Associations of maternal consumption of sugary beverages in pregnancy with infant weight status

Abstract

Objectives:

To examine associations of maternal consumption of 100% juice and sugar-sweetened beverages (SSBs) in the third trimester of pregnancy with infant weight status at 6 and 12 months.

Methods:

We studied 379 mother-infant dyads from Rise & SHINE, a prospective cohort study. Exposures were maternal consumption of 100% juice and SSBs in the third trimester. Outcome measures were infant weight-for-length (WFL) z-scores at 6 and 12 months and rapid infant weight gain (RIWG; change in weight-for-age z-score ≥ 0.67) from birth to 6 and 12 months.

Results:

Mean (SD) maternal age was 32.8 (5.1) years; 71.7% reported household income ≥$50,000. In the third trimester, nearly daily or daily consumption of 100% juice and SSBs was 25.9% and 16.6%, respectively. Mean (SD) WFL z-scores at 6 and 12 months were 0.35 (0.96) and 0.50 (0.98). RIWG was present in 30.2% and 36.6% of infants from birth to 6 months and birth to 12 months, respectively. In multivariable models, 100% juice consumption was associated with higher WFL z-score at 6 months (β = 0.26; 95% confidence interval [CI]: 0.03, 0.49) and higher odds of RIWG from birth to 6 months (adjusted odds ratio [aOR] = 2.09; 95%CI: 1.23, 3.56) and birth to 12 months (aOR = 1.85; 95%CI: 1.04, 3.28). 100% juice consumption was not associated with WFL z-score at 12 months and SSB consumption was not associated with any of the outcomes.

Conclusions:

Consumption of 100% juice, but not SSBs, in the third trimester of pregnancy is associated with infant weight status at 6 months and RIWG.

INTRODUCTION

The first 1,000 days (pregnancy through 24 months of age) is increasingly recognized as a critical period for the development of obesity risk factors.¹ Multiple studies have found an association between growth trajectories in infancy and obesity later in childhood.^2,3 Identification of potentially modifiable risk factors during pregnancy could allow for more targeted policies and interventions to prevent childhood obesity. In recent years, the effect of maternal dietary intake during pregnancy on infant and childhood growth and adiposity has been investigated.^4–9 According to the developmental origins of disease hypothesis, suboptimal maternal diet during pregnancy may adversely affect an offspring’s risk for metabolic disease.¹⁰ There may be critical time windows of developmental plasticity early in life that influence how an individual responds to later exposures.¹⁰

Consumption of sugar-sweetened beverages (SSBs) is a risk factor for the development of obesity in children and adults,¹¹ but little is known about the effects of sugary beverage consumption during pregnancy. A limited but growing body of research has examined the potential impacts of maternal beverage consumption during pregnancy on children’s weight trajectories, ranging from infancy to mid-childhood. A study of 1078 mother-child pairs in the United States found that SSB consumption during the second trimester of pregnancy was positively associated with adiposity in mid-childhood, independent of maternal body mass index.¹² However, a study of 3033 mother-child dyads¹³ and another study of 918 dyads with mothers with gestational diabetes¹⁴ found positive associations between maternal artificially sweetened beverage (ASB) intake during pregnancy, but not SSB intake, and infant BMI z-scores and mid-childhood overweight/obesity, respectively.

Although prior studies have examined potential influences of maternal SSB consumption on children’s weight trajectories after birth, existing evidence is still limited and findings of significant associations are mixed. As opposed to some prior studies that focus on weight status in midchildhood,^12,14 our analysis focuses on the outcome of weight status in first year of life, as there are likely fewer external factors influencing growth at this time. Prior studies have not examined the influence of maternal 100% juice consumption, despite some 100% juice products having fructose concentrations similar to, or even higher than, SSBs.¹⁵ To address the existing gaps in the literature, the purpose of this study was to examine: (1) the association between maternal consumption of 100% juice and SSBs in the third trimester of pregnancy and infant weight-for-length z-score, and (2) the association between maternal consumption of 100% juice and SSBs in the third trimester of pregnancy and rapid infant weight gain (RIWG). We hypothesized that higher maternal consumption of 100% juice and SSBs in the third trimester of pregnancy is associated with higher infant weight-for-length z-score and higher odds of RIWG at 6 months and 12 months of age.

