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Lena Lewis1, Suzanne Baker1, PhD, MPH*
Department of Public Health, College of Liberal Arts and Sciences
Relationship Between Maternal
Weight and Child Respiratory
Problems
The effects of maternal overweight or obesity during pregnancy on the health of the
mother have been studied extensively but the effects on the child are widely unknown. A
potential consequence that gestational weight gain, overweight, or obesity will have on
child health is poor respiratory outcomes. In this study, the extent of maternal overweight
or obesity during pregnancy as a potential risk factor for poor child respiratory outcomes
was investigated through a literature review of 15 research articles. It was hypothesized
that, as maternal weight increases, the likelihood of the offspring developing poor
respiratory outcomes will also increase. The results demonstrate that high prepregnancy
weight, pregnancy weight, and weight gain during pregnancy is positively associated with
poor child respiratory outcomes including child wheeze, child asthma, and child bronchitis.
These results remained consistent across all articles and some suggested that there is a
threshold at which maternal weight gain becomes a risk factor for poor child respiratory
outcomes. Child asthma was the most common child respiratory outcome that was
investigated, which merits the need for further research into other types of child
respiratory conditions. The findings suggest the need for the update of recommendations
to pregnant women with regards to how weight gain during pregnancy will affect the
health of their child. These updates should be geared directly towards pregnant women as
well as healthcare professionals that provide care to pregnant women.
Abstract
Introduction
• Maternal health is linked to child health.
• Gestational overweight/obesity linked to obesity, cardiac issues, and high birth weight of
child.
• Effects of maternal weight on child respiratory outcomes largely unknown.
• 48% of women gain more weight than recommended during pregnancy.
• 23.7% of women are overweight prior to pregnancy.
• 20.7% of women are obese prior to pregnancy.
• Indicators:
• GWG: gestational weight gain.
• Prepregnancy weight
• Pregnancy weight
• Most common respiratory outcomes:
• Asthma
• Wheeze
As maternal weight increases, the likelihood of the offspring
developing poor respiratory outcomes will also increase.
Methodology/Experimental
• Literature review.
• Databases consulted: PubMed, JAMA Network, Wiley Online Library, European Research
Journal, Proquest, ScienceDirect, Springer Link, NCBI, and CDC.
• Search terms: gestational weight gain, child respiratory, child lungs, child asthma, child
wheeze maternal overweight, and maternal obesity. Search terms were later expanded.
• Exclusion criteria: multiple birth pregnancy, fetal lung status, gestational illnesses as
mediating factors, and articles published prior to 2005.
• Total of 15 articles included in the review.
Results and Discussion
• Positive association between maternal overweight/obesity and poor child respiratory
outcomes.
• Child asthma and child wheeze were the outcomes most investigated.
• Prepregnancy weight: One study only found an association if mother also had respiratory
illness. Another found that association was only significant if effect of GWG also present.
• GWG: Two studies found no association between GWG and child respiratory illness.
• Pregnancy weight: Two studies found that no association existed if the mother was
overweight but did exist if the mother was obese.
• Suggests that there is a point at which maternal weight becomes dangerous for the
health of the child.
* One study investigated both asthma and wheeze and was therefore included in both of the sections above.
Results and Discussion
Conclusions and Limitations
• Limitations:
• Exclusion of research prior to 2005.
• Exclusion of multiple birth pregnancies.
• Exclusion of studies that looked at child obesity or illnesses as a mediating factor.
• Inclusion of studies with mothers who had preexisting conditions.
• Association between overweight or obesity during pregnancy, whether it presents prior to
pregnancy or during pregnancy, and poor child respiratory outcomes.
• Supports hypothesis.
• Need for additional research.
• Investigate additional respiratory outcomes.
• Investigate weight gain during specific trimester.
• Public health professionals responsible for educating healthcare professionals and general
public.
• General public can be contacted through billboards, commercials, and social media.
