Maternal pre-pregnancy weight status and gestational weight gain in association with child behavior: The mediating role of prenatal systemic inflammation

Elnaz Vaghef-Mehrabani; Rhonda C. Bell; Catherine J. Field; Megan Jarman; Jenna L. Evanchuk; Nicole Letourneau; Deborah Dewey; Gerald F. Giesbrecht

doi:10.1016/j.clnesp.2023.12.006

Maternal pre-pregnancy weight status and gestational weight gain in association with child behavior: The mediating role of prenatal systemic inflammation

Elnaz Vaghef-Mehrabani
, Rhonda C. Bell
, Catherine J. Field
, Megan Jarman
, Jenna L. Evanchuk
, Nicole Letourneau
, Deborah Dewey
, Gerald F. Giesbrecht

Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Psychology, University of Calgary, Calgary, AB, Canada. Electronic address: [email protected].

Research output: Contribution to journal › Article › peer-review

Abstract

Background and aims: Maternal pre-pregnancy obesity and excessive gestational weight gain (EGWG) may predispose children to behavioral problems through increased prenatal inflammation. We investigated the association between maternal body mass index (BMI) and gestational weight gain (GWG), and child behavioral problems (primary aim), and the mediating role of prenatal inflammation (secondary aim). Methods: We used self-reported pre-pregnancy BMI and estimated-GWG data (N = 1137) from a longitudinal cohort study. Maternal serum C-reactive protein (CRP) was measured in the 3rd-trimester. Parent-reported Child Behavior Checklist (CBCL) was used to assess child internalizing and externalizing behaviors at 3-years-of-age. We used analysis of covariance (ANCOVA), multiple linear regression, and mediation analyses for data analysis. Results: Maternal obesity (F = 21.98, df 3836), EGWG (F = 6.53, df 2764), and their combination (F = 18.51, df 3764) were associated with the 3rd trimester CRP, but not child behavior in the whole sample. Maternal underweight was associated with withdrawal problems in all children (β = 0.56, 95%CI, 0.11,1.00) and aggressive behaviors in female children (β = 2.59, 95%CI, 0.28,4.91). Obesity had a significant association with externalizing behaviors in female children after controlling for maternal CRP (β = 3.72, 95%CI, 0.12,7.32). Both inadequate and EGWG were associated with somatic complaints in male children (β = 0.50, 95%CI, 0.05,0.95; β = 0.36, 95%CI, 0.01,0.71, respectively). Combined obesity/EGWG was associated with externalizing (β = 6.12, 95%CI, 0.53,11.70) and aggressive (β = 4.23, 95%CI, 0.90,7.56) behaviors in female children. We found no significant effects through CRP. Conclusions: Maternal pre-pregnancy BMI and GWG showed sex-specific associations with child behavioral problems. Prenatal CRP, although increased in obesity and EGWG, did not mediate these associations.

Original language	English
Pages (from-to)	249-256
Number of pages	8
Journal	Clinical nutrition ESPEN
Volume	59
Early online date	15 Dec 2023
DOIs	https://doi.org/10.1016/j.clnesp.2023.12.006
Publication status	Published - Feb 2024

Bibliographical note

Funding

The APrON study received funding from Alberta Innovates Health Solutions , the Canadian Institutes of Health Research (CIHR) , and the Alberta Children's Hospital Research Foundation , Canada. The CRP analyses were funded by funding from CIHR . The funding sources had no role in study design, in the collection, analysis and interpretation of data, in the writing of the report, or in the decision to submit the article for publication. Elnaz Vaghef-Mehrabani is supported by an ACHRI postdoctoral fellowship and a CIHR postdoctoral fellowship (No. 187823 ).

Funders	Funder number
Alberta Children's Hospital Research Institute	187823
Alberta Children's Hospital Research Institute
Canadian Institutes of Health Research
Alberta Innovates - Health Solutions
Alberta Children's Hospital Foundation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Inflammation
Gestational Weight Gain
Behavioral problems
Pre-school children
Female
Male
Pregnancy
Alberta Pregnancy Outcomes and Nutrition (APrON) study
Gestational weight gain
Humans
Longitudinal Studies
Obesity
Child Behavior
Weight Gain
Child
Maternal obesity

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10.1016/j.clnesp.2023.12.006

