Catch-up growth in early infancy is associated with overweight in childhood (1), but seems to lead to benefits in neurodevelopment in SGA infants (2, 3). This rises the question whether catch-up growth should be avoided or not (4). To our knowledge, there are no studies on the effect of early rapid growth on neurodevelopment in AGA and LGA infants.

We performed a pre-analysis on a merged dataset from four independent clinical trials originally designed to test the effect of LCPUFA supplementation in term and preterm infants (5-8). The data were provided in the framework of EARNEST (9) and included a total of 871 children (495 term, 376 preterm). Neurodevelopment had been assessed by Bayley Scales of Infant Development II (BSID II) at 18 months (10).

Our results indicate a possible benefit of rapid growth in respect to neurodevelopment in both term and preterm infants. However, the analysis is limited by its relatively small sample size and by the assessment of neurodevelopment by Bayley Scales at 18 months which may be an outcome variable of minor relevance.

Within ALSPAC, the required data to answer this research question are available. We would require the following variables from the data set:

o Weight, height and head circumference at birth, 4, 8 and 12 months

o Assessment of cognitive function (at the latest available age)

o Sex

o Gestational age

o Maternal age

o Maternal and paternal education / profession

o Smoking in pregnancy

o Breastfeeding

References:

1. Ong KK, Ahmed ML, Emmett PM, Preece MA, Dunger DB. Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. BMJ 2000;320:967-71.

2. Lundgren EM, Cnattingius S, Jonsson B, Tuvemo T. Intellectual and psychological performance in males born small for gestational age with and without catch-up growth.Pediatr Res 2001;50:91-6.

3. Latal-Hajnal B, von Siebenthal K, Kovari H, Bucher HU, Largo RH.Postnatal growth in VLBW infants: significant association with neurodevelopmental outcome. J Pediatr 2003;143:163-70.

4. Postnatal growth, neurodevelopment and altered adiposity after preterm birth--from a clinical nutrition perspective. Acta Paediatr 2006;95:909-17.

5. Bouwstra H, Dijck-Brouwer DAJ, Boehm G, Boersma ER, Muskiet FAJ, Hadders-Algra M. Long-chain polyunsaturated fatty acids and neurological development outcome at 18 months in healthy term infants. Acta Paediatr 2004;94:26-32.

6. Lucas A, Stafford M, Morley R, et al. Efficacy and safety of long-chain polyunsaturated fatty acid supplementation of infant-formula milk: a randomised trial. Lancet 1999;354:1948-54.

7. Fewtrell MS, Morley R, Abbott RA, et al. Double-blind, randomized trial of long-chain polyunsaturated fatty acid supplementation in formula fed to preterm infants. Pediatrics 2002;110:73-82.

8. Fewtrell MS, Abott RA, Kennedy K, et al. Randomized, double-blind trial of long-chain polyunsaturated fatty acid supplementation with fish oil and borage oil in preterm infants. J Pediatr 2004;144:471-9.

9. Fewtrell MS; EARNEST consortium. Session 6: Infant nutrition: future research developments in Europe. EARNEST, the early nutrition programming project: EARly Nutrition programming - long-term Efficacy and Safety Trials and integrated epidemiological, genetic, animal, consumer and economic research. Proc Nutr Soc 2007;66:435-41.

10. Bayley N. Bayley Scales of Infant Development, 2nd edn.San Antonio, TX: Psychological Corporation; 1993.

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A growing body of epidemiological and experimental evidence indicates that the prenatal period is a sensitive period for later health outcomes, and prenatal priming is a term increasingly used to describe the long term effects on health outcomes programmed by prenatal and early postnatal factors (1). While the roles of maternal obesity (2), maternal smoking in pregnancy (3), gestational diabetes and birth weight (4) are established, there are only few publications assessing the association between gestational weight gain (GWG) and childhood obesity (5-8).

The potential impact of GWG is of particular interest since increases in GWG have been reported in several populations (9, 10), and because GWG may be modified by diet or exercise (11, 12).

A cooperative analysis of the ALSPAC data of Andy Ness and Richard Martin and collaborators from our institution to assess these interdependencies is proposed. We would require the following variables from the data set:

Child:

* Weight and height at latest available age

* DXA at age of 11 years

* Birth weight

* Sex and age

* Gestational age at birth

* TV consumption

* Physical activity (self-reported and objective, if possible)

* Energy intake (calories, protein, fat, carbohydrates, saturated / unsaturated fat)

Mother:

* Weight gain in pregnancy

* Age at delivery

* BMI before pregnancy

* Education / profession

* Smoking in pregnancy

* Breastfeeding

* Married / unmarried

* Gestational diabetes

* Diabetes mellitus

* Pre-eclampsia

* Maternal birth weight

* Parity

References:

1. Gillman MW. Developmental origins of health and disease. N Engl J Med. Oct 27 2005;353(17):1848-1850.

2. Whitaker RC. Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy.Pediatrics. Jul 2004;114(1):e29-36.

3. Von Kries R, Bolte G, Baghi L, Tochke AM.Parental smoking and childhood obesity - is maternal smoking in pregnancy the critical exposure? Int J Epidemiol. 2007;doi:10.1093/IJE/dym239.

4. Oken E, Gillman MW. Fetal origins of obesity. Obes Res. Apr 2003;11(4):496-506.

5. Moreira P, Padez C, Mourao-Carvalhal I, Rosado V. Maternal weight gain during pregnancy and overweight in Portuguese children. Int J Obes (Lond). Apr 2007;31(4):608-614.

6. Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol. Apr 2007;196(4):322 e321-328.

7. Schack-Nielsen L, Mortensen EL, Michaelsen KF, TIA S. High maternal pregnancy weight gain is associated with an increased risk of obesity in childhood and adulthood independent of maternal BMI [abstract]. Pediatr Res. 2005;58:1020.

8. Seidman DS, Laor A, Shmer J, Galr R, DK S. Excessive maternal weight gain during pregnancy and being overweight at 17 years of age. [abstract]. Pediatr Res. 1996;39:112A.

9. Schieve LA, Cogswell ME, Scanlon KS. Trends in pregnancy weight gain within and outside ranges recommended by the Institute of Medicine in a WIC population.Matern Child Health J. Jun 1998;2(2):111-116.

10. Bergmann RL, Richter R, Bergmann KE, Plagemann A, Brauer M, Dudenhausen JW.Secular trends in neonatal macrosomia in Berlin: influences of potential determinants. Paediatr Perinat Epidemiol. Jul 2003;17(3):244-249.

11. Artal R, Catanzaro RB, Gavard JA, Mostello DJ, Friganza JC. A lifestyle intervention of weight-gain restriction: diet and exercise in obese women with gestational diabetes mellitus. Appl Physiol Nutr Metab. Jun 2007;32(3):596-601.

12. Wolff S, Legarth J, Vangsgaard K, Toubro S, Astrup A. A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. Int J Obes (Lond). Mar 2008;32(3):495-501.