METHODS

We recruited participants into Rise & SHINE (Sleep Health in Infancy & Early Childhood), a prospective birth cohort study of mother-infant dyads with the goal to examine infant sleep patterns and their effects on weight status in early life. Women and their newborn infants were recruited after delivery from the Massachusetts General Hospital (MGH) Newborn Unit in Boston, Massachusetts between 2016 and 2018. Women were eligible if they were the biological and birthing mother of the infant from a singleton birth, fluent in English or Spanish, at least 18 years old, and with no chronic condition that precluded participation in the study. Eligibility criteria for infants included gestational age of at least 37 weeks at birth, no genetic disorder or other condition that could affect sleep or growth, intent to receive care at an MGH-affiliated pediatric clinic, and the family living within 40 miles of Boston without plans to move from the area within the study period. Of 1459 eligible mother-infant dyads, 433 consented to participate in the study and completed an intake survey. Mass General Brigham Institutional Review Board approved the study protocol and procedures.

Exposures

Self-reported frequencies of maternal consumption of 100% fruit juice and SSBs were collected via survey at the time of enrollment in the study, which occurred after the infant’s birth and prior to discharge from the nursery. Survey questions referred to maternal dietary intake over the previous 4 weeks and these responses were attributed to consumption in the third trimester of pregnancy. The survey included food frequency questions, slightly modified from the National Health and Nutrition Examination Survey (NHANES) Dietary Screener Questionnaire.¹⁶ Specifically, the questions asked mothers to indicate how often, on average, in the past 4 weeks they consumed: (1) 100% pure fruit juices such as orange, mango, apple, grape and pineapple juices; (2) punch, sweetened fruit drinks, sports drinks, Kool-Aid, Tampico, lemonade, Hi-C, cranberry drink, Goya, or Vitamin Water; and (3) regular sodas or soft drinks, including Manzanita, Penafiel, Coke, Pepsi, Dr. Pepper, or Mountain Dew (excluding diet sodas). Response options included: never, less than once per week, once per week, 2-4 times per week, nearly daily or daily, 2-4 times per day, and 5 or more times per day.

A dichotomous variable was created for maternal 100% juice consumption in the third trimester by grouping responses into nearly daily or daily (or more frequently) versus less than daily (all choices less frequent than nearly daily or daily). A dichotomous variable was also created for SSB consumption by combining responses from the sweetened fruit drinks category and the regular soda category. Responses were grouped into nearly daily or daily if either sweetened fruit drinks or regular soda was consumed nearly daily or daily (or more frequently) or if both sweetened fruit drinks and regular soda were consumed 2-4 times per week. All other combinations were grouped into less than daily. The cutoff for the dichotomous beverage consumption variables was decided at nearly daily or daily due to theoretical clinical significance as well as to enhance the interpretation and implementation of findings.

Outcome Measures

Infant weight and length measures were collected from Rise & SHINE study home visits at approximately 6 and 12 months of age. At study home visits, research staff measured infant length to the nearest 0.1 cm and weight to the nearest 1 g using calibrated scales. All research staff were trained in anthropometric measurements and inter- and intra-rater reliability were evaluated to ensure data quality. Study home visit anthropometric data was supplemented with measurements from routine MGH clinic well-child visits if study home visit data was missing. We calculated age- and sex-specific weight-for-length (WFL) and weight-for-age (WFA) z-scores using the World Health Organization (WHO) Child Growth Standards.¹⁷ Z-scores represent the number of standard deviations above or below the mean, with a z-score of 0 equivalent to the mean.

Primary outcomes for this analysis were continuous WFL z-scores at 6 months and 12 months and RIWG from birth to 6 months and birth to 12 months of age. RIWG was defined as an increase in WFA z-score between time points of greater than or equal to 0.67, which is consistent with other studies.³

Covariates

We collected sociodemographic data at enrollment. Maternal age was obtained from the electronic health record. Mothers self-reported their race and ethnicity, household income, and educational attainment on the baseline survey. Maternal race and ethnicity was categorized as Non-Hispanic White, Hispanic or Latino, Non-Hispanic Black or African American, and Non-Hispanic Asian. Families with annual income less than $50,000 were classified as low-income, approximately consistent with $48,470, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) eligibility cutoff (185% of the federal poverty level) for a household size of 4 in 2020.¹⁸ Maternal educational attainment was dichotomized into Bachelor’s degree or higher versus less than Bachelor’s degree.