References
Chen, Y., Zhu, J., Lyu, J., Xia, Y., Ying, Y., Hu, Y., Qu, J., Tong, S., & Li, S. (2020). Association of maternal prepregnancy weight and gestational
weight gain with children’s allergic diseases. JAMA Network Open, 3(9). https://doi.org/10.1001/jamanetworkopen.2020.15643
Dumas, O., Varraso, R., Gillman, M. W., Field, A. E., & Camargo, C. A. (2016). Longitudinal study of maternal body mass index, gestational
weight gain, and offspring asthma. European Journal of Allergy and Clinical Immunology, 71(9), 1295–1304.
https://doi.org/10.1111/all.12876
Eising, J. B., Uiterwaal, C. S., & van der Ent, C. K. (2015). Maternal body mass index, neonatal lung function and respiratory symptoms in
childhood. European Respiratory Journal, 46(5), 1342–1349. https://doi.org/10.1183/13993003.00784-2014
Harpsøe, M. C., Basit, S., Bager, P., Wohlfahrt, J., Benn, C. S., Nøhr, E. A., Linneberg, A., & Jess, T. (2013). Maternal obesity, gestational
weight gain, and risk of asthma and atopic disease in offspring: A study within the Danish national birth cohort. Journal of Allergy
and Clinical Immunology, 131(4), 1033–1040. https://doi.org/10.1016/j.jaci.2012.09.008
Leddy, M. A., Power, M. L., & Schulkin, J. (2008). The impact of maternal obesity on maternal and fetal health. Reviews in obstetrics &
gynecology, 1(4), 170–178.
Leermakers, E. T., Sonnenschein-van der Voort A. M., Gaillard, R., Hofman, A., Jongste, J. C. D., Jaddoe, V. W., & Duijts, L. (2013). Maternal
weight, gestational weight gain and preschool wheezing: The generation R study. European Respiratory Journal, 42(5), 1234–1243.
https://doi.org/10.1183/09031936.00148212
Lowe, A., Bråbäck, L., Ekeus, C., Hjern A., & Forsberg, B. (2011). Maternal obesity during pregnancy as a risk for early-life asthma. Journal of
Allergy and Clinical Immunology, 128(5), 1107-1109.e2. https://doi.org/10.1016/j.jaci.2011.08.025
Mayo Clinic Staff. (2020, February 8). High-risk pregnancy: Know what to expect. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-
week-by-week/in-depth/high-risk-pregnancy/art-20047012.
Murphy, V. E., Jensen, M. E., Robijn, A. L., Wright, T. K., Mattes, J., Collison, A., & Gibson, P. G. (2020). How maternal BMI modifies the
impact of personalized asthma management in pregnancy. The Journal of Allergy and Clinical Immunology: In Practice, 8(1), 219–
228. https://doi.org/10.1016/j.jaip.2019.06.033
Parsons, E. C., Patel, K., Tran, B. T., & Littman, A. J. (2013). Maternal pre-gravid obesity and early childhood respiratory hospitalization: A
population-based case-control study. Maternal and Child Health Journal, 17(6), 1095-1102. http://doi.org/10.1007/s10995-012-
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Polinski, K. J., Liu, J., Boghossian, N. S., & Mclain, A. C. (2017). Maternal obesity, gestational weight gain, and asthma in offspring.
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References
Rajappan, A., Pearce, A., Inskip, H. M., Baird, J., Crozier, S. R., Cooper, C., Godfrey, K. M., Roberts, G., Lucas, J., & Pike, K. C. (2017). Maternal
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https://doi.org/10.1002/ppul.23779
Reichman, N. E., & Nepomnyaschy, L. (2007). Maternal pre-pregnancy obesity and diagnosis of asthma in offspring at age 3 years. Maternal
and Child Health Journal, 12(6), 725–733. https://doi.org/10.1007/s10995-007-0292-2
Rusconi, F., Galassi, C., Forastiere, F., Bellasio, M., Sario, M. D., Ciccone, G., Brunetti, L., Chellini, E., Corbo, G., Grutta, S. L., Lombardi, E.,
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Relationship Between Maternal Weight and Child Respiratory Problems

  • 1.
