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Infant Weight Gain and Childhood Overweight Status in a Multicenter, Cohort Study

Nicolas Stettler, MD, MSCE^*,, Babette S. Zemel, PhD^*, Shiriki Kumanyika, PhD, MPH and Virginia A. Stallings, MD^*

^* The Children’s Hospital of Philadelphia, Division of Gastroenterology and Nutrition, Philadelphia, Pennsylvania
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

--> Objective. To determine whether a rapid rate of weight gain in early infancy is associated with overweight status in childhood.

Design. Prospective, cohort study from birth to age 7 years.

Setting. Twelve sites across the United States.

Participants. Twenty-seven thousand, eight hundred ninety-nine (27 899) eligible participants born at full term between 1959 and 1965.

Main Outcome Measure. Overweight status at age 7 years, defined by a body mass index above the 95th percentile of the Centers for Disease Control and Prevention reference data.

Results. In the 19 397 participants with complete data (69.6%), the prevalence of overweight status at age 7 years was 5.4%. The rate of weight gain during the first 4 months of life (as 100 g/month) was associated with being overweight at age 7 years, after adjustment for several confounding factors: odds ratio: 1.38; 95% confidence interval: 1.32–1.44. This association was present in each birth weight quintile, and remained significant after adjustment for the weight attained at age 1 year (odds ratio: 1.17; 95% confidence interval: 1.11–1.24).

Conclusions. A pattern of rapid weight gain during the first 4 months of life was associated with an increased risk of overweight status at age 7 years, independent of birth weight and weight attained at age 1 year. These findings may lead to new hypotheses regarding the cause of childhood obesity, which may contribute to our understanding of this increasing public health problem in the United States.

Key Words: birth order • birth weight • child • obesity • weight gain

Abbreviations: CPP, National Collaborative Perinatal Project • BMI, body mass index • OR, odds ratio • CI, confidence interval

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