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BACKGROUND: In socially vulnerable populations, evidence is needed regarding the role of maternal nutritional status on child weight during the first 2 years of life. OBJECTIVES: We aimed to assess the association of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with offspring BMI-for-age z-scores (BAZs) during the first 2 years of life. METHODS: A population-based birth cohort study was conducted with 900 mother-child pairs. Pre-pregnancy weight and weight at delivery were collected from medical records, and anthropometric data were measured at birth and at 6-month, 1-year and 2-year follow-up visits. Linear regression and linear mixed-effect models assessed associations with pre-pregnancy BMI, GWG and BAZ during the first 2 years of life. RESULTS: Pre-pregnancy overweight and obesity and excessive GWG were positively associated with BAZ at birth and at 1- and 2-year follow-up visits. There were no significant additional BAZ changes per year based on the exposures up to age 2 years. CONCLUSIONS: Elevated maternal pre-pregnancy BMI and GWG were associated with a child's higher BAZ at birth, and these differences remained constant throughout the first 2 years of life in Amazonian children. These findings highlight the importance of promoting adequate maternal weight before pregnancy and during prenatal care also in socially vulnerable populations.

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BACKGROUND: Maternal malnutrition and infant feeding mode impact short and long term infant and child morbidity and mortality. The period of lactation may provide an opportunity to modulate the risk of disease later in life. Our aim was to estimate the effect of maternal body mass index (BMI) and infant feeding mode, particularly breastfeeding practices, on the anthropometric status of children under 2 years in Colombia. METHODS: A secondary analysis was performed using the data from ENSIN 2010. Term infants under 2y, singleton, with a mother older than 18y, were included in the analysis. Outcomes were wasting (WLZ < -2SD), overweight (WLZ > +2SD) and stunting (LAZ < -2SD). Predictors were infant feeding (exclusive and predominant BF constructed from 24-h recall, age at introduction of liquids, semisolids and solids) and maternal BMI. Socioeconomic variables, maternal education and age, conditions during pregnancy and birth weight were analyzed as covariates. RESULTS: Mothers of overweight infants had higher BMI (Mean dif = 1.47 kg/m2; 95% CI = 2.1, 0.8) than those with normal weight infants. Stunting and wasting were not predicted by maternal anthropometry or infant feeding mode. Fewer maternal years of education were associated with wasting (OR = 0.90; 95% CI = 0.86, 0.97; p = 0.003) and stunting (OR = 0.92; 95% CI = 0.89, 0.94; p < 0.0001), while more maternal years of education were associated with overweight (OR = 1.06; 95% CI = 1.02, 1.01; p = 0.001); higher birth weight was associated with overweight (OR = 1.001; 95% CI = 1.00, 1.001; p < 0.0001) and lower birth was associated with stunting (OR = 0.99; 95% CI = 0.89; p < 0.0001) in the final regression model. CONCLUSIONS: Maternal BMI is a modifiable target for public health policy to promote healthy infant growth. Infant nutritional status is affected by direct and indirect factors that need to be addressed in further studies.

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A case-control study was conducted to determine the association between maternal height and infant length-for-age, and to evaluate how this association is modified by either maternal or infant nutritional status. We hypothesised that maternal excess caloric intake [measured as body mass index (BMI)] would increase the association, while infant nutrition (measured in main meals consumed in addition to breastfeeding) will diminish the effect. Mother and infant pairs in Chimaltenango, Guatemala, were measured for anthropometric values and nutritional status, and mothers were interviewed to elicit nutritional and socio-economic information. Infant length was converted into z-scores based on the World Health Organization's (WHO) standards. Odds ratios (ORs), associated 95% confidence intervals (CIs) and the relative excess risk due to interaction (RERI) were calculated. Cases were infants below 2 z-scores of the WHO's length-for-age, while controls were infants within the -2 to 2 z-score range. Cases (n = 84) had an increased odds (OR: 3.00, 95% CI: 1.57-5.74) of being born to a stunted mother (below 145 cm) when compared with controls (n = 85). When adjusted for potential confounders, the OR decreased to 2.55 (95% CI: 1.30-5.02). Negative RERI values were produced for the joint exposure of maternal BMI ≥ 25 and maternal stuntedness (RERI: -0.96), as well as for the joint exposure of maternal stuntedness and infant nutrition (RERI: -2.27). Our results confirm that maternal stuntedness is a significant contributor to infant stuntedness; however, this association is modified negligibly by maternal nutritional status and significantly by infant nutritional status, each in a protective manner.