Cite this

Vaghef-Mehrabani, E., Bell, R. C., Field, C. J., Jarman, M., Evanchuk, J. L., Letourneau, N., Dewey, D., & Giesbrecht, G. F. (2024). Maternal pre-pregnancy weight status and gestational weight gain in association with child behavior: The mediating role of prenatal systemic inflammation. Clinical nutrition ESPEN, 59, 249-256. https://doi.org/10.1016/j.clnesp.2023.12.006

@article{3b21ede1e0554ff59a662a2e9ff0886c,

title = "Maternal pre-pregnancy weight status and gestational weight gain in association with child behavior: The mediating role of prenatal systemic inflammation",

abstract = "Background and aims: Maternal pre-pregnancy obesity and excessive gestational weight gain (EGWG) may predispose children to behavioral problems through increased prenatal inflammation. We investigated the association between maternal body mass index (BMI) and gestational weight gain (GWG), and child behavioral problems (primary aim), and the mediating role of prenatal inflammation (secondary aim). Methods: We used self-reported pre-pregnancy BMI and estimated-GWG data (N = 1137) from a longitudinal cohort study. Maternal serum C-reactive protein (CRP) was measured in the 3rd-trimester. Parent-reported Child Behavior Checklist (CBCL) was used to assess child internalizing and externalizing behaviors at 3-years-of-age. We used analysis of covariance (ANCOVA), multiple linear regression, and mediation analyses for data analysis. Results: Maternal obesity (F = 21.98, df 3836), EGWG (F = 6.53, df 2764), and their combination (F = 18.51, df 3764) were associated with the 3rd trimester CRP, but not child behavior in the whole sample. Maternal underweight was associated with withdrawal problems in all children (β = 0.56, 95\%CI, 0.11,1.00) and aggressive behaviors in female children (β = 2.59, 95\%CI, 0.28,4.91). Obesity had a significant association with externalizing behaviors in female children after controlling for maternal CRP (β = 3.72, 95\%CI, 0.12,7.32). Both inadequate and EGWG were associated with somatic complaints in male children (β = 0.50, 95\%CI, 0.05,0.95; β = 0.36, 95\%CI, 0.01,0.71, respectively). Combined obesity/EGWG was associated with externalizing (β = 6.12, 95\%CI, 0.53,11.70) and aggressive (β = 4.23, 95\%CI, 0.90,7.56) behaviors in female children. We found no significant effects through CRP. Conclusions: Maternal pre-pregnancy BMI and GWG showed sex-specific associations with child behavioral problems. Prenatal CRP, although increased in obesity and EGWG, did not mediate these associations.",

keywords = "Inflammation, Gestational Weight Gain, Behavioral problems, Pre-school children, Female, Male, Pregnancy, Alberta Pregnancy Outcomes and Nutrition (APrON) study, Gestational weight gain, Humans, Longitudinal Studies, Obesity, Child Behavior, Weight Gain, Child, Maternal obesity",

author = "Elnaz Vaghef-Mehrabani and Bell, \{Rhonda C.\} and Field, \{Catherine J.\} and Megan Jarman and Evanchuk, \{Jenna L.\} and Nicole Letourneau and Deborah Dewey and Giesbrecht, \{Gerald F.\}",

year = "2024",

month = feb,

doi = "10.1016/j.clnesp.2023.12.006",

language = "English",

volume = "59",

pages = "249--256",

journal = "Clinical nutrition ESPEN",

issn = "2405-4577",

publisher = "Elsevier",

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TY - JOUR

T1 - Maternal pre-pregnancy weight status and gestational weight gain in association with child behavior: The mediating role of prenatal systemic inflammation

AU - Vaghef-Mehrabani, Elnaz

AU - Bell, Rhonda C.

AU - Field, Catherine J.

AU - Jarman, Megan

AU - Evanchuk, Jenna L.

AU - Letourneau, Nicole

AU - Dewey, Deborah

AU - Giesbrecht, Gerald F.