Prepregnancy body mass index (BMI) was calculated using prepregnancy weight and maternal height. Prepregnancy weight was obtained from the electronic health record if it was obtained within 9 months prior to the start of pregnancy. Missing or outlier prepregnancy weights were replaced with self-reported prepregnancy weight (n= 213) or weight obtained at the first obstetric visit of the pregnancy within the first trimester (n= 18). Maternal height was obtained from the EHR and missing values were supplemented with maternal height obtained by study staff at the home visit at approximately 1 month after birth (n= 2). Infant sex, gestational age, and birth weight were collected from the electronic health record.

Statistical Analysis

Descriptive statistics were used to characterize the overall study sample and the sample stratified by maternal 100% juice and SSB consumption in the third trimester of pregnancy. Multivariable linear regression models estimated the beta (β) coefficients and 95% confidence intervals (CIs) for infant WFL z-score in association with maternal 100% juice or SSB consumption in the third trimester of pregnancy. Multivariable logistic regression models estimated odds ratios and 95% CIs for RIWG from birth to 6 months and birth to 12 months of age in association with maternal 100% juice or SSB consumption in the third trimester of pregnancy.

We considered inclusion of variables as confounders in the multivariable regression models if they preceded the exposure and the outcome in time, to avoid inclusion of variables that could potentially be on the causal pathway (eg, maternal gestational weight gain, infant breastfeeding, and timing of introduction of complementary foods). We compiled a list of a priori confounding variables and examined bivariate associations with exposure and outcome and relative impact of confounding to decide on the final group of confounders that were included in each multivariable regression model: maternal age at delivery, maternal race and ethnicity, household income, maternal educational attainment, and maternal prepregnancy BMI. Parity and infant sex were not included in the models.

Results are presented as unadjusted and adjusted β estimates and odds ratios. Mother-infant dyads with complete exposure, outcome, and confounding variable information were included in each model. Separate models were constructed for each exposure-outcome combination at each time point. Statistical significance was considered at P < .05. Data were analyzed using SAS, version 9.4.

RESULTS

All 433 mothers provided exposure (sugary beverage consumption) information on the enrollment survey, but the cohort for this analysis was restricted to the 379 mother-infant dyads with at least one set of infant anthropometric measurements (at 6 months or 12 months of age). Compared to the dyads who were included in the analysis, the group of dyads that were excluded had a higher proportion with household income <$50,000 and maternal educational attainment of less than a Bachelor’s degree. Among the 379 mother-infant dyads included in the analyses, mean (SD) maternal age at delivery was 32.8 (5.1) years and prepregnancy BMI was 25.5 (6.0). Seventy two percent of mothers reported a household income of at least $50,000, and 68.9% completed at least a Bachelor’s degree education. Forty five percent of mothers identified as Non-Hispanic White, 33.5% Hispanic, 14.1% Non-Hispanic Asian, and 7.5% Non-Hispanic Black or African American (Table 1).

Table 1.

Maternal and Infant Characteristics According to Frequency of Maternal 100% Juice and SSB^a Consumption During Third Trimester of Pregnancy From 379 Mother-Infant Pairs

	Overall (N=379)	Maternal 100% Juice Consumption in 3rd Trimester		Maternal SSB Consumption in 3rd Trimester
		Less than daily N= 281	Nearly daily or daily N= 98	Less than daily N= 316	Nearly daily or daily N= 63
Maternal Characteristics	Mean (SD)
Age at delivery (years)	32.8 (5.1)	33.3 (4.8)	31.4 (5.8)	33.2 (5.0)	30.8 (5.3)
Prepregnancy BMI (kg/m2)b	25.5 (6.0)	25.4 (6.0)	25.7 (6.1)	25.0 (5.7)	27.8 (7.2)
	N (%)
Household income ≥$50,000c	263 (71.7)	205 (75.9)	58 (59.8)	228 (74.5)	35 (57.4)
Educational attainment- Bachelor's degree or higher	261 (68.9)	202 (71.9)	59 (60.2)	230 (72.8)	31 (49.2)
Race and ethnicityd
Non-Hispanic White	169 (45.0)	133 (47.5)	36 (37.5)	151 (48.2)	18 (28.6)
Hispanic or Latino	126 (33.5)	83 (29.6)	43 (44.8)	95 (30.4)	31 (49.2)
Non-Hispanic Asian	53 (14.1)	46 (16.4)	7 (7.3)	47 (15.0)	6 (9.5)
Non-Hispanic Black or African American	28 (7.5)	18 (6.4)	10 (10.4)	20 (6.4)	8 (12.7)
Parity- Multiparous	182 (48.0)	135 (48.0)	47 (48.0)	147 (46.5)	35 (55.6)
Infant Characteristics	N (%)
Sex- Female	196 (51.7)	142 (50.5)	54 (55.1)	162 (51.3)	34 (54.0)
	Mean (SD)
Gestational age at birth (weeks)	39.5 (1.0)	39.6 (1.0)	39.2 (1.0)	39.5 (1.0)	39.3 (1.1)
Birth weight (kg)d	3.34 (0.43)	3.36 (0.43)	3.28 (0.42)	3.34 (0.42)	3.34 (0.47)
WFL z-score at 6 monthse	0.35 (0.96)	0.27 (0.95)	0.57 (0.96)	0.33 (0.99)	0.45 (0.80)
WFL z-score at 12 monthsf	0.50 (0.98)	0.44 (0.95)	0.70 (1.06)	0.51 (0.98)	0.47 (0.97)
	N (%)
RIWG birth to 6 monthsg	109 (30.2)	70 (26.3)	39 (41.1)	86 (28.5)	23 (39.0)
RIWG birth to 12 monthsh	111 (36.6)	76 (33.0)	35 (48.0)	93 (36.2)	18 (39.1)

