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Casas, Maribel; Chatzi, Leda; Carsin, Anne-Elie; Amiano, Pilar; Guxens, Monica; Kogevinas, Manolis; Koutra, Katerina; Lertxundi, Nerea; Murcia, Mario; & Rebagliato, Marisa, et al. (2013). Maternal Pre-Pregnancy Overweight and Obesity, and Child Neuropsychological Development: Two Southern European Birth Cohort Studies. International Journal of Epidemiology, 42(2), 506-517.


BACKGROUND: Maternal pre-pregnancy obesity may be associated with impaired infant neuropsychological development; however, there are few studies and it is unclear if reported associations are due to intrauterine mechanisms.
METHODS: We assessed whether maternal pre-pregnancy overweight and obesity were associated with cognitive and psychomotor development scores (mean 100 +/- 15) of children aged 11-22 months in two birth cohorts: Environment and Childhood (INMA, Spain; n = 1967) and Mother-Child (RHEA, Greece: n = 412). Paternal body mass index (BMI) was used as a negative control exposure.
RESULTS: The percentage of overweight and obese mothers was 18% and 8%, respectively, in INMA and 20% and 11% in RHEA, respectively. Maternal pre-pregnancy obesity was associated with reduced infant cognitive development scores in both INMA (score reduction: -2.72; 95% CI: -5.35, -0.10) and RHEA (score reduction: -3.71; 95% CI: -8.45, 1.02), after adjusting for socioeconomic variables and paternal BMI. There was evidence in both cohorts of a dose-response relationship with continuous maternal BMI. Paternal overweight/obesity was not associated with infant cognitive development. Associations with psychomotor scores were not consistent between cohorts, and were stronger for paternal than maternal BMI in RHEA.
CONCLUSIONS: This study in two birth cohorts with moderately high obesity prevalence suggests that maternal pre-pregnancy obesity is associated with reduced child cognitive development at early ages. This association appears more likely to be due to maternal than shared family and social mechanisms, but further research is needed to disentangle a direct intrauterine effect from other maternal confounding factors.


Reference Type

Journal Article

Year Published


Journal Title

International Journal of Epidemiology


Casas, Maribel
Chatzi, Leda
Carsin, Anne-Elie
Amiano, Pilar
Guxens, Monica
Kogevinas, Manolis
Koutra, Katerina
Lertxundi, Nerea
Murcia, Mario
Rebagliato, Marisa
Riano, Isolina
Rodriguez-Bernal, Clara L.
Roumeliotaki, Theano
Sunyer, Jordi
Mendez, Michelle A.
Vrijheid, Martine