Adriëtte Oostvogels

7 Prepregnancy BMI (kg/m 2 ) Offspring’s postnatal weight gain Offspring’s postnatal weight-for-length gain b 95% CI b 95% CI b 95% CI Metabolic score Model 1 0.088 0.053 - 0.124* Model 2 0.079 0.039 - 0.118* Model 3 0.077 0.038 - 0.117* 0.405# 0.128 - 0.682* Model 4 0.078 0.039 - 0.118* 0.301# 0.125 - 0.477* Table 2 - Continued * p <0.05 # p <0.05 for interaction maternal prepregnancy BMI*postnatal weight gain or interaction maternal prepregnancy BMI*postnatal weight-for-length gain. a) Model 1 is adjusted for sex of the child and age at health check (and height of child at age 5 years for SBP/DBP/Metabolic score). b) Model 2 is adjusted for all covariates in model 1 and maternal age, height, education level, ethnicity, parity, hypertension during pregnancy, smoking during pregnancy, birth weight, gestational age, duration of exclusive breastfeeding, screen time per day (TV, computer games, etc.) and energy intake per day (kcal). c) Model 3 is adjusted for all covariates in model 2 and postnatal weight gain. d) Model 4 is adjusted for all covariates in model 2 and postnatal weight-for-length gain. BMI=body mass index; WHtR=waist-height ratio; SBP=systolic blood pressure; DBP=diastolic blood pressure; TG=triglycerides; HDL= high-density lipoprotein Discussion Summary of findings This study explored the association between maternal pBMI, early postnatal growth and offspring’s metabolic components, both individually and combined. It is shown that increased maternal pBMI and early postnatal growth are both independently associated with offspring’s metabolic components at age 5-6 years. In contrast to our expectations, we found stronger associations with most metabolic components for weight gain than for weight-for-length gain. We extend previous research by showing that there is no evidence for a mediating role of early postnatal growth in the association between maternal pBMI and the metabolic components. Moreover, we demonstrate that the combination of high maternal pBMI and postnatal accelerated growth amplify both of these individual effects. 187 pBMI, postnatal growth and offspring’s CMP