{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:40:50Z","timestamp":1791420050511,"version":"4.3.3"},"reference-count":46,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,7,29]],"date-time":"2023-07-29T00:00:00Z","timestamp":1690588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Pre-pregnancy overweight and obesity in reproductive-aged women becomes a growing tendency in middle- and high-income populations. This study aimed to evaluate whether maternal excess body mass index (BMI) before gestation is associated with children\u2019s anthropometric characteristics, as well as perinatal and postnatal outcomes. Methods: This was a cross-sectional study performed on 5198 children aged 2\u20135 years old and their paired mothers, assigned from 9 different areas of Greece. Maternal and childhood anthropometric data, as well as perinatal and postnatal outcomes, were collected from medical history records or validated questionnaires. Results: Prevalences of 24.4% and 30.6% of overweight\/obesity were recorded for the enrolled children and their mothers 2\u20135 years postpartum. Maternal pre-pregnancy overweight\/obesity was more frequently observed in older mothers and female children, and was also associated with high childbirth weight, preterm birth, high newborn ponderal index, caesarean section delivery, diabetes type 1, and childhood overweight\/obesity at pre-school age. In multivariate analysis, maternal pre-pregnancy overweight\/obesity was independently associated with a higher risk of childhood overweight\/obesity at pre-school age, as well as with a higher increased incidence of childbirth weight, caesarean section delivery, and diabetes type 1. Conclusions: Maternal overweight\/obesity rates before gestation were related with increased childhood weight status at birth and 2\u20135 years postpartum, highlighting the necessity of encouraging healthy lifestyle promotion, including healthier nutritional habits, and focusing on obesity population policies and nutritional interventions among women of reproductive age.<\/jats:p>","DOI":"10.3390\/nu15153384","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T01:48:50Z","timestamp":1690768130000},"page":"3384","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association of Maternal Pre-Pregnancy Overweight and Obesity with Childhood Anthropometric Factors and Perinatal and Postnatal Outcomes: A Cross-Sectional Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7764-3544","authenticated-orcid":false,"given":"Eleni","family":"Pavlidou","sequence":"first","affiliation":[{"name":"Department of Food Science and Nutrition, School of the Environment, University of the Aegean, Myrina, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4923-484X","authenticated-orcid":false,"given":"Dimitrios","family":"Papandreou","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Mantzorou","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanos","family":"Tyrovolas","sequence":"additional","affiliation":[{"name":"Instituto de Salud Carlos III, Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios N.","family":"Kiortsis","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evmorfia","family":"Psara","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of the Environment, University of the Aegean, Myrina, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6408-6128","authenticated-orcid":false,"given":"Sousana K.","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marios","family":"Yfantis","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of the Environment, University of the Aegean, Myrina, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Spanoudaki","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Antasouras","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of the Environment, University of the Aegean, Myrina, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Mentzelou","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of the Environment, University of the Aegean, Myrina, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2878-4831","authenticated-orcid":false,"given":"Constantinos","family":"Giaginis","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of the Environment, University of the Aegean, Myrina, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1038\/oby.2007.621","article-title":"Trends in Pre-Pregnancy Obesity in Nine States, 1993\u20132003","volume":"15","author":"Kim","year":"2007","journal-title":"Obesity"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1159\/000525792","article-title":"Prevalence and Correlates of Overweight and Obesity in 12 European Countries in 2017\u20132018","volume":"15","author":"Stival","year":"2022","journal-title":"Obes. Facts"},{"key":"ref_3","first-page":"E36","article-title":"Current Data in Greek Children Indicate Decreasing Trends of Obesity in the Transition from Childhood to Adolescence; Results from the National Action for Children\u2019s Health (EYZHN) Program","volume":"59","author":"Tambalis","year":"2018","journal-title":"J. Prev. Med. Hyg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1038\/oby.2009.188","article-title":"Eleven-Year Prevalence Trends of Obesity in Greek Children: First Evidence That Prevalence of Obesity Is Leveling Off","volume":"18","author":"Tambalis","year":"2010","journal-title":"Obesity"},{"key":"ref_5","unstructured":"(2022, September 02). State of Inequality: Reproductive, Maternal, Newborn and Child Health. Available online: https:\/\/www.who.int\/data\/inequality-monitor\/publications\/report_2015_rmnch."