Insufficient Gestational Weight Gain and Infant Neurodevelopment at 12 Months of Age: the Japan Environment and Children’s Study

Abstract Background Abnormal gestational weight gain (GWG) increases the risk of obstetric-related complications. This investigation examined the impact of GWG on infant neurodevelopmental abnormalities at 12 months of age using the data of a nationwide Japanese cohort study. Methods Questionnaire data were obtained from the ongoing Japan Environment and Children’s Study cohort study. GWG was subdivided as below, within, or above the reference values of the Institution of Medicine pregnancy weight guidelines. The Ages and Stages Questionnaire, third edition (ASQ-3) is a parent-reported developmental screening instrument for children across five domains: communication, gross motor, fine motor, problem solving, and personal-social. Multiple logistic regression analysis was employed to identify correlations between GWG and developmental delay defined as ASQ-3 scores of less than two standard deviations below the mean. Results A total of 30,694 mothers with singleton live births and partners who completed the questionnaire were analyzed. The prevalence of mothers below, within, and above the GWG guidelines was 60.4% (18,527), 32.1% (9,850), and 7.5% (2,317), respectively. We recorded 10,943 infants (35.7%) who were outliers in at least one ASQ-3 domain. After controlling for covariates, GWG below established guidelines was associated with a significantly higher risk of developmental delay for the communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09-1.34), gross motor (OR 1.14, 95% CI 1.05-1.24), fine motor (OR 1.13, 95% CI 1.04-1.24), problem solving (OR 1.09, 95% CI 1.01-1.18), and personal-social domains (OR 1.15, 95% CI 1.07-1.24). Conclusion This large survey revealed a possible deleterious effect of insufficient GWG on infant neurodevelopment.The Japan Environment and Children’s Study (JECS) was registered in the UMIN Clinical Trials Registry on 15 January 2018 (number: UMIN000030786).