Gestational Weight Gain and Early Child Neurodevelopment: Prospective Cohort Study

OBJECTIVE: To examine the association of gestational weight gain (GWG) z-scores and their trajectories with neurodevelopmental delays in children aged 0-24 months. DESIGN: Prospective study. SETTING: Shenzhen, China. POPULATION: 19 702 mother-singleton child pairs. METHODS: GWG z-score trajectories were established using group-based trajectory modelling. Associations of GWG z-scores and their trajectories with neurodevelopmental delays were assessed by multivariable logistic regression. MAIN OUTCOME MEASURES: Neurodevelopmental delays assessed using the parent-completed Ages and Stages Questionnaire, third edition. Most assessments (63.51%) were conducted at child age 0-6 months. RESULTS: Compared with children whose mothers had average GWG (z-score ≥ -0.5 and < 0.5), those with very low GWG (z-score < -1.5) had higher risks of delay in communication (OR: 1.30, 95% CI: 1.09, 1.56), gross motor (OR: 1.34, 95% CI: 1.07, 1.68), problem-solving (OR: 1.32, 95% CI: 1.06, 1.65) and personal-social skills (OR: 1.25, 95% CI: 1.03, 1.51). Among children of overweight/obese mothers, very high GWG (z-score > 1.5) was associated with higher risks of delay in problem-solving (OR: 2.66, 95% CI: 1.20, 5.90) and personal-social skills (OR: 2.68, 95% CI: 1.39, 5.15). Compared with children whose mothers followed GWG trajectories that started at high levels and ended at average levels, those with GWG trajectories ending at low levels had higher risks of neurodevelopmental delays. CONCLUSION: Very low GWG and GWG trajectories ending at low levels were associated with modestly higher risks of neurodevelopmental delays in early childhood. Very high GWG in mothers with overweight/obesity was also associated with higher risks of neurodevelopmental delays in children.