^aSSB= Sugar-sweetened beverage

^bBMI= Body Mass Index

^cMissing=12

^dMissing=3

^eWFL= Weight-for-length; Missing=15

^fWFL= Weight-for-length; Missing=75

^gRIWG= Rapid infant weight gain, defined by change in weight-for-age z-score ≥ 0.67; Missing=18

^hRIWG= Rapid infant weight gain, defined by change in weight-for-age z-score ≥ 0.67; Missing=76

Overall, 25.9% of mothers endorsed nearly daily or daily consumption of 100% juice in the third trimester of pregnancy and 16.6% endorsed nearly daily or daily consumption of SSBs in the third trimester of pregnancy. Mean (SD) infant WFL z-scores at 6 months and 12 months of age were 0.35 (0.96) and 0.50 (0.98), respectively. Thirty percent of infants had RIWG from birth to 6 months and 36.6% had RIWG from birth to 12 months of age (Table 1).

In unadjusted models (Table 2a), we found that maternal nearly daily or daily consumption of 100% juice during the third trimester of pregnancy was associated with higher infant WFL z-scores at 6 months [β 0.31 (95% confidence interval [CI]: 0.08, 0.53] and a similar association but of less magnitude at 12 months [β 0.25 (−0.003, 0.51)]. Figures 1 and 2 present the distribution of infant WFL z-scores at 6 and 12 months according to maternal 100% juice consumption. In multivariable adjusted models (Table 2a), we found that maternal nearly daily or daily consumption of 100% juice during the third trimester of pregnancy was associated with higher infant WFL z-scores at 6 months [β 0.26 (0.03, 0.49)], but not at 12 months [β 0.22 (−0.05, 0.49)]. In unadjusted models (Table 2b), maternal nearly daily or daily consumption of 100% juice during the third trimester of pregnancy was associated with higher odds of RIWG from birth to 6 months [unadjusted odds ratio [OR] 1.95 (1.19, 3.19)] and birth to 12 months [OR 1.87 (1.09, 3.19)]. The positive associations remained after adjustment (Table 2b), as maternal nearly daily or daily consumption of 100% juice during the third trimester of pregnancy was associated with higher odds of RIWG from birth to 6 months [adjusted odds ratio [aOR] 2.09 (1.23, 3.56)] and birth to 12 months [aOR 1.85 (1.04, 3.28)].

Table 2a.

Maternal Beverage Consumption During 3^rd Trimester of Pregnancy and Infant Weight-for-Length z-Score

	Weight-For-Length z-Score β (95% CI)
	6 months		12 months
	Unadjusted	Adjusted a	Unadjusted	Adjusted a
100% juice
Less than daily	0 [Reference]	0 [Reference]	0 [Reference]	0 [Reference]
Nearly daily or daily	0.31 (0.08, 0.53)	0.26 (0.03, 0.49)	0.25 (−0.003, 0.51)	0.22 (−0.05, 0.49)
SSB b
Less than daily	0 [Reference]	0 [Reference]	0 [Reference]	0 [Reference]
Nearly daily or daily	0.12 (−0.15, 0.39)	−0.02 (−0.30, 0.25)	−0.04 (−0.34, 0.27)	−0.19 (−0.52, 0.13)

Bold values indicate significance of P < .05.

