Weight Gain in Infancy and Vascular Risk Factors in Later Childhood WHAT’S KNOWN ON THIS SUBJECT: Excessive weight gain over the first 18 months of life may have consequences for later body size. However, the relationship of weight gain in this period to atherogenic risk factors in later childhood is not well characterized. WHAT THIS STUDY ADDS: Early postnatal weight gain from birth to 18 months is independently associated with childhood overweight and obesity, excess central adiposity, and greater arterial wall thickness at age 8 years. abstract OBJECTIVE: We hypothesized that early weight gain would be associ- ated with incident obesity, higher blood pressure, systemic inflamma- tion, and arterial wall thickening in later childhood. METHODS: A longitudinal birth cohort was recruited antenatally from 2 maternity hospitals in Sydney, Australia, between September 1997 and December 1999. Three hundred ninety-five nondiabetic children who were followed to age 8 years had complete data for early weight gain and arterial wall thickness. RESULTS: Independent predictors of excess early weight gain (age 0–18 months; adjusted for height gain) included male gender (0.411 kg [SE: 0.103], P , .001), fewer weeks’ gestation (20.121 kg [SE: 0.044] per week, P = .006), birth length (0.156 kg [SE: 0.024] per cm, P , .001), and failure to breastfeed to 6 months of age (0.498 kg [SE: 0.108], P , .001). Early height-adjusted weight gain was significantly associated with later childhood overweight (odds ratio [OR]: 1.67 [95% confidence interval (CI): 1.26 to 2.20] per kg) and obesity (OR: 2.07 [95% CI: 1.53 to 2.79] per kg), excess central adiposity (OR: 1.54 [95% CI: 1.20 to 1.98] per kg), higher systolic blood pressure (1.24 mm Hg [SE: 0.33] per kg, P , .001), higher C-reactive protein (0.17 mg/dL [SE: 0.06] per 100% increase in weight gain, P = .006), and greater carotid intima-media thickness (0.012 mm [SE: 0.004] per kg, P = .002). CONCLUSIONS: Early postnatal weight gain from birth to age 18 months is significantly associated with later childhood overweight and obesity, excess central adiposity, and greater arterial wall thick- ness. Pediatrics 2013;131:e1821–e1828 AUTHORS: Michael R. Skilton, PhD, a,b Guy B. Marks, PhD, c Julian G. Ayer, PhD, b Frances L. Garden, MBiostat, b,c,d Sarah P. Garnett, PhD, b,e,f Jason A. Harmer, MBBS, b Stephen R. Leeder, PhD, b,d,g Brett G. Toelle, PhD, c Karen Webb, PhD, h Louise A. Baur, PhD, b,d,e and David S. Celermajer, PhD b a Boden Institute of Obesity, Nutrition, Exercise, and Eating Disorders, b Sydney Medical School; d Sydney School of Public Health; e The Children’ s Hospital at Westmead Clinical School; and g Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; c Woolcock Institute of Medical Research, Glebe, Australia; f Institute of Endocrinology and Diabetes, The Children’ s Hospital at Westmead, Westmead, Australia; and h Atkins Center for Weight and Health, Department of Nutritional Sciences and Toxicology and School of Public Health, University of California, Berkeley, California KEY WORDS carotid intima-media thickness, obesity, blood pressure, inflammation, risk factor ABBREVIATIONS CI—confidence interval DBP—diastolic blood pressure HDL-C—high-density lipoprotein cholesterol hsCRP—high-sensitivity C-reactive protein IMT—intima-media thickness OR—odds ratio SBP—systolic blood pressure Dr Skilton conceptualized and designed the study, carried out the initial analyses, drafted the initial manuscript, and approved the final manuscript as submitted; Dr Marks contributed to the design and conduct of the Childhood Asthma Prevention Study (CAPS), contributed to the design and conduct of the cardiovascular substudy, reviewed and revised the manuscript, and approved the final manuscript as submitted; Drs Ayer and Harmer contributed to the design and conduct of the cardiovascular substudy, reviewed and revised the manuscript, and approved the final manuscript as submitted; Ms Garden and Drs Garnett, Toelle, and Baur contributed to the interpretation of data, reviewed and revised the manuscript, and approved the final manuscript as submitted; Dr Leeder contributed to the design and conduct of the CAPS, reviewed and revised the manuscript, and approved the final manuscript as submitted; Dr Webb contributed to the design and conduct of the CAPS, reviewed and revised the manuscript, and approved the final manuscript as submitted; and Dr Celermajer contributed to the design and conduct of the cardiovascular substudy, conceptualized and designed the study, reviewed and revised the manuscript, and approved the final manuscript as submitted. (Continued on last page) PEDIATRICS Volume 131, Number 6, June 2013 e1821 ARTICLE by guest on May 17, 2016 Downloaded from