Prenatal Substance Exposure and Obesity: Trajectories of Tri-Ponderal Mass Index in Early Adolescence.

Abstract

The long-term impact of prenatal substance exposure on obesity remains inconclusive. Few studies have explored the trajectories of tri-ponderal mass index, despite its greater accuracy and reliability in assessing adolescent adiposity. The aim of this study was to examine adiposity trajectories assessed by tri-ponderal mass index from preadolescence age to early adolescence and the influence of prenatal substance exposure on these patterns. This study used data from the Adolescent Brain Cognitive Development study (Release 5.1), an ongoing longitudinal study on child development. Data were collected between 2016 and 2021. A total of 7,881 children with data across 5 waves were included. Prenatal substance exposure (tobacco, alcohol, caffeine, marijuana) was reported by mothers. Latent growth mixture modeling was conducted to identify tri-ponderal mass index trajectories, followed by multinomial logistic regression to examine the role of prenatal substance exposure, controlling for covariates. All analyses were conducted in 2024. Three trajectories emerged: stable tri-ponderal mass index (86.6%), increasing tri-ponderal mass index (12.5%), and decreasing tri-ponderal mass index (0.9%). The risk of increasing tri-ponderal mass index was associated with prenatal tobacco and caffeine exposure, showing dose-dependent effects. Tobacco exposure both before and after awareness of pregnancy increased the risk, with no significant benefit from cessation. Prenatal exposure to multiple substances further elevated the risk of increasing tri-ponderal mass index. Obesity risk can originate prenatally. The long-term impact of prenatal substance exposure on adiposity development during adolescence highlights the need for preconception and prenatal health interventions to reduce obesity risk in offspring.