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Placental samples collected at delivery underwent RNA sequencing to obtain transcriptome data. BMI trajectories from birth to 4\u2009years (rising\u2010high\u2010, moderate\u2010, and low\u2010BMI) and overweight\/obesity at 4\u2009years were the childhood outcomes of interest. Differentially expressed genes (DEGs) associated with the outcomes were identified using DESeq2. Pathway enrichment analysis was performed on DEGs. Their causal relationships with outcomes were explored using the Mendelian randomization (MR) approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 22 and 23 DEGs associated with BMI trajectories and overweight\/obesity, respectively, with false discovery rates (FDR)\u2009&lt;\u20090.05. Pathway analysis of these DEGs identified 26 biological pathways, primarily related to the immune system. MR analysis suggested that one (\n                      <jats:italic>SSX2B<\/jats:italic>\n                      ) and eight DEGs (e.g.,\n                      <jats:italic>HSPA1A<\/jats:italic>\n                      ,\n                      <jats:italic>DNAJB1<\/jats:italic>\n                      ) might be causally associated with the BMI trajectories and overweight\/obesity (FDR &lt;\u20090.05), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study identified placental gene expression associated with early childhood growth outcomes. These findings suggest the potential important role of placental immune system genes in the development of childhood obesity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oby.70000","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T09:19:19Z","timestamp":1753435159000},"page":"1713-1724","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Placental Gene Expression Associated With Early Childhood Growth Trajectories and Obesity Risk"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7627-8493","authenticated-orcid":false,"given":"Hyo Young","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine College of Medicine, University of Tennessee Health Science Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luhang","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine College of Medicine, University of Tennessee Health Science Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison G.","family":"Paquette","sequence":"additional","affiliation":[{"name":"Center for Developmental Biology and Regenerative Medicine Seattle Children's Research Institute  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health Sciences University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"Bammler","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health Sciences University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Loftus","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health Sciences University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Enquobahrie","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaja Z.","family":"LeWinn","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole R.","family":"Bush","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of California San Francisco  San Francisco California USA"},{"name":"Department of Pediatrics University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine J.","family":"Karr","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health Sciences University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheela","family":"Sathyanarayana","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health Sciences University of Washington  Seattle Washington USA"},{"name":"Department of Epidemiology University of Washington  Seattle Washington USA"},{"name":"Department of Pediatrics University of Washington  Seattle Washington USA"},{"name":"Center for Child Health, Behavior, and Development Seattle Children's Research Institute  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5079-1803","authenticated-orcid":false,"given":"Qi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine College of Medicine, University of Tennessee Health Science Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"C. 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