Table 2.
Natural Direct, Natural Indirect, and Total Effects of Maternal Pre-Pregnancy Overweight/Obesity on Child’s Overweight/Obesity for Measures of Birth Anthropometry and in the Presence of Multiple Mediatorsa,b
| Birth anthropometry | Birth anthropometry + gestational weight gain |
Birth anthropometry + gestational diabetes |
Birth anthropometry + hypertensive disorders of pregnancy |
|||||
|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | Percent Mediated |
OR (95% CI) | Percent Mediated |
OR (95% CI) | Percent Mediated |
OR (95% CI) | Percent Mediated |
|
| Birthweight | ||||||||
| Natural direct effect | 1.68 (1.33, 2.15) | 1.69 (1.34, 2.13) | 1.67 (1.31, 2.10) | 1.66 (1.31, 2.09) | ||||
| Natural indirect effect | 1.07 (1.03, 1.11) | 15.50% | 1.07 (1.02, 1.12) | 15.05% | 1.08 (1.04, 1.12) | 16.29% | 1.09 (1.03, 1.14) | 17.60% |
| Total effect | 1.81 (1.43, 2.31) | 1.82 (1.43, 2.28) | 1.81 (1.41, 2.26) | 1.81 (1.42, 2.26) | ||||
| Birth Length | ||||||||
| Natural direct effect | 1.76 (1.39, 2.22) | 1.78 (1.41, 2.23) | 1.75 (1.38, 2.21) | 1.75 (1.37, 2.18) | ||||
| Natural indirect effect | 1.02 (1.00, 1.05) | 5.16% | 1.02 (0.98, 1.05) | 3.67% | 1.03 (1.00, 1.06) | 6.31% | 1.03 (0.99, 1.07) | 7.01% |
| Total effect | 1.81 (1.42, 2.27) | 1.81 (1.44, 2.27) | 1.80 (1.42, 2.27) | 1.80 (1.41, 2.25) | ||||
| Birth Head Circumference | ||||||||
| Natural direct effect | 1.71 (1.34, 2.15) | 1.73 (1.35, 2.18) | 1.69 (1.33, 2.12) | 1.70 (1.33, 2.14) | ||||
| Natural indirect effect | 1.04 (1.01, 1.07)* | 8.48% | 1.03 (0.99, 1.07) | 6.98% | 1.04 (1.01, 1.08) | 9.81% | 1.04 (1.00, 1.09) | 9.81% |
| Total effect | 1.78 (1.39, 2.23) | 1.78 (1.39, 2.25) | 1.76 (1.39, 2.21) | 1.78 (1.39, 2.23) | ||||
| Birth Ponderal Index | ||||||||
| Natural direct effect | 1.79 (1.43, 2.26) | 1.81 (1.42, 2.27) | 1.78 (1.41, 2.23) | 1.77 (1.39, 2.24) | ||||
| Natural indirect effect | 1.01 (0.99, 1.03) | 2.18% | 1.00 (0.98, 1.03) | 0.78% | 1.02 (0.99, 1.04) | 3.32% | 1.02 (0.99, 1.06) | 4.56% |
| Total effect | 1.81 (1.44, 2.29) | 1.81 (1.43, 2.28) | 1.81 (1.43, 2.26) | 1.81 (1.42, 2.28) | ||||
| Small-for-Gestational-Age | ||||||||
| Natural direct effect | 1.74 (1.36, 2.21) | 1.77 (1.36, 2.26) | 1.73 (1.35, 2.20) | 1.74 (1.35, 2.20) | ||||
| Natural indirect effect | 1.01 (1.00, 1.03) | 2.91% | 1.00 (0.97, 1.04) | 1.09% | 1.02 (0.99, 1.05) | 4.64% | 1.02 (0.98, 1.06) | 4.56% |
| Total effect | 1.77 (1.37, 2.23) | 1.78 (1.37, 2.27) | 1.76 (1.38, 2.24) | 1.77 (1.38, 2.24) | ||||
| Large-for-Gestational-Age | ||||||||
| Natural direct effect | 1.86 (1.43, 2.38) | 1.89 (1.45, 2.43) | 1.84 (1.42, 2.36) | -- | ||||
| Natural indirect effect | 1.02 (0.99, 1.05) | 4.23% | 1.01 (0.97, 1.05) | 2.20% | 1.03 (0.99, 1.07) | 5.87% | -- | -- |
| Total effect | 1.90 (1.46, 2.43) | 1.91 (1.47, 2.45) | 1.90 (1.46, 2.42) | -- | ||||
a
Model adjusted for maternal & child sociodemographics (maternal age, maternal education, maternal insurance, maternal smoking, first birth, child’s sex, and child’s age)
b
n=3950 mother-child dyads examined using imputation-based methods, which fit a working model for the outcome mean
*
p=0.04 test for moderation by gestational weight gain