| ObjectivesTo investigate the prevalence of developmental delay of 6 months infants, and further examine the effect of being overweight or obese before pregnancy and excessive weight gain during pregnancy on developmental behaviors of infants at age 6 months. MethodsThis study was based on Ma’anshan Birth Cohort Study(MABC). Pregnant women were recruited from May 2013 to September 2014 in prenatal clinics of Maternal and Child Health Care Centre in Ma’anshan. Women who were willing to undergo their prenatal care and delivery in the centre were recruited at their first prenatal care visit in the first trimester. Information of baseline characteristics, pregnancy history and smoking of pregnant women, mode of delivery, birth weight, gestational age, body length, head and chest circumference of newborns, and weight, head circumference, body length, breast feeding at 3 months and 6 months old of 6 months infants was collected. Pre-pregnancy body mass index was calculated and categorized according to the recommendations by the Working Group on Obesity in China. The difference of weight before delivery and pre-pregnancy weight was grouped by interquartile range. Gestational weight gain less than P25 was regarded as lack of gestational weight gain, more than P75 was regarded as excessive gestational weight gain, the remaining groups were regarded as normal gestational weight gain group. Scores of each domain of ASQ-C were also grouped by interquartile range, and less than or equal to P25 were regarded as abnormal group, the remaining groups were regarded as normal group. A total of 3 474 pregnant women were enrolled in our study and 3 312 women had live births. Among them, 162 pregnant women had adverse pregnancy outcomws, 6 infants died up to they were 6 months old, 355 infants did not complete ASQ-C, 39 twins were excluded, and 41 pregnant women had no gestational weight gain data, yielding 2 871 mothers and their infants were included in our analysis. One-way analysis of variance(ANOVA) and χ2 test were used to compare continuous and categorical variables in groups, respectively. Binary logistic regressions were conducted to determine the effect of being overweight or obese before pregnancy and excessive weight gain during pregnancy on developmental behavior of 6 months infants. ResultsThe prevalence of being underweight, normal weight, and overweight/obese before pregnancy was 18.4%, 69.4%, and 12.2%, respectively. The prevalence of lack of gestational weight gain, normal gestational weight gain, and excessive gestational weight gain was 24.1%, 50.5%, and 25.5%, respectively. The prevalence of delayed development of 5 ASQ-C domains was 30.8% for communication(CM), 27.5% for gross motor(GM), 27.5% for fine motor(FM), 32.4% for problem solving(CG), and 28.6% for personal-social(PS). Compared to infants born of normal weight mothers, infants born of overweight/obese mothers had higher prevalence of delayed development in CG(31.6 VS 37.8), and PS domain(27.4 VS 33.8), χ2 values were 5.31, and 6.02, respectively, and P values were 0.021 and 0.014, respectively. Infants born of mothers who had excessive weight gain during pregnancy had lower prevalence of delayed development in GM domain(27.9 VS 23.3), compared to infants born of mothers who had normal weight gain during pregnancy(χ2=5.36, P=0.021). After controlling for maternal age, gestational age, gravidity, mode of delivery, gestational diabetes and breast feeding at 6 months old, the results suggested that being overweight or obese before pregnancy is a risk factor for delayed development of CG, and PS domain, RR values(95%CI) were 1.29(1.01~1.64)for CG domain, and 1.35(1.06~1.74)forPS domain. After controlling for gestational weight gain, only find that being overweight or obese before pregnancy was a risk factor for delayed development of PS domain, RR(95%CI) was 1.33(1.03~1.71). We found that excessive weight gain during pregnancy could decrease the risk of delayed development of GM domain RR(95%CI) was 0.78(0.63~0.96). ConclusionBeing overweight or obese before pregnancy was associated with delayed development of CG, and PS domain. However, excessive gestational weight gain during pregnancy did not increase the risk of infants’ developmental disabilities. |
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