Associations between gestational weight gain and weight development of the offspring: Differences depending on maternal pre-pregnancy BMI

Abstract Purpose Obesity rates are rising, and the gestational weight gain (GWG) of most women does not comply with current guidelines. This study assesses the association of pre-pregnancy BMI (ppBMI) and GWG with the child’s weight development and investigates whether associations with GWG differ depending on ppBMI. Methods Data were obtained from the cohort study LIFE Child (Germany), comprising 691 mother–child pairs. Children’s weight was followed until age five. Associations between maternal ppBMI, GWG, and children’s weight were evaluated using regression analyses. Results The association between GWG and birth weight (BW) was significantly positive in normal and underweight (n/u) women (β GWG = 0.05, p < 0.01, 95% confidence interval (CI) 0.03—0.07), but not in women with overweight or obesity (o/o) (β GWG = 0.0002, p = 0.99, 95% CI −0.03 to 0.03). The risk of giving birth to an infant who was large for gestational age (LGA) increased with rising GWG in n/u women (OR = 1.6, p < 0.01, 95% CI 1.23—2.25). Women with o/o were at increased risk for a LGA baby regardless of GWG (OR = 3, p < 0.01, 95% CI 1.34—6.97). This trend persisted in the child’s weight development during the first 5 years of life. Conclusion Women with o/o might increase their offspring’s risk for higher weight at birth and in early childhood. In n/u women, GWG might be the more influential factor. Women should strive for normal weight before conception and should be more attentive to GWG.