Chiolero, Arnaud

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Adult maternal body size mattersFrom ARNAUD CHIOLERO1,21Institute of Social and Preventive Medicine (IUMSP), University Hospital Center and University of Lausanne, Lausanne,Switzerland and 2Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, CanadaCorresponding author. Institute of Social and Preventive Medicine (IUMSP), University Hospital Center, 17 rue du Bugnon, 1005Lausanne, Switzerland. E-mail: arnaud.chiolero@chuv.chHorta et al.1 elegantly demonstrated that maternal,but not paternal, birthweight and weight gain inearly childhood may be directly associated withnext-generation birthweight.However, the relative contributions of early andadult body weight (i.e. at the time of conception orduring pregnancy) may have been overlooked. It isnot clear whether the associations were still observedonce adult maternal body weight was accounted for.Maternal weight is a major determinant of off-spring’s birthweight. Pre-pregnancy body mass indexand gestational weight gain are both associated withinfant birthweight.2 While offspring’s adult body sizeis strongly determined by both parents’ size, maternalweight has greater influence than paternal weight onbirthweight.3 Maternal constraint is a complex regu-lator of fetal growth and, for instance, uterine andpelvic canal size may themselves determine fetalweight gain.4–7 Actually, matching fetal growth andmaternal size at the time of pregnancy helps the fetusto be delivered vaginally, irrespective of the paternal/fetal genotype.5 Thus, when the father is of large stat-ure, such a matching is critical to prevent a mother ofshort stature giving birth to large babies not suited toher uterus size or pelvic dimensions.Since birth size or early weight gain are directlyassociated with body size in adulthood,8 and maybewith uterus size,9 it may be expected that these fac-tors determine offspring’s birthweight. Still, compar-ing the relative contributions of early body size andadult body size would help assess the importance—ifnot the existence—of critical periods of maternalgrowth for the offspring’s birthweight. Such informa-tion may also help decide the best timing toimplement interventions to improve health acrossgenerations.Conflict of interest: None declared.References1 Horta BL, Gigante DP, Osmond C, Barros FC, Victora CG.Intergenerational effect of weight gain in childhood onoffspring birthweight. Int J Epidemiol 2009;38:724–32.2 Frederick IO, Williams MA, Sales AE, Martin DP, Killien M.Pre-pregnancy body mass index, gestational weight gain,and other maternal characteristics in relation to infantbirth weight. Matern Child Health J 2008;12:557–67.3 Griffiths LJ, Dezateux C, Cole TJ. Differential parentalweight and height contributions to offspring birthweightand weight gain in infancy. Int J Epidemiol 2007;36:104–7.4 Hanson MA, Godfrey KM. Commentary: maternal con-straint is a pre-eminent regulator of fetal growth. Int JEpidemiol 2008;37:252–54.5 Gluckman PD, Hanson MA. Maternal constraint of fetalgrowth and its consequences. Semin Fetal Neonatal Med2004;9:419–25.6 Dunger DB, Petry CJ, Ong KK. Genetics of size at birth.Diabetes Care 2007;30(Suppl 2):S150–55.7 Ounsted M, Scott A, Ounsted C. Transmission throughthe female line of a mechanism constraining humanfetal growth. Int J Epidemiol 2008;37:245–50.8 Druet C, Ong KK. Early childhood predictors of adultbody composition. Best Pract Res Clin Endocrinol Metab2008;22:489–502.9 Iba´n˜ez L, Potau N, Enriquez G, de Zegher F. Reduceduterine and ovarian size in adolescent girls born smallfor gestational age. Pediatr Res 2000;47:575–77.doi:10.1093/ije/dyp375Advance Access publication 16 January 2010 The Author 2010; all rights reserved.LETTERS TO THE EDITOR 1681

Adult maternal body size matters

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