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In a secondary aim, we explored potential bidirectional relationships, as higher weight-for-length z scores may impede motor development, and poor motor development may lead to obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>The design was an observational birth cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>We used data from the Nurture study, a birth cohort of predominately black women and their infants residing in the Southeastern USA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>666 women enrolled their infants in Nurture. We excluded infants with missing data on exposure, outcome or main covariates, leaving a total analytic sample of 425 infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary outcome<\/jats:title><jats:p>The outcome was weight-for-length z score, measured when infants were 3, 6, 9 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among infants, 64.7% were black, 18.8% were white and 16.9% were other\/multiple race. Mean (SD) breastfeeding duration was 17.6 (19.7) weeks. Just over one-third (38.5%) had an annual household income of &lt; $20\u2009000. After adjusting for potential confounders, higher motor development score was associated with lower weight-for-length z score (\u22120.004; 95%\u2009CI \u22120.001 to \u20130.007; p=0.01), mainly driven by associations among boys (\u22120.007; 95%\u2009CI \u22120.014 to \u20130.001; p=0.03) and not girls (0.001; 95%\u2009CI \u22120.005 to 0.008; p=0.62). Earlier crawling was the only milestone associated with a lower weight-for-length z score at 12 months (\u22120.328; 95%\u2009CI \u22120.585 to 0.072; p=0.012). However, this association appeared to be driven by male infants only (\u22120.461; 95%\u2009CI \u22120.825 to \u22120.096; p=0.01). Weight-for-length z score was unrelated to subsequent motor development score and was thus not bidirectional in our sample.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Higher motor development score and earlier crawling were associated with lower subsequent weight-for-length z score. However, this was primary true for male infants only. These findings contribute to the growing body of evidence suggesting that delayed motor development may be associated with later obesity.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2018-024440","type":"journal-article","created":{"date-parts":[[2019,1,15]],"date-time":"2019-01-15T14:52:04Z","timestamp":1547563924000},"page":"e024440","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Longitudinal associations of gross motor development, motor milestone achievement and weight-for-length z score in a racially diverse cohort of US infants"],"prefix":"10.1136","volume":"9","author":[{"given":"Azza","family":"Shoaibi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Neelon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Truls","family":"\u00d8stbye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara E","family":"Benjamin-Neelon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,1,15]]},"reference":[{"key":"2024051714353564000_9.1.e024440.1","doi-asserted-by":"crossref","first-page":"3869","DOI":"10.1111\/jocn.13802","article-title":"Overweight or obesity in children aged 0 to 6 and the risk of adult metabolic syndrome: A systematic review and meta-analysis","volume":"26","author":"Kim","year":"2017","journal-title":"J Clin Nurs"},{"key":"2024051714353564000_9.1.e024440.2","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2009.61"},{"key":"2024051714353564000_9.1.e024440.3","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1161\/HYPERTENSIONAHA.115.06635","article-title":"Early Weight Gain, Linear Growth, and Mid-Childhood Blood Pressure: A Prospective Study in Project Viva","volume":"67","author":"Perng","year":"2016","journal-title":"Hypertension"},{"key":"2024051714353564000_9.1.e024440.4","doi-asserted-by":"publisher","DOI":"10.1159\/000281141"},{"key":"2024051714353564000_9.1.e024440.5","unstructured":"Obesity prevention policies. 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