Associations Between Gestational Weight Gain and Children's Neurodevelopment at 3 Years of Age.

Abstract

This study aimed to investigate the associations of gestational weight gain (GWG) and GWG trajectory with children's neurodevelopment at age three. This prospective analysis included 4177 mother-child pairs from the Jiangsu Birth Cohort. GWG was assessed both as categories (insufficient/optimal/excessive) and trajectories based on repeated prenatal measurements. Children's neurodevelopment at age three was assessed using the Bayley Scales of Infant and Toddler Development, Version-III Screening Test. A Robust Poisson regression model was used to examine the associations of GWG categories and trajectories with children's neurodevelopment. Compared with children of mothers with optimal GWG, those exposed to excessive GWG had 50% higher noncompetent cognitive risk (RR = 1.50), while insufficient GWG increased noncompetent fine motor risk by 30% (RR = 1.30). Notably, the association between insufficient GWG and noncompetent cognitive development was observed only among those with breastfeeding duration ≤ 12 months (RR = 2.07), not among those breastfeeding > 12 months (RR = 0.72). The "Slow-Rapid" GWG trajectory was associated with elevated risks of both noncompetent cognitive development (RR = 2.51) and expressive communication (RR = 1.94). Excessive GWG, insufficient GWG, and the Slow-Rapid GWG trajectory showed associations with children's noncompetent neurodevelopment. As GWG is a modifiable factor, these findings could inform early intervention for high-risk mother-child dyads.