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.3109\/14767058.2015.1081167","article-title":"Risk of Adverse Pregnancy Outcomes Stratified for Pre-Pregnancy Body Mass Index","volume":"29","author":"Wei","year":"2016","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"287.e1","DOI":"10.1016\/j.ajog.2015.09.093","article-title":"Effect of Obesity on Neonatal Outcomes in Pregnancies with Preterm Premature Rupture of Membranes","volume":"214","author":"Faucett","year":"2016","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/jhn.12999","article-title":"Overweight, Obesity and Excessive Weight Gain in Pregnancy as Risk Factors for Adverse Pregnancy Outcomes: A Narrative Review","volume":"35","author":"Pearce","year":"2022","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1001\/jama.289.1.76","article-title":"Prevalence of Obesity, Diabetes, and Obesity-Related Health Risk Factors, 2001","volume":"289","author":"Mokdad","year":"2003","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"436","DOI":"10.2105\/AJPH.91.3.436","article-title":"Pregnancy Complications and Outcomes among Overweight and Obese Nulliparous Women","volume":"91","author":"Baeten","year":"2001","journal-title":"Am. J. Public. Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s00404-006-0219-y","article-title":"Effect of Prepregnancy Body Mass Index Categories on Obstetrical and Neonatal Outcomes","volume":"275","author":"Abenhaim","year":"2007","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1186\/2047-783X-14-5-216","article-title":"Impact of Maternal Body Mass Index on Neonatal Outcome","volume":"14","author":"Kalk","year":"2009","journal-title":"Eur. J. Med. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s00404-009-1349-9","article-title":"Risks of Pregnancy and Birth in Obese Primiparous Women: An Analysis of German Perinatal Statistics","volume":"283","author":"Briese","year":"2011","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_14","first-page":"33","article-title":"Blood Sugar in Newborn Infants of Diabetic Mothers","volume":"15","author":"Pedersen","year":"1954","journal-title":"Acta Endocrinol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3449","DOI":"10.1093\/jn\/133.11.3449","article-title":"Low Preconception Body Mass Index Is Associated with Birth Outcome in a Prospective Cohort of Chinese Women","volume":"133","author":"Ronnenberg","year":"2003","journal-title":"J. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1111\/j.1467-789X.2008.00511.x","article-title":"The Impact of Maternal BMI Status on Pregnancy Outcomes with Immediate Short-Term Obstetric Resource Implications: A Meta-Analysis","volume":"9","author":"Heslehurst","year":"2008","journal-title":"Obes. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1038\/s41366-021-00946-8","article-title":"Impact of Pre-Pregnancy Body Mass Index and Gestational Weight Gain on the Risk of Maternal and Infant Pregnancy Complications in Korean Women","volume":"46","author":"Choi","year":"2022","journal-title":"Int. J. Obes."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"203","DOI":"10.3233\/NPM-1370313","article-title":"Pre-Pregnancy Obesity: Maternal, Neonatal and Childhood Outcomes","volume":"6","author":"Papachatzi","year":"2013","journal-title":"J. Neonatal Perinatal Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/j.1365-3016.2009.01034.x","article-title":"Maternal Obesity in Pregnancy and Respiratory Health in Early Childhood","volume":"23","author":"Stigum","year":"2009","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"9790","DOI":"10.1038\/s41598-021-88360-y","article-title":"Maternal Pre-Pregnancy Weight and Early Life Lower Respiratory Tract Infections in a Low-Income Urban Minority Birth Cohort","volume":"11","author":"Gutierrez","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1007\/s00125-017-4481-2","article-title":"Maternal Obesity as a Risk Factor for Early Childhood Type 1 Diabetes: A Nationwide, Prospective, Population-Based Case-Control Study","volume":"61","author":"Lindell","year":"2018","journal-title":"Diabetologia"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1017\/S1368980016002640","article-title":"Perinatal, Sociodemographic and Lifestyle Correlates of Increased Total and Visceral Fat Mass Levels in Schoolchildren in Greece: The Healthy Growth Study","volume":"20","author":"Moschonis","year":"2017","journal-title":"Public Health Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Papandreou, D., Mantzorou, M., Tyrovolas, S., Pavlidou, E., Antasouras, G., Psara, E., Poulios, E., Vasios, G.K., and Giaginis, C. (2022). Pre-Pregnancy Excess Weight Association with Maternal Sociodemographic, Anthropometric and Lifestyle Factors and Maternal Perinatal Outcomes. Nutrients, 14.","DOI":"10.3390\/nu14183810"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Mantzorou, M., Papandreou, D., Vasios, G.K., Pavlidou, E., Antasouras, G., Psara, E., Taha, Z., Poulios, E., and Giaginis, C. (2022). Exclusive Breastfeeding for at Least Four Months Is Associated with a Lower Prevalence of Overweight and Obesity in Mothers and Their Children after 2\u20135 Years from Delivery. Nutrients, 14.","DOI":"10.3390\/nu14173599"},{"key":"ref_25","unstructured":"World Health Organization (1995). Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Papadopoulou, S.K., Mentzelou, M., Pavlidou, E., Vasios, G.K., Spanoudaki, M., Antasouras, G., Sampani, A., Psara, E., Voulgaridou, G., and Tsourouflis, G. (2023). Caesarean Section Delivery Is Associated with Childhood Overweight and Obesity, Low Childbirth Weight and Postnatal Complications: A Cross-Sectional Study. Medicina, 59.","DOI":"10.3390\/medicina59040664"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1080\/09637486.2017.1330403","article-title":"Higher Adherence to Mediterranean Diet Prior to Pregnancy Is Associated with Decreased Risk for Deviation from the Maternal Recommended Gestational Weight Gain","volume":"69","author":"Koutelidakis","year":"2018","journal-title":"Int. J. Food Sci. Nutr."