Maternal Underestimation of Child's Weight at Pre-School Age and Weight Development between Age 5 and 12 Years: The ABCD-Study

Background: Healthcare monitoring of child growth reduces with age, which may increase parental influences on children's weight development. This study aimed to examine the association between maternal underestimation of child's weight at age 5/6 and weight development between 5 and 12 years. Methods: We performed univariate and multivariate linear regression analyses with data on maternal perception of child's weight and weight development ( increment SDS body-mass index; BMI) derived from the Amsterdam Born Children and their Development (ABCD) birth-cohort study. Underestimation was defined by comparing maternal perception of child's weight with the actual weight status of her child. Associations were studied in two groups: children with overweight (n= 207) and children with normal weight (n= 1982) at baseline (children with underweight were excluded). Results: Underestimation was 5.5% in children with normal weight and 79.7% in children with overweight. Univariate analyses in children with normal weight and overweight showed higher weight development for children with underestimated vs. accurately estimated weights (respectively: beta = 0.19,p< 0.01; beta = 0.22,p< 0.05). After adjusting for child sex and baseline SDS BMI, the effect size became smaller for children with a normal weight (beta = 0.15,p< 0.05) and overweight (beta = 0.18,p> 0.05). Paternal and maternal BMI, ethnicity, and educational level explained the association further (remaining beta = -0.11,p> 0.05 in children with normal weight; beta = 0.06,p> 0.05 in children with overweight). Conclusions: The relationship between maternal underestimation of child's weight and higher weight development indicates a need for promoting a realistic perception of child's weight, this is also the case if the child has a normal weight.