PY - 2024/2

Y1 - 2024/2

N2 - Background and aims: Maternal pre-pregnancy obesity and excessive gestational weight gain (EGWG) may predispose children to behavioral problems through increased prenatal inflammation. We investigated the association between maternal body mass index (BMI) and gestational weight gain (GWG), and child behavioral problems (primary aim), and the mediating role of prenatal inflammation (secondary aim). Methods: We used self-reported pre-pregnancy BMI and estimated-GWG data (N = 1137) from a longitudinal cohort study. Maternal serum C-reactive protein (CRP) was measured in the 3rd-trimester. Parent-reported Child Behavior Checklist (CBCL) was used to assess child internalizing and externalizing behaviors at 3-years-of-age. We used analysis of covariance (ANCOVA), multiple linear regression, and mediation analyses for data analysis. Results: Maternal obesity (F = 21.98, df 3836), EGWG (F = 6.53, df 2764), and their combination (F = 18.51, df 3764) were associated with the 3rd trimester CRP, but not child behavior in the whole sample. Maternal underweight was associated with withdrawal problems in all children (β = 0.56, 95%CI, 0.11,1.00) and aggressive behaviors in female children (β = 2.59, 95%CI, 0.28,4.91). Obesity had a significant association with externalizing behaviors in female children after controlling for maternal CRP (β = 3.72, 95%CI, 0.12,7.32). Both inadequate and EGWG were associated with somatic complaints in male children (β = 0.50, 95%CI, 0.05,0.95; β = 0.36, 95%CI, 0.01,0.71, respectively). Combined obesity/EGWG was associated with externalizing (β = 6.12, 95%CI, 0.53,11.70) and aggressive (β = 4.23, 95%CI, 0.90,7.56) behaviors in female children. We found no significant effects through CRP. Conclusions: Maternal pre-pregnancy BMI and GWG showed sex-specific associations with child behavioral problems. Prenatal CRP, although increased in obesity and EGWG, did not mediate these associations.

AB - Background and aims: Maternal pre-pregnancy obesity and excessive gestational weight gain (EGWG) may predispose children to behavioral problems through increased prenatal inflammation. We investigated the association between maternal body mass index (BMI) and gestational weight gain (GWG), and child behavioral problems (primary aim), and the mediating role of prenatal inflammation (secondary aim). Methods: We used self-reported pre-pregnancy BMI and estimated-GWG data (N = 1137) from a longitudinal cohort study. Maternal serum C-reactive protein (CRP) was measured in the 3rd-trimester. Parent-reported Child Behavior Checklist (CBCL) was used to assess child internalizing and externalizing behaviors at 3-years-of-age. We used analysis of covariance (ANCOVA), multiple linear regression, and mediation analyses for data analysis. Results: Maternal obesity (F = 21.98, df 3836), EGWG (F = 6.53, df 2764), and their combination (F = 18.51, df 3764) were associated with the 3rd trimester CRP, but not child behavior in the whole sample. Maternal underweight was associated with withdrawal problems in all children (β = 0.56, 95%CI, 0.11,1.00) and aggressive behaviors in female children (β = 2.59, 95%CI, 0.28,4.91). Obesity had a significant association with externalizing behaviors in female children after controlling for maternal CRP (β = 3.72, 95%CI, 0.12,7.32). Both inadequate and EGWG were associated with somatic complaints in male children (β = 0.50, 95%CI, 0.05,0.95; β = 0.36, 95%CI, 0.01,0.71, respectively). Combined obesity/EGWG was associated with externalizing (β = 6.12, 95%CI, 0.53,11.70) and aggressive (β = 4.23, 95%CI, 0.90,7.56) behaviors in female children. We found no significant effects through CRP. Conclusions: Maternal pre-pregnancy BMI and GWG showed sex-specific associations with child behavioral problems. Prenatal CRP, although increased in obesity and EGWG, did not mediate these associations.

KW - Inflammation

KW - Gestational Weight Gain

KW - Behavioral problems

KW - Pre-school children

KW - Female

KW - Male

KW - Pregnancy

KW - Alberta Pregnancy Outcomes and Nutrition (APrON) study

KW - Gestational weight gain

KW - Humans

KW - Longitudinal Studies

KW - Obesity

KW - Child Behavior

KW - Weight Gain

KW - Child

KW - Maternal obesity

UR - https://www.sciencedirect.com/science/article/pii/S2405457723022313

UR - https://www.scopus.com/pages/publications/85180583532

U2 - 10.1016/j.clnesp.2023.12.006

DO - 10.1016/j.clnesp.2023.12.006

M3 - Article

C2 - 38220383

SN - 2405-4577

VL - 59

SP - 249

EP - 256

JO - Clinical nutrition ESPEN

JF - Clinical nutrition ESPEN

ER -

Maternal pre-pregnancy weight status and gestational weight gain in association with child behavior: The mediating role of prenatal systemic inflammation

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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