Do Adverse Intrauterine Environments Affect Body Mass Index in Infants and Preschool Children?
Gabriela Koglin, Clécio Homrich da Silva, Denise Ruschel Bandeira, Nadia Cristina Valentini, Marcelo Zubaran Goldani, Juliana Rombaldi BernardiABSTRACT
Introduction
Exposure to adverse intrauterine environments resulting from different maternal clinical conditions may alter childhood growth patterns. This study investigated the influence of such environments on body mass index‐for‐age (BMI‐for‐age) trajectories from birth to preschool age.
Methods
A total of 342 mother–child dyads recruited from three hospitals in southern Brazil were allocated into five groups: diabetes mellitus (DM), systemic arterial hypertension (SAH), maternal smoking, small for gestational age (SGA, used here as a proxy for impaired fetal growth), and a control group. Children were assessed at seven time points from birth to preschool age using anthropometric measurements to calculate BMI‐for‐age z‐scores.
Results
Generalized estimating equations (GEE) identified a significant interaction between group and time ( p < 0.001). Among girls, at birth, the DM group presented higher BMI‐for‐age z‐scores than the smoking group and reached elevated BMI‐for‐age z‐scores at preschool age, differing from the control group. At 6 months of age, girls in the SGA group showed a marked increase in BMI‐for‐age. Among boys, the SGA group reached higher BMI‐for‐age values at preschool age than the DM and control groups. Differences were observed across time, group, and sex in the SGA and control groups ( p < 0.001).
Conclusion
These findings suggest that adverse intrauterine environments may influence BMI‐for‐age trajectories during early life, with greater variability and evidence of catch‐up growth among children exposed to maternal DM and SGA. Results should be interpreted cautiously due to unequal subgroup sizes and substantial loss to follow‐up at preschool age.