We aimed to explore
whether or not maternal overweight/obesity is a risk factor for childhood
overweight/obesity in Malawi.  It is well
established that overweight and obesity are known risk factors for many health
problems, including coronary heart disease, type 2 diabetes, cancers,
hypertension, dyslipidemia, stroke, respiratory problems and osteoarthritis 62223. However, its association with
childhood overweight/obesity has never been tested in Malawian setting. In this
study, we have demonstrated that maternal overweight/obesity is linked to an
increased risk of childhood overweight/obesity.

Pre-pregnancy BMI
was not available in our datasets, therefore we anticipated that maternal BMI
categories at the time of the survey would be the same as that before the index
birth. This assumption was made base on previous research has reported that women
who are already overweight or obese
before a first pregnancy tend to retain or gain more weight after pregnancy
than average weight women 2425. Studies have reported that for
the newborn infant, the strongest predictor of later obesity is maternal
preconception BMI 2627. Thus, the mother’s preconception
weight status could be a marker of socioeconomic, environmental and genetic
risk for the child 28. Consequently, the genetic traits of the family can influence childhood
overweight/obesity risk 2930. It is well established that relatively
common obesity susceptibility gene variants interact with diet in three
possible ways: 1) by increasing saturated fat and refined carbohydrate consumption;
2) altering the lipid metabolism regulation, or
3) decreasing energy expenditure 28313233.

Excess gestational
weight gain is associated with risk for a number of poor health outcomes for both
the infant and the mother 343536. It was reported that excess
gestational weight gain is associated with fetal macrosomia 3738 and macrosomia has been implicated
in an increased risk of overweight or obesity in childhood and adulthood
compared to normal birthweight infants 39. This argument is supported by our
finding where infants born with very large/larger sizes than average had
increased risk of developing overweight/obesity later in their lives. Moreover,
it is well documented that many women tend to increase caloric intake and
decrease physical activity during pregnancy which is implicated in maternal
overweight/obesity and subsequent fetal macrosomia.