},{"key":"ref_28","unstructured":"World Health Organization (2006). WHO Child Growth Standards: Length\/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age: Methods and Development."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1136\/bmj.320.7244.1240","article-title":"Establishing a Standard Definition for Child Overweight and Obesity Worldwide: International Survey","volume":"320","author":"Cole","year":"2000","journal-title":"BMJ"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/j.jaci.2019.10.039","article-title":"Prenatal Polyunsaturated Fatty Acids and Child Asthma: Effect Modification by Maternal Asthma and Child Sex","volume":"145","author":"Rosa","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1089\/chi.2010.0419","article-title":"Associations Between Mothers\u2019 and Their Children\u2019s Weights at 4 Years of Age","volume":"6","author":"Olson","year":"2010","journal-title":"Child. Obes."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1097\/GRF.0000000000000043","article-title":"The Effect of Maternal Obesity on the Offspring","volume":"57","author":"Williams","year":"2014","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"881452","DOI":"10.3389\/fnut.2022.881452","article-title":"Body Composition in Preschool Children and the Association with Prepregnancy Weight and Gestational Weight Gain: An Ambispective Cohort Study","volume":"9","author":"Chen","year":"2022","journal-title":"Front. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"209.e1","DOI":"10.1016\/j.ajog.2009.04.019","article-title":"Differential Regulation of Genes for Fetoplacental Lipid Pathways in Pregnancy with Gestational and Type 1 Diabetes Mellitus","volume":"201","author":"Radaelli","year":"2009","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.3945\/ajcn.2008.27416","article-title":"Perinatal Risk Factors for Childhood Obesity and Metabolic Dysregulation","volume":"90","author":"Catalano","year":"2009","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/ejcn.2012.176","article-title":"Obesity in Adolescence Is Associated with Perinatal Risk Factors, Parental BMI and Sociodemographic Characteristics","volume":"67","author":"Birbilis","year":"2013","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/j.1467-789X.2007.00397.x","article-title":"Maternal Obesity and Risk of Cesarean Delivery: A Meta-Analysis","volume":"8","author":"Chu","year":"2007","journal-title":"Obes. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"9934","DOI":"10.1080\/14767058.2022.2076591","article-title":"Impact of Pre-Pregnancy Obesity on Cesarean Delivery Rates in Nulliparous Pregnant People Undergoing Induction of Labor","volume":"35","author":"Bebeau","year":"2022","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1111\/pedi.13248","article-title":"Maternal Prepregnancy BMI and Physical Activity and Type 1 Diabetes in the Offspring","volume":"22","author":"Azeredo","year":"2021","journal-title":"Pediatr. Diabetes"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"696812","DOI":"10.3389\/fcvm.2021.696812","article-title":"Maternal Obesity: A Focus on Maternal Interventions to Improve Health of Offspring","volume":"8","author":"Shrestha","year":"2021","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1093\/eurpub\/ckz223","article-title":"The Effect of Prenatal Maternal Physical Activity and Lifestyle in Perinatal Outcome: Results from a Greek Study","volume":"30","author":"Babili","year":"2020","journal-title":"Eur. J. Public Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1159\/000520811","article-title":"Early Nutrition and Later Excess Adiposity during Childhood: A Narrative Review","volume":"95","author":"Mesa","year":"2022","journal-title":"Horm. Res. Paediatr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.advnut.2023.04.011","article-title":"Mediterranean Diet-Based Interventions to Improve Anthropometric and Obesity Indicators in Children and Adolescents: A Systematic Review with Meta-Analysis of Randomized Controlled Trials","volume":"14","author":"Kales","year":"2023","journal-title":"Adv. Nutr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"225","DOI":"10.7570\/jomes.2019.28.4.225","article-title":"Nutritional Management in Childhood Obesity","volume":"28","author":"Kim","year":"2019","journal-title":"J. Obes. Metab. Syndr."},{"key":"ref_45","first-page":"E4","article-title":"Foods of the Mediterranean diet: Tomato, olives, chili pepper, wheat flour and wheat germ","volume":"63","author":"Naureen","year":"2022","journal-title":"J. Prev. Med. Hyg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/hpm.2881","article-title":"Evaluating Mediterranean diet adherence in university student populations: Does this dietary pattern affect students\u2019 academic performance and mental health?","volume":"35","author":"Antonopoulou","year":"2020","journal-title":"Int. J. Health Plann. Manag."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/15\/3384\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:22:24Z","timestamp":1760127744000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/15\/3384"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,29]]},"references-count":46,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["nu15153384"],"URL":"https:\/\/doi.org\/10.3390\/nu15153384","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,29]]}}}