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American Journal of Epidemiology Advance Access published online on April 29, 2007

American Journal of Epidemiology, doi:10.1093/aje/kwm094
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American Journal of Epidemiology Copyright © 2007 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

ORIGINAL CONTRIBUTION

Maternal, Birth, and Early-Life Influences on Adult Body Size in Women

Mary Beth Terry1, Ying Wei2 and Denise Esserman2

1 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
2 Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY

Correspondence to Dr. Mary Beth Terry, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 724 A, New York, NY 10032 (e-mail: mt146{at}columbia.edu).

Received for publication March 16, 2006. Accepted for publication July 12, 2006.

The authors conducted a follow-up study of 261 women born during 1959–1965 (38% White, 40% African-American, and 22% Latina) to investigate whether maternal and infant factors are independently associated with adult body size after accounting for childhood growth. Standard statistical methods (linear regression and logistic regression) were compared with quantile regression methods to assess the independent effect maternal factors (body mass index (BMI), maternal weight gain), birth measures (birth weight, placental weight), and early infancy and childhood growth measures (birth–4 months, 4 months–1 year, and 1–7 years) had on predicting adult body size. While most of these factors were important predictors of BMI at age 20 years, the size and relative importance of the effect differed across models. For example, maternal weight gain was associated with being overweight (BMI ≥ 25) at age 20 years (per 10-pound (4.5-kg) change, odds ratio = 1.65, 95% confidence interval: 1.11, 2.44) and was associated with the upper quantiles (≥75th percentile) of BMI at age 20 years. In contrast, maternal BMI and birth weight were relatively more important for lower quantiles, particularly at age 40 years. Only rapid growth from ages 1 to 7 years was an important predictor of adult BMI at both age 20 and age 40, irrespective of statistical model. However, the persistence of effects of maternal and infant factors on adult BMI, even after rapid childhood growth is accounted for, suggests a greater need to investigate these early-life influences and whether their impact differs for smaller and larger women.

birth weight; body mass index; body size; growth; obesity; overweight

Abbreviations: BMI, body mass index


Editor's note: An invited commentary on this article appears on page 000, and the authors' response appears on page 000.


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