Table 2. Associations of Late Pregnancy Maternal BMI (Continuous, per 5-unit Increment) With Child Cognitive and Behavioral Outcomes, Adjusted for Different Characteristicsa.
| Cognitive and behavioral outcomes | No. | Mean (SD) | Effect estimate, (95% CI) | |||
|---|---|---|---|---|---|---|
| Fully adjusteda | Fully adjusted plus GDM, PIHa,b | Fully adjusted plus paternal BMIa,b,c | Fully adjusted plus child BMIa,b,c | |||
| WASI IQ at 6.5 y | ||||||
| Full | 10 497 | 106.6 (16.0) | −0.27 (−0.61 to 0.07) | −0.24 (−0.58 to 0.10) | −0.30 (−0.64 to 0.04) | −0.42 (−0.77 to −0.08) |
| Performance | 10 503 | 107.1 (15.3) | −0.52 (−0.87 to −0.17) | −0.49 (−0.84 to −0.14) | −0.52 (−0.87 to −0.17) | −0.54 (−0.90 to −0.18) |
| Verbal | 10 501 | 104.6 (17.1) | 0.00 (−0.36 to 0.36) | 0.03 (−0.34 to 0.39) | −0.04 (−0.41 to 0.32) | −0.24 (−0.61 to 0.13) |
| SDQ parent report at 6.5 yd | ||||||
| Total difficulties | 10 483 | 11.5 (5.0) | 0.05 (−0.08 to 0.18) | 0.04 (−0.10 to 0.17) | 0.07 (−0.06 to 0.21) | 0.03 (−0.10 to 0.17) |
| Internalizing | 10 484 | 5.2 (3.0) | 0.03 (−0.05 to 0.11) | 0.02 (−0.06 to 0.10) | 0.03 (−0.05 to 0.11) | 0.03 (−0.06 to 0.11) |
| Externalizing | 10 485 | 6.3 (3.2) | 0.03 (−0.06 to 0.11) | 0.02 (−0.07 to 0.10) | 0.04 (−0.05 to 0.12) | 0.01 (−0.08 to 0.10) |
| Prosocial | 10 488 | 8.3 (1.6) | 0.03 (−0.01 to 0.07) | 0.03 (−0.01 to 0.08) | 0.03 (−0.02 to 0.07) | 0.02 (−0.02 to 0.07) |
| SDQ teacher report at 6.5 yd | ||||||
| Total difficulties | 9236 | 9.5 (5.8) | 0.14 (−0.02 to 0.30) | 0.13 (−0.03 to 0.29) | 0.17 (0.01 to 0.33) | 0.15 (−0.01 to 0.32) |
| Internalizing | 9237 | 4.3 (3.0) | 0.01 (−0.08 to 0.10) | 0.01 (−0.07 to 0.10) | 0.02 (−0.07 to 0.11) | 0.04 (−0.05 to 0.13) |
| Externalizing | 9238 | 5.2 (4.0) | 0.13 (0.02 to 0.24) | 0.12 (0.01 to 0.23) | 0.15 (0.04 to 0.26) | 0.12 (0.00 to 0.23) |
| Prosocial | 9236 | 7.5 (2.2) | −0.02 (−0.08 to 0.04) | −0.02 (−0.08 to 0.05) | −0.03 (−0.09 to 0.03) | −0.02 (−0.09 to 0.04) |
| Neurotrax at 16 y | ||||||
| Global standardized score | 10 304 | 100.1 (14.8) | −0.67 (−1.06 to −0.29) | −0.67 (−1.06 to −0.28) | −0.72 (−1.11 to −0.33) | −0.68 (−1.07 to −0.28) |
| Attention | 10 310 | 100.1 (14.8) | −0.74 (−1.13 to −0.35) | −0.73 (−1.12 to −0.33) | −0.75 (−1.14 to −0.35) | −0.79 (−1.20 to −0.38) |
| Executive function | 10 302 | 100.2 (14.8) | −0.50 (−0.89 to −0.11) | −0.47 (−0.87 to −0.08) | −0.57 (−0.96 to −0.17) | −0.50 (−0.90 to −0.09) |
| Processing speed | 9547 | 99.9 (14.9) | −0.57 (−0.98 to −0.15) | −0.56 (−0.98 to −0.14) | −0.55 (−0.97 to −0.13) | −0.60 (−1.02 to −0.17) |
| Memory | 10 304 | 100.0 (15.0) | −0.42 (−0.82 to −0.02) | −0.40 (−0.81 to 0.00) | −0.45 (−0.86 to −0.05) | −0.35 (−0.77 to 0.06) |
| Motor skills | 10 026 | 100.3 (14.7) | −0.06 (−0.45 to 0.33) | −0.06 (−0.45 to 0.33) | −0.13 (−0.52 to 0.26) | −0.16 (−0.56 to 0.25) |
| Verbal function | 10 293 | 99.9 (15.0) | −0.62 (−1.02 to −0.23) | −0.63 (−1.03 to −0.23) | −0.64 (−1.04 to −0.24) | −0.61 (−1.02 to −0.21) |
| Visual/spatial | 10 290 | 100.0 (15.0) | −0.21 (−0.61 to 0.19) | −0.19 (−0.59 to 0.21) | −0.24 (−0.65 to 0.16) | −0.16 (−0.58 to 0.25) |
| National examination scoresd | ||||||
| 9-y examination scores | 3345 | 6.7 (1.1) | −0.03 (−0.08 to 0.02) | −0.03 (−0.08 to 0.02) | −0.04 (−0.08 to 0.01) | −0.03 (−0.08 to 0.02) |
| 11-y examination scores | 5906 | 8.0 (1.1) | −0.05 (−0.09 to −0.02) | −0.05 (−0.09 to −0.02) | −0.06 (−0.09 to −0.02) | −0.05 (−0.08 to −0.01) |
Abbreviations: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); GDM, gestational diabetes; IQ, intelligence quotient; PIH, pregnancy-induced hypertension; SDQ, Strengths and Difficulties Questionnaire; WASI, Wechsler Abbreviated Scales of Intelligence.
Results from mixed-effects linear regression models corrected for clustering within polyclinics. All models adjusted for geographic location; maternal age, height, and smoking; maternal and paternal education and occupation; number of older siblings; child sex; and treatment group.
Multiple imputation was used for missing data on GDM, preeclampsia, paternal BMI, and child BMI. All models have the same sample size across each outcome.
Paternal BMI by maternal reported height and weight at 6.5 years postpartum; child BMI by research measured child weight and height at 6.5 years.
Ranges: SDQ total difficulties 0-40; internalizing and externalizing behaviors 0-20; prosocial behaviors 0-10; national examination scores 2.5-10.