95th PCTL.; OB: BMI ≥95th PCTL; (CDC)	Maternal age, race, parity, marital status, education, participation in special supplement nutrition program for women and child, smoking at the last 3 months of pregnancy, and postpartum exercise habits; child’s exercise habit; and child birth weight, breastfeeding, gestational age, sugar-sweetened beverage intake, fast food intake, and TV viewing
Laitinen et al. 2012, Finland; (pros) [24]	6,637; (1985–2002)	16 years	Measured weight at 20-wk gestation minus self-reported prepregnancy weight	GWG at 20-week gestation (kg) (quartiles were used)	BMI -score based on measured height and weight (IOTF)	Maternal education, glucose metabolism, hemoglobin at 8–10 weeks of gestation, parity, prepregnancy BMI, and smoking; child’s sex
Linberg et al. 2012, USA; (mixed) [49]	471 (2004)	5–8 years	Medical record retrieved weight at delivery minus recorded prepregnancy weight	IOM 2009; (i) Excessive; (ii) Not excessive (Ref)	BMI -score based on measured height and weight; OW: BMI ≥85th PCTL; (CDC)	Maternal education, gestational diabetes, prepregnancy BMI, and smoking before and during pregnancy; child’s birth weight and breastfeeding duration
Magerison-Zilko et al. 2012, USA; (pros) [39]	3,015; (1959–1967)	5 years	Medical record retrieved last prenatal weight minus self-reported prepregnancy weight	Total GWG; trimester-specific rates of GWG	BMI -score based on measured height and weight; OW: BMI ≥85th PCTL; (CDC)	Maternal age, education, marital status, parity, prepregnancy BMI, smoking during pregnancy, and race; paternal overweight; and child gestational age, and sex
Stamnes Køpp et al. 2012,; Norway; (pros) [45]	5,898; (1999–2009)	3 years	Self-reported weight at 30-week pregnancy minus self-reported prepregnancy weight	GWG at 30-week gestation (kg)	BMI based on parent-reported height and weight	Maternal age, education, exercise habit, parity, prepregnancy BMI, smoking during pregnancy, and paternal BMI; child birth weight, breastfeeding at 6 month, types of day care, hours in screen-based activities, and sex
Ehrenthal et al. 2013, USA (retro) [48]	3,320; (2004–2007)	4 years	Self-reported weight at delivery minus self-reported prepregnancy weight	Net GWG (adjusted for gestational age) (kg); IOM 2009; (i) Excessive; (ii) Adequate (Ref); (iii) Inadequate	BMI -score based on medical record retrieved height and weight (CDC)	Maternal age, gestational diabetes and hypertension, insurance status, marital status, parity, preeclampsia, prepregnancy BMI, diabetes, hypertension, race, and smoking during pregnancy; child age and child born to same mother

BMI = body mass index; CDC = Center for Disease Control and Prevention; GWG = gestational weight gain; IOM = Institute of Medicine; IOTF = International Obesity Task Force; mixed = mixed cohort; NW = normal weight; OB = obese; OW = overweight; PCTL = percentile; pros = prospective cohort; Ref = referent group; retro = retrospective cohort; SES = socioeconomic status; UW = underweight; and WHO = World Health Organization.