Search Results

METHODS: We analyzed 3917 women with 1 to 3 pregnancies in the prospective US National Longitudinal Survey of Youth, from 1979 to 2012. We compared the estimated obesity prevalence between 2 scenarios: gestational weight gain as reported and under the scenario of a hypothetical intervention that all women with excessive gestational weight gain instead gained as recommended by the Institute of Medicine (2009).

RESULTS: A hypothetical intervention was associated with a significantly reduced estimated prevalence of obesity for first (3.3 percentage points; 95% confidence interval [CI] = 1.0, 5.6) and second (3.0 percentage points; 95% CI = 0.7, 5.2) births, and twice as high in Black as in White mothers, but not significant in Hispanics. The population attributable fraction was 10.7% (95% CI = 3.3%, 18.1%) in first and 9.3% (95% CI = 2.2%, 16.5%) in second births.

CONCLUSIONS: Development of effective weight-management interventions for childbearing women could lead to meaningful reductions in long-term obesity.

Results: In most cases, women with more education had increased odds of gaining a recommended amount of gestational weight, independent of educational aspirations and educational expectations and relatively robust to sensitivity analyses. This trend manifested itself in a few different ways. Those with less education had higher odds of inadequate GWG than those with more education. Among those who were not overweight before pregnancy, those with less education had higher odds of excessive GWG than college graduates. Among women who were White, those with less than a high school degree had higher odds of excessive GWG than those with more education.

Methods: Data on 6,199 pregnancies from 2,873 women followed from 1979 to 2012 by the National Longitudinal Survey of Youth 1979 were analyzed in 2014. Associations between three adversity exposures before age 18 years (history of physical abuse, alcohol problems, or mental illness in the household) and two maternal weight outcomes (prepregnancy obesity and excessive gestational weight gain) were modeled separately using survey-adjusted log-binomial models.

Results: After adjusting for race/ethnicity and early-life socioeconomic factors, childhood physical abuse was associated with a 60% increase in the risk of prepregnancy obesity (adjusted risk ratio=1.6, 95% CI=1.1, 2.2). Household alcohol abuse was associated with a 30% increase in prepregnancy obesity (adjusted risk ratio=1.3, 95% CI=1.0, 1.7), as was household mental illness (adjusted risk ratio=1.3, 95% CI=0.8, 1.9), but the mental illness exposure was not significant. Physical abuse and household alcohol abuse were associated with a significant 20% increase in the risk of excessive gestational weight gain; mental illness was not.

Conclusions: Adversity in early life may affect maternal weight before and during pregnancy. Screening and treating women of reproductive age for childhood adversity and its negative effects could significantly reduce obesity-related health outcomes for women and their children.

Methods: We used data from the 1979 U.S. National Longitudinal Survey of Youth to test associations between measures of adverse childhood experiences with obesity and smoking and used an instrumental variables approach to address potential measurement error of the exposure.

Results: Models demonstrated associations between childhood physical abuse and obesity at age 40 years (OR 1.23, 95% CI 1.00-1.52) and ever smoking (OR 1.83, 95% CI 1.56-2.16), as well as associations between household alcohol abuse (OR 1.53, 95% CI 1.31-1.79) and household mental illness (OR 1.29, 95% CI 1.04-1.60) with ever smoking. We find no evidence of association modification by gender, socioeconomic position or race/ethnicity. Instrumental variables analysis using a sibling's report of adverse childhood experiences demonstrated a relationship between household alcohol abuse and smoking, with a population attributable fraction of 17% (95% CI 2.0% to 37%) for ever smoking and 6.7% (95% CI 1.6% to 12%) for currently smoking.

Conclusions: Findings suggest long-term impacts of childhood exposure to physical abuse, household alcohol abuse and parental mental illness on obesity and smoking, and that the association between household alcohol abuse and smoking is not solely due to measurement error.