Nutrition/Obesity
Associations of in utero overnutrition and early life emotional health with child body size and composition: The Healthy Start Study Madeline Farron* Madeline Farron Greta Wilkening Wei Perng Dana M. Dabelea
Background: Childhood obesity is a public health challenge affected by multiple factors. We explored in utero overnutrition, child anxiety and depression, and possible joint effects of these exposures on child body size and composition at ages 4-8 years using data from Healthy Start, a pre-birth cohort in Colorado. We aimed to assess independent and synergistic effects of these in utero and early childhood exposures on adiposity outcomes.
Methods: In utero overnutrition was defined as maternal gestational diabetes and/or pre-pregnancy body mass index (BMI)≥25 kg/m2. Child anxiety and depression were each assessed by parent-reported Child Behavior Checklist DSM-oriented T-scores (<60/≥60) at age 4-8 years. Outcomes included child BMI z-scores, fat mass (kg), % fat mass, and fat free mass (kg) measured by whole body air displacement plethysmography. We used multivariable linear regression in base models adjusted for child age and sex, and fully adjusted models additionally adjusted for maternal age, education, parity, and household income among N=524 mother-child pairs. Interaction terms between overnutrition and anxiety, and overnutrition and depression were used to assess joint effects in base models.
Results: In base models, in utero overnutrition exposure was associated with higher child BMI z-score (β=0.57, 95% CI=0.38,0.77), fat mass (β=0.77, 95% CI=0.46,1.08), % fat mass (β=2.47, 95% CI=1.34,3.60), and fat free mass (β=0.53, 95% CI=0.16,0.90). Fully adjusted models yielded similar results. Child anxiety and depression were not associated with any outcome, and there were no significant interactions with overnutrition on any of the outcomes.
Discussion: In utero overnutrition exposure, but not child emotional health, was associated with larger body size and adiposity in early childhood specifically. Future studies that explore the role of multi-level environmental factors in increasing or protecting against adiposity throughout the life course are warranted.