The mediating effects of home environment on the relationship between maternal BMI and childhood obesity: Findings from the ECHO-wide cohort
Year: 2026
Type: article
Study design: Observational Study
Abstract: Maternal pre-pregnancy obesity could affect long-term excessive child weight gain. Positive home environments, encompassing supportive social settings within a household, may mitigate such effects by promoting engagement in healthier behaviours. However, the mediating role of home environments is not established. The study examined whether nurturing and stimulating home environments mediate the association between maternal pre-pregnancy body mass index (BMI) and BMI z-score in early childhood (3-6 years of age). A retrospective cohort study of mother-child pairs using data from the Environmental Influences on Child Health Outcomes (ECHO) program in the USA was conducted, with data collected between September 2016 and March 2023 in children born between 2002 and 2011. The home environment was assessed using the Infant-Toddler Home Observation for Measurement of Environment (IT-HOME) questionnaire, with the Parental Responsivity, Acceptance, Learning Materials, Organisation, Variety and Parental Involvement subscales. Structural equation modelling (SEM) was used to test the potential mediating effects of IT-HOME subscales. The final analytic sample comprised 1341 mother-child pairs. Children whose mothers were overweight and obese during pre-pregnancy had significantly higher BMI z-scores in early childhood as compared to those of mothers who had normal weight, across models examining the six IT-HOME subscales as well as the total IT-HOME z-score. The home environment did not mediate the association between maternal pre-pregnancy BMI and early childhood BMI z-score. CONCLUSION: This study had insufficient evidence to show that the home environment acted as a mediator in reducing the childhood BMI z-score associated with maternal pre-pregnancy BMI. Other dimensions, such as quality diet and physical activity stimulation, should be further explored as potential mediators in future studies. WHAT IS KNOWN: • To the best of our knowledge, this is the first study to look at the mediation effect of home environment in the relationship between childhood obesity and maternal pre-pregnancy BMI in 3-6-year-olds in the USA population. WHAT IS NEW: • There was no evidence that a supportive and enriched home environment during infancy and toddlerhood acted as a mediator in attenuating the otherwise positive relationship between childhood obesity and maternal pre-pregnancy BMI in the USA population. • Future research should explore the mediating effects of dietary quality, physical activity dimensions, and the dynamics of age-specific effects of the home environment on weight trajectories across infancy, early childhood, middle childhood, and adolescence to have targeted interventions that are protective against childhood obesity.
Source: European Journal of Pediatrics
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,990
Awards: Multi-omic approaches to mechanisms of vitamin D, environmental influences, and the microbiome on asthma, Prenatal and Early Childhood Pathways To Health: An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory Outcomes, Minnesota HHEAR Targeted Analysis Laboratory, Early Life Stress and the Environmental Origins of Disease: a Population-based Prospective Longitudinal Study of Children in Rural Poverty (ECHO), Common and distinct early environmental influences on cardiometabolic and respiratory health: Mechanisms and methods, Wadsworth Center's Human Health and Exposure Analysis Resource (WC-HHEAR), Lifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory health (LA