^aAdjusted for maternal age at delivery (continuous), maternal race/ethnicity, household income (≥$50,000), maternal educational attainment (Bachelor’s degree or higher), maternal prepregnancy body mass index (continuous)

^bSSB= sugar-sweetened beverage

Figure 1.

Infants whose mothers consumed 100% juice nearly daily or daily during pregnancy had higher weight-for-length z-scores at 6 months of age. Data are from 364 mother-infant pairs.

Figure 2.

Infants whose mothers consumed 100% juice nearly daily or daily during pregnancy had higher weight-for-length z-scores at 12 months of age (borderline significant prior to adjustment). Data are from 304 mother-infant pairs.

Table 2b.

Maternal Beverage Consumption During 3^rd Trimester of Pregnancy and Rapid Infant Weight Gain

	Rapid infant weight gain a Odds Ratio (95% CI)
	Birth to 6 months		Birth to 12 months
	Unadjusted	Adjusted b	Unadjusted	Adjusted b
100% juice
Less than daily	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]
Nearly daily or daily	1.95 (1.19, 3.19)	2.09 (1.23, 3.56)	1.87 (1.09, 3.19)	1.85 (1.04, 3.28)
SSB c
Less than daily	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]
Nearly daily or daily	1.61 (0.90, 2.87)	1.47 (0.79, 2.74)	1.13 (0.60, 2.16)	1.03 (0.51, 2.09)

Bold values indicate significance of P < .05.

^aChange in weight-for-age z-score ≥ 0.67

^bAdjusted for maternal age at delivery (continuous), maternal race/ethnicity, household income (≥$50,000), maternal educational attainment (Bachelor’s degree or higher), maternal prepregnancy body mass index (continuous)

^cSSB= sugar-sweetened beverage

There were no associations between maternal nearly daily or daily consumption of SSBs during the third trimester of pregnancy and any of the measured outcomes (WFL z-scores at 6 months or 12 months; RIWG from birth to 6 months or birth to 12 months of age) in unadjusted or adjusted models (Table 2a, b).

DISCUSSION

In this prospective, birth cohort study, we found that nearly daily or daily maternal 100% juice consumption during late pregnancy was associated with higher infant weight-for-length z-score at 6 months and rapid infant weight gain from birth to 6 months and birth to 12 months of age, after adjusting for confounding variables. However, weight-for-length z-scores and rapid infant weight gain did not differ according to maternal report of SSB consumption during late pregnancy. Though the WFL z-scores observed in the infants of mothers who consumed nearly daily or daily 100% juice were higher than the group with less frequent 100% juice consumption, this difference was small and the mean and standard deviations remain within normal limits. Additionally, this difference was only observed at 6 months and not 12 months; therefore the clinical significance of this finding is unclear. However, there was also a difference in RIWG at 6 and 12 months between maternal 100% juice consumption groups, which is a strong predictor of adiposity later in childhood.³

The findings extend prior literature by examining the association of maternal 100% juice consumption in pregnancy with infant weight status, which has not been previously investigated. The null findings related to maternal SSB consumption and infant weight status are consistent with the Canadian Healthy Infant Longitudinal Development (CHILD) Study, which also did not find an association between maternal SSB consumption and higher infant BMI z-scores.¹³ However, the findings are contradictory to a small study of predominantly low-income Hispanic mother-infant pairs that found that SSB consumption was associated with infant risk for obesity, though their outcome was dichotomous WFL at or above the 85^th percentile.¹⁹

Based on the developmental origins of disease hypothesis,¹⁰ we hypothesized that maternal consumption of 100% juice or SSBs in late gestation, a time period when the fetus has increased adipose tissue deposition,²⁰ may predispose the developing fetus to higher infant WFL and risk for RIWG. Potential mechanisms underlying the developmental origins of disease hypothesis remain debated, but include altered insulin signaling, increased adipocyte differentiation, increased lipogenesis, and mitochondrial dysfunction in the offspring.^20,21 One possibility we considered was mediation of the association between maternal 100% juice consumption and infant weight status by infant feeding practices. As a preliminary investigation into mediation, we included breastfeeding duration (any breastfeeding with a maximum of 6 months for the 6-month outcomes and 12 months for the 12-month outcomes) in the models and there was no meaningful change in point estimates or confidence intervals (Supplemental Tables 1a and 1b). These findings preliminarily suggest the mechanism for the association does not operate through breastfeeding.