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Introducción: El estado nutricional de la gestante es factor fundamental para su salud y la de su hijo. El adecuado peso al nacer favorece el bienestar y disminuye considerables riesgos para el neonato.Objetivo: Evaluar la asociación del estado nutricional en embarazadas de término y las medidas antropométricas de sus recién nacidos (RN).Materiales y Métodos: Estudio transversal, observacional, analítico, realizado con 75 embarazadas sanas del Hospital de Lambaré y sus RN. Se estudiaron: datos sociodemográficos, presencia de anemia, estado nutricional materno pre-gestacional (OMS) y al término de gestación según Atalah y Rosso-Mardones (RM); peso (PN) y talla de nacimiento de los RN según edad gestacional (EG) y criterios OMS.Resultados: La edad materna promedio fue de 26±5 años, la mediana fue de 3 personas/familia. Hubo 15%(n=11) de madres con anemia. El índice de masa corporal pre-gestacional (IMCPreg) promedio fue de 24,0±4kg/m2 y de término fue de 29,4±4kg/m2. El 68%(n=51) presentó un IMCPreg adecuado según OMS. Fueron obesas 18,7%(n=14) y con bajo peso el 12%(n=9) según Atalah y con gráfico de Rosso-Mardones 29,3%(n=22) y 18,7%(n=14) respectivamente. El Peso de Nacimiento promedio de los RN fue 3447±405g, talla 50±2,2cm, perímetro cefálico 34±1,4cm. El 79%(n=59) de los RN tuvo peso adecuado para EG, 93%(n=70) fueron eutróficos (zPeso/Edad), 89%(n=67) presentó talla adecuada (zTalla/Edad). En embarazadas obesas (n=22, RM), hubo mayor proporción de RN grandes para EG (27% vs 9%; χ2, p=0,04), las gestantes con bajo peso (n=14, por RM) tuvieron mayor porcentaje de RN con PN <3.000 (36% vs 11%, χ2, Fisher p=0,04). Sin correlación entre IMCPreg con PN o talla (r=0,2; r=0,04 respectivamente).Conclusiones: Hubo alta prevalencia de embarazadas con exceso de peso y RN con antropometría de nacimiento adecuada. Gestantes obesas presentaron mayor proporción de RN grandes y las de bajo peso, RN con peso insuficiente.

Introduction: The nutritional status of pregnant women is a key factor in their own health and that of their child. Appropriate birth weight benefits health and significantly reduces risk for neonates. Objective: To assess the association of nutritional status in at-term pregnant women with anthropometric measurements of their newborns (NB). Materials and Methods: A cross sectional, observational, and analytical study conducted with 75 healthy pregnant women and their NB at the Hospital de Lambaré. The study recorded demographic data, presence of anemia, pregestational (per WHO) and end-term (per Atalah and Rosso-Mardones) nutritional status of the mother, along with the weight and length of newborns for gestational age (GA) by WHO criteria. Results: Mean maternal age was 26±5 years and median family size was 3 persons. Anemia was found in 11 mothers (15%). Pregestational body mass index (PBMI) averaged 24.0±4 kg/m2 and 29.4±4 kg/m2 at term. A total of 51 (68%) presented appropriate PBMI by WHO standards. Using Atalah, 14 (18.7%) were obese and 9 (12%) underweight, while the Rosso-Mardones graph showed 22 (29.3%) were obese and 14 (18.7%) were underweight. Average birthweight was 3447±405g and length 50 ± 2.2 cm, while head circumference was 34±1.4 cm. Appropriate weight for gestational age was found in 59 newborns (79%), while 70 (93%) had normal weight/age Z-scores, and 67 (89%) had appropriate Z-scores for length/age. Obese pregnant women as defined by Rosso-Mardones (n=22) had a greater proportion of large for gestational age newborns (27% vs 9%; χ2, p = 0.04), while underweight pregnant women (n = 14, per Rosso-Mardones) had a higher percentage of infants with BW <3,000 (36% vs 11%, χ2, Fisher p = 0.04).No correlation was found between PBMI and BW (r = 0.2) or length (r = 0.04)...

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