Abstract
BackgroundAccording to the Developmental Origins of Health and Diseases concept, exposures in the preconception period may be critical. For the first time, we evaluated the effect of preconception poor anthropometric status on infant’s growth in sub-Saharan Africa.MethodsA mother-child cohort was followed prospectively from preconception to 1 year old in Benin. Maternal anthropometric status was assessed by pre-pregnancy body mass index (BMI), approximated by BMI at the 1st antenatal visit before 7weeks’ gestation, and gestational weight gain (GWG). BMI was categorized as underweight, normal, overweight and obesity according to World Health Organization standards. GWG was categorized as low (<7kg), mild (7-12kg) and high (>12kg). In infant, stunting and wasting were defined as length-for-age and weight-for-length z-scores <-2SD, respectively. We evaluated the association between BMI/GWG and infant’s weight and length at birth and during the first year of life, as well as with stunting and wasting at 12 months using mixed linear and logistic regression models.ResultsIn multivariate, preconceptional underweight was associated with a lower infant’s weight at birth and during the first year (-164g, 95%CI [-307;-22] and -342g, 95%CI [-624;-61], respectively), and with a higher risk of stunting at 1 year of age (aOR=3.98, 95%CI [1.01;15.85]). Furthermore, preconceptional obesity and a high GWG were associated with a higher weight and length at birth and during the first year.ConclusionUnderweight and obesity before conception as well as GWG were associated with infant’s growth. These results argue for preventive interventions starting as early as the preconception period to support child long-term health.