We had hypothesized that both 100% juice and SSB consumption would be associated with infant weight status, however, we did not find an association for SSBs. We propose a few possible interpretations of these findings. The first interpretation is that third trimester SSB consumption may not be associated with infant weight status. This would be consistent with the findings from the CHILD study,¹³ which also found that SSB consumption in the second or third trimester of pregnancy was not associated with infant BMI z-score at 1 year of age. However, Phelan et al.⁹ assessed diet between 10 and 16 weeks of pregnancy and found that in mothers with overweight/obesity, but not in mothers with normal weight, consumption of a greater percentage of calories from sweets early in pregnancy was associated with higher weight-for-age at 6 months. Additionally, the Project Viva study found that maternal SSB consumption in the second trimester of pregnancy was associated with child weight status in mid-childhood.¹² Given these findings, it might be possible that the impact on growth trajectories as a result of maternal 100% juice and SSB consumption are different in some way (eg, different sensitive period during pregnancy or different age at which effect becomes apparent).

Another potential interpretation of our findings is that the effect estimates for SSB exposure were biased towards the null and underestimated a true existing association. Given the low prevalence of SSB consumption in the sample, there may not have been enough variability in maternal SSB consumption across participants or the sample may not have been large enough for an association to be observed. Additionally, there may have been non-differential underreporting of SSB consumption frequency. This underreporting could be due to the perceived stigma of SSB consumption, given an increase in public knowledge of the negative health effects of SSBs in recent years. In contrast, there may be less stigma to report 100% juice consumption, as 100% juice is often thought of as a healthier alternative to SSBs and the United States Department of Agriculture (USDA) includes consumption of 100% juice as an option for a serving of fruit.²² Additionally, loss to follow up was higher among SSB-consuming mothers, though these associations were not statistically significant.

Another possibility is that there could be additional concurrent or downstream factors not controlled for in this analysis that affect infant weight and are associated with juice-consuming mothers and not SSB-consuming mothers. These factors could include other aspects of maternal diet or behaviors during pregnancy or other factors that influence infant weight postnatally. The CHILD study found an association with ASBs and infant weight status at 12mo, but not SSBs,¹³ so there is a chance that pregnant women consuming 100% juice also consume ASBs, resulting in either our study or the CHILD study attributing the significant association to the incorrect exposure.

Limitations

As mentioned above, a limitation of our study was the high socioeconomic status of the cohort, which may have contributed to the relatively low reported maternal consumption of sugary beverages, resulting in less overall variability in exposure in our sample. The relatively high socioeconomic status of the cohort as well as exclusion of mothers who did not speak English or Spanish also limits the generalizability of the findings to other populations. Additionally, although we collected information on several confounding variables, there is always the possibility of residual confounding, especially related to unmeasured aspects of socio-economic status, which could bias the results away from or towards the null. Due to the low prevalence of gestational diabetes in this sample, we were unable to include gestational diabetes as a confounder in the adjusted models. A major limitation is that beverage consumption was collected by self-report, which could lead to social desirability bias. Additionally, the food frequency questionnaire only assessed intake frequency, so we do not know the actual volume of beverages consumed. Lastly, we did not measure artificially sweetened beverage consumption, so we are not able to determine if our findings are consistent with prior studies.^13,14

Conclusions

Nearly daily or daily consumption of 100% juice in the third trimester of pregnancy was associated with higher infant WFL z-scores at 6 months and higher odds of RIWG from birth to 6 months and birth to 12 months of age. Nearly daily or daily consumption of SSBs was not associated with WFL z-scores or RIWG. These findings suggest the possible intergenerational effects of maternal beverage consumption during pregnancy, which should be considered in future intervention trials aimed at obesity prevention. Further research is needed to clarify the differing impact of maternal 100% juice and SSB intake on infant weight status.

What’s New:

In a prospective cohort study of mother-infant dyads, maternal consumption of 100% juice, but not sugar-sweetened beverages, in the third trimester of pregnancy was associated with infant weight status at 6 months and rapid infant weight gain.

Abbreviations:

ASB

artificially sweetened beverage

CHILD

Canadian Healthy Infant Longitudinal Development

MGH

Massachusetts General Hospital

NHANES

National Health and Nutrition Examination Survey

RIWG

rapid infant weight gain

SHINE

Sleep Health in Infancy & Early Childhood

SSB

sugar-sweetened beverage

USDA

United States Department of Agriculture

WFL

weight-for-length

WFA

weight-for-age

WIC

Special Supplemental Nutrition Program for Women, Infants, and Children