The association between maternal healthy lifestyle factors during pregnancy and the neonatal anthropometric indicators based on a prospective cohort study

Background and Objectives: We aimed to evaluate the associations between a combined healthy lifestyle during the second and third trimesters and offspring anthropometric outcomes in China. Methods and Study Design: We examined these associations among 548 participants from nine community health centers and three hospitals in the North China cohort. A pregnant women's healthy lifestyle score (HLS) was constructed based on six life-style factors: smoking, alcohol consumption, physical activity, sedentary behavior, diet, and gestational weight gain. Anthropometric indicators at birth like birth weight (BW), head circumference (HC), and birth length (BL) were collected, and weight to head circumference ratio (WHC, kg/m), body mass index (BMI, kg/m(2)) and Ponderal Index (PI, kg/m(3)) were calculated. Multivariate linear and logistic regression models were used to examine the effects of HLS during the second and third trimesters on anthropometric outcomes at birth, respectively. Results: In fully adjusted models, we found a negative association between second and third-trimester HLS and off-spring HC and a positive relationship between second-trimester HLS and BL (p<0.05). Neonates with mothers in the highest HLS tertile had a 5.6% relatively lower HC and 2.3% relatively longer body length than women in the lowest tertile. Each additional unit in third-trimester HLS had an associated decrease in HC by 0.96 cm. None of the associations between HLS and BW, WHC, BMI, and PI of offspring were observed. Conclusions: A healthy lifestyle score may significantly impact offspring head circumference and body length, supporting the important role of healthy lifestyles in improving the health of offspring.