  • 2. Lena Lewis1, Suzanne Baker1, PhD, MPH* Department of Public Health, College of Liberal Arts and Sciences Relationship Between Maternal Weight and Child Respiratory Problems
  • 3. The effects of maternal overweight or obesity during pregnancy on the health of the mother have been studied extensively but the effects on the child are widely unknown. A potential consequence that gestational weight gain, overweight, or obesity will have on child health is poor respiratory outcomes. In this study, the extent of maternal overweight or obesity during pregnancy as a potential risk factor for poor child respiratory outcomes was investigated through a literature review of 15 research articles. It was hypothesized that, as maternal weight increases, the likelihood of the offspring developing poor respiratory outcomes will also increase. The results demonstrate that high prepregnancy weight, pregnancy weight, and weight gain during pregnancy is positively associated with poor child respiratory outcomes including child wheeze, child asthma, and child bronchitis. These results remained consistent across all articles and some suggested that there is a threshold at which maternal weight gain becomes a risk factor for poor child respiratory outcomes. Child asthma was the most common child respiratory outcome that was investigated, which merits the need for further research into other types of child respiratory conditions. The findings suggest the need for the update of recommendations to pregnant women with regards to how weight gain during pregnancy will affect the health of their child. These updates should be geared directly towards pregnant women as well as healthcare professionals that provide care to pregnant women. Abstract
  • 4. Introduction • Maternal health is linked to child health. • Gestational overweight/obesity linked to obesity, cardiac issues, and high birth weight of child. • Effects of maternal weight on child respiratory outcomes largely unknown. • 48% of women gain more weight than recommended during pregnancy. • 23.7% of women are overweight prior to pregnancy. • 20.7% of women are obese prior to pregnancy. • Indicators: • GWG: gestational weight gain. • Prepregnancy weight • Pregnancy weight • Most common respiratory outcomes: • Asthma • Wheeze As maternal weight increases, the likelihood of the offspring developing poor respiratory outcomes will also increase.
  • 5. Methodology/Experimental • Literature review. • Databases consulted: PubMed, JAMA Network, Wiley Online Library, European Research Journal, Proquest, ScienceDirect, Springer Link, NCBI, and CDC. • Search terms: gestational weight gain, child respiratory, child lungs, child asthma, child wheeze maternal overweight, and maternal obesity. Search terms were later expanded. • Exclusion criteria: multiple birth pregnancy, fetal lung status, gestational illnesses as mediating factors, and articles published prior to 2005. • Total of 15 articles included in the review.
  • 6. Results and Discussion • Positive association between maternal overweight/obesity and poor child respiratory outcomes. • Child asthma and child wheeze were the outcomes most investigated. • Prepregnancy weight: One study only found an association if mother also had respiratory illness. Another found that association was only significant if effect of GWG also present. • GWG: Two studies found no association between GWG and child respiratory illness. • Pregnancy weight: Two studies found that no association existed if the mother was overweight but did exist if the mother was obese. • Suggests that there is a point at which maternal weight becomes dangerous for the health of the child. * One study investigated both asthma and wheeze and was therefore included in both of the sections above.
  • 8. Conclusions and Limitations • Limitations: • Exclusion of research prior to 2005. • Exclusion of multiple birth pregnancies. • Exclusion of studies that looked at child obesity or illnesses as a mediating factor. • Inclusion of studies with mothers who had preexisting conditions. • Association between overweight or obesity during pregnancy, whether it presents prior to pregnancy or during pregnancy, and poor child respiratory outcomes. • Supports hypothesis. • Need for additional research. • Investigate additional respiratory outcomes. • Investigate weight gain during specific trimester. • Public health professionals responsible for educating healthcare professionals and general public. • General public can be contacted through billboards, commercials, and social media.
