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September 12, 2026European Journal of PediatricsOpen Access

The mediating effects of home environment on the relationship between maternal BMI and childhood obesity: Findings from the ECHO-wide cohort

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Authors

DHDivya Nair HaridasATAngham Ibrahim TartourOSOnno C. P. van Schayck

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Overview

Retrospective cohort study reveals maternal pre-pregnancy obesity directly associates with higher child BMI z-scores unmediated by home environment, indicating a need for diet-focused interventions.

Key Points

  • Determine whether nurturing and stimulating home environments mediate the relationship between maternal pre-pregnancy BMI and early childhood BMI z-scores between ages 3 and 6 years.
  • Retrospective cohort study of N=1341 mother–child pairs from the ECHO program in the USA (births 2002–2011, data collected September 2016 to March 2023).
  • Infant–Toddler Home Observation for Measurement of Environment (IT-HOME) questionnaire evaluated six subscales of home enrichment and responsiveness.
  • Structural equation modelling was performed to analyze the potential mediating effects of individual IT-HOME subscales and total score on child BMI z-scores.
  • Children of mothers with overweight or obesity prior to pregnancy had significantly higher BMI z-scores at ages 3–6 years compared with children of mothers with normal weight across all models.
  • The home environment did not mediate the association between maternal pre-pregnancy BMI and early childhood BMI z-scores across any individual IT-HOME subscale or total score.

Cite This Study

Haridas et al. (2026) studied this question.

synapsesocial.com/papers/6aa51f18327956e4761f93f4https://doi.org/10.1007/s00431-026-07368-6
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