EDITOR-TJ Parsons, et al demonstrated in a large British cohort that
the association between birth weight and adult body mass index is largely
explained by self-reported maternal body weight (1). Although it is
suggested that this is the first report that maternal weight and other
confounding variables may explain the association between birth weight and
adult weight, we published similar conclusions from a study of a North
American cohort of African descent (2).
In the 354 subjects of our cohort
study, we also investigated the influence of birth weight on young
adulthood adiposity, and the impact of potential confounding factors on
this association. The adulthood adiposity, expressed in standard deviation
of triceps and subscapular skinfold thickness measured at age 20 years,
increased with increasing quintiles of birth weight, adjusted for
gestational age, in the univariate analysis (test for trend: z = 2.84, P =
0.004). However, after adjustment for pre-pregnancy maternal body mass
index, birth order and sex, using multiple regression, this association
disappeared (P = 0.39). We therefore concluded, as in the study of the
British cohort described by TJ Parsons, et al, that in this North American
cohort, "an observed association of birth weight and adult weight might be
confounded by other important factors in the absence of adjustment for
these factors" (2), in particular by maternal body mass index.
1. Parsons TJ, Power C, Manor O. Fetal and early life growth and body
mass index from birth to early adulthood in 1958 British cohort:
longitudinal study. BMJ 2001; 323: 1331-1335.
2. Stettler N, Tershakovec AM, Zemel BM, Leonard MB, Boston RC, Katz
SH, Stallings VA. Early risk factors for increased adiposity : a cohort
study of African American subjects followed from birth to young adulthood.
Am J Clin Nutr 2000 ; 72: 378-383.
Nicolas Stettler, Assistant Professor of Pediatrics and Epidemiology
Virginia A. Stallings, Professor of Pediatrics
Division of Gastroenterology and Nutrition, The Children's Hospital
of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA
19104-4399, USA
Rapid Response:
Birth weight, maternal weight, and adult weight
Birth weight, maternal weight, and adult weight
EDITOR-TJ Parsons, et al demonstrated in a large British cohort that
the association between birth weight and adult body mass index is largely
explained by self-reported maternal body weight (1). Although it is
suggested that this is the first report that maternal weight and other
confounding variables may explain the association between birth weight and
adult weight, we published similar conclusions from a study of a North
American cohort of African descent (2).
In the 354 subjects of our cohort
study, we also investigated the influence of birth weight on young
adulthood adiposity, and the impact of potential confounding factors on
this association. The adulthood adiposity, expressed in standard deviation
of triceps and subscapular skinfold thickness measured at age 20 years,
increased with increasing quintiles of birth weight, adjusted for
gestational age, in the univariate analysis (test for trend: z = 2.84, P =
0.004). However, after adjustment for pre-pregnancy maternal body mass
index, birth order and sex, using multiple regression, this association
disappeared (P = 0.39). We therefore concluded, as in the study of the
British cohort described by TJ Parsons, et al, that in this North American
cohort, "an observed association of birth weight and adult weight might be
confounded by other important factors in the absence of adjustment for
these factors" (2), in particular by maternal body mass index.
1. Parsons TJ, Power C, Manor O. Fetal and early life growth and body
mass index from birth to early adulthood in 1958 British cohort:
longitudinal study. BMJ 2001; 323: 1331-1335.
2. Stettler N, Tershakovec AM, Zemel BM, Leonard MB, Boston RC, Katz
SH, Stallings VA. Early risk factors for increased adiposity : a cohort
study of African American subjects followed from birth to young adulthood.
Am J Clin Nutr 2000 ; 72: 378-383.
Nicolas Stettler, Assistant Professor of Pediatrics and Epidemiology
Virginia A. Stallings, Professor of Pediatrics
Division of Gastroenterology and Nutrition, The Children's Hospital
of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA
19104-4399, USA
Corresponding author: Nicolas Stettler
email: nstettle@cceb.med.upenn.edu
Competing interests: No competing interests