  • 9. References Chen, Y., Zhu, J., Lyu, J., Xia, Y., Ying, Y., Hu, Y., Qu, J., Tong, S., & Li, S. (2020). Association of maternal prepregnancy weight and gestational weight gain with children’s allergic diseases. JAMA Network Open, 3(9). https://doi.org/10.1001/jamanetworkopen.2020.15643 Dumas, O., Varraso, R., Gillman, M. W., Field, A. E., & Camargo, C. A. (2016). Longitudinal study of maternal body mass index, gestational weight gain, and offspring asthma. European Journal of Allergy and Clinical Immunology, 71(9), 1295–1304. https://doi.org/10.1111/all.12876 Eising, J. B., Uiterwaal, C. S., & van der Ent, C. K. (2015). Maternal body mass index, neonatal lung function and respiratory symptoms in childhood. European Respiratory Journal, 46(5), 1342–1349. https://doi.org/10.1183/13993003.00784-2014 Harpsøe, M. C., Basit, S., Bager, P., Wohlfahrt, J., Benn, C. S., Nøhr, E. A., Linneberg, A., & Jess, T. (2013). Maternal obesity, gestational weight gain, and risk of asthma and atopic disease in offspring: A study within the Danish national birth cohort. Journal of Allergy and Clinical Immunology, 131(4), 1033–1040. https://doi.org/10.1016/j.jaci.2012.09.008 Leddy, M. A., Power, M. L., & Schulkin, J. (2008). The impact of maternal obesity on maternal and fetal health. Reviews in obstetrics & gynecology, 1(4), 170–178. Leermakers, E. T., Sonnenschein-van der Voort A. M., Gaillard, R., Hofman, A., Jongste, J. C. D., Jaddoe, V. W., & Duijts, L. (2013). Maternal weight, gestational weight gain and preschool wheezing: The generation R study. European Respiratory Journal, 42(5), 1234–1243. https://doi.org/10.1183/09031936.00148212 Lowe, A., Bråbäck, L., Ekeus, C., Hjern A., & Forsberg, B. (2011). Maternal obesity during pregnancy as a risk for early-life asthma. Journal of Allergy and Clinical Immunology, 128(5), 1107-1109.e2. https://doi.org/10.1016/j.jaci.2011.08.025 Mayo Clinic Staff. (2020, February 8). High-risk pregnancy: Know what to expect. https://www.mayoclinic.org/healthy-lifestyle/pregnancy- week-by-week/in-depth/high-risk-pregnancy/art-20047012. Murphy, V. E., Jensen, M. E., Robijn, A. L., Wright, T. K., Mattes, J., Collison, A., & Gibson, P. G. (2020). How maternal BMI modifies the impact of personalized asthma management in pregnancy. The Journal of Allergy and Clinical Immunology: In Practice, 8(1), 219– 228. https://doi.org/10.1016/j.jaip.2019.06.033 Parsons, E. C., Patel, K., Tran, B. T., & Littman, A. J. (2013). Maternal pre-gravid obesity and early childhood respiratory hospitalization: A population-based case-control study. Maternal and Child Health Journal, 17(6), 1095-1102. http://doi.org/10.1007/s10995-012- 1092-x Polinski, K. J., Liu, J., Boghossian, N. S., & Mclain, A. C. (2017). Maternal obesity, gestational weight gain, and asthma in offspring. Preventing Chronic Disease, 14(E109). https://doi.org/10.5888/pcd14.170196
  • 10. References Rajappan, A., Pearce, A., Inskip, H. M., Baird, J., Crozier, S. R., Cooper, C., Godfrey, K. M., Roberts, G., Lucas, J., & Pike, K. C. (2017). Maternal body mass index: Relation with infant respiratory symptoms and infections. Pediatric Pulmonology, 52(10), 1291-1299. https://doi.org/10.1002/ppul.23779 Reichman, N. E., & Nepomnyaschy, L. (2007). Maternal pre-pregnancy obesity and diagnosis of asthma in offspring at age 3 years. Maternal and Child Health Journal, 12(6), 725–733. https://doi.org/10.1007/s10995-007-0292-2 Rusconi, F., Galassi, C., Forastiere, F., Bellasio, M., Sario, M. D., Ciccone, G., Brunetti, L., Chellini, E., Corbo, G., Grutta, S. L., Lombardi, E., Piffer, S., Talassi, F., Biggeri, A., & Pearce, N. (2007). Maternal complications and procedures in pregnancy and at birth and wheezing phenotypes in children. American Journal of Respiratory and Critical Care Medicine, 175(1), 16–21. https://doi.org/10.1164/rccm.200512-1978oc Scholtens, S., Wijga, A. H., Brunekreef, B., Kerkhof, M., Postma, D. S., Oldenwening, M., De Jongste, J. C., & Smit, H. A. (2010). Maternal overweight before pregnancy and asthma in offspring followed for 8 years. International Journal of Obesity, 34(4), 606-613. http://doi.org/0.1038/ijo.2009.194 Story, R. E., Hong, X., Kumar, R., Yu, Y., Pongracic, J., & Wang, X. (2009). Maternal pre-pregnancy obesity is associated with recurrent wheezing in children. Journal of Allergy and Clinical Immunology, 123(2). http://doi.org/10.1016/j.jaci.2008.12.996 Wright, R., Fisher, K., Chiu, Y. M., Wright, R. O., Fein, R., Cohen, S., & Coull, B. A. (2013). Disrupted prenatal maternal cortisol, maternal obesity, and childhood wheeze. Insights into prenatal programming. American Journal of Respiratory and Critical Care Medicine, 187(11), 1186-1193. https://doi.org/10.1164/rccm.201208-1530OC