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Maternal obesity and offspring adiposity trajectories during early childhood: a longitudinal study from the PONCH cohort

Åberg S, Andersson-Hall U, Kristiansson E, Holmäng A · 5 Jul 2026

Abstract

Abstract Background/Objectives Maternal obesity and gestational diabetes mellitus (GDM) are increasingly common metabolic conditions during pregnancy, potentially affecting offspring metabolic development and adiposity across childhood. We investigated longitudinal adiposity and anthropometric development in preschool children born to women with normal weight, obesity, or GDM, and explored associations between maternal metabolic markers during pregnancy and offspring adiposity outcomes. Subjects/Methods The Pregnancy Obesity Nutrition Child Health (PONCH) cohort is a longitudinal mother–child study including offspring of women with normal weight (NW), obesity (OB), or GDM during pregnancy. Repeated anthropometric measurements and body composition assessments by air-displacement plethysmography were obtained annually between ages 2 and 6 years in 178 children (NW, n = 80; OB, n = 57; GDM, n = 41). Longitudinal differences between maternal groups were evaluated using mixed-effects models. Results Children in the OB group exhibited higher adiposity throughout preschool age compared with the NW group, including BMI (16.9 vs 16.2kg/m², p < 0.001), body fat percentage (28.0% vs 24.9%, p < 0.001), and fat mass (5.22 vs 4.35kg, p < 0.001). Differences became more pronounced with age and were generally greater in boys, whereas adiposity profiles remained similar between the GDM and NW groups. Maternal adiposity-related markers showed progressively stronger associations with offspring adiposity across childhood, including fat mass in 6-year-old boys (r = 0.60, p < 0.001) and girls (r = 0.40, p = 0.04). Maternal glycaemic markers showed limited associations, primarily observed at 2 years of age in girls, whereas associations at later ages were sparse and inconsistent. Conclusions Offspring of women with obesity exhibited progressively greater adiposity throughout preschool age compared with offspring of women with normal weight and GDM. These findings suggest that maternal obesity may represent a more sustained determinant of offspring adiposity development during early childhood and support early preventive strategies. Continued longitudinal follow-up will be important to determine whether these differences persist into later childhood and adolescence.