Gestational diabetes. A subsequent retrospective cohort survey of 14,881 children born to mothers with gestational diabetes—and controlled for age, sex, and Tanner stage—found that the odds ratio (OR) for adolescent overweight was 1.4 (95% CI, 1.2-1.6) for each 1-kg increment in birth weight.4 The correlation persisted (OR=1.3; 95% CI, 1.1-1.5) when other covariates were controlled (television viewing, physical activity, energy intake, breastfeeding duration, birth order, household income, mother’s smoking, dietary restraint, and mother’s current BMI).
Large for gestational age. A US national cohort study of 3192 children adjusted for gestational age, found that large-for-gestational-age (LGA) infants with birth weights above the 90th percentile remained longer and heavier through 83 months of life.5 The triceps and subscapular skinfold measurements at 3 years of age for children born LGA were virtually identical to those of children born appropriate for gestational age, but by 6 years of age, skinfold measurements had diverged considerably, to more than 0.60 standard deviations. The researchers concluded that intrauterine growth is associated with obesity in early childhood.
Finally, a large Chinese population-based, case-control study (N=1322), found birth weight above 4.0 kg to be a risk factor for obesity in preschool-age children (OR=3.77; 95% CI, 2.06-6.29).6 The absolute rate of overweight increased from 8% to 26% among LGA infants.
In adolescence, parental weight may be a factor
A prospective cohort study of 1993 white LGA infants found a greater propensity to become obese in adolescence, but only if their mothers or fathers were also obese (RR=5.7).7 Children with lean parents did not have an increased risk of being over-weight in adolescence.
Recommendations
Although major organizations don’t focus on infant birth weight as a predictor of overweight, they do address childhood obesity. The American Academy of Pediatrics states that genetic, environmental, or combinations of risk factors predisposing children to obesity can and should be identified.2 The US Preventive Services Task Force concludes that the evidence is insufficient to recommend for or against routine screening for overweight in children and adolescents as a means of preventing adverse health outcomes (Grade I recommendation).1
Acknowledgements
The opinions and assertions contained herein are the private view of the author and not to be construed as official or as reflecting the view of the US Air Force Medical Service or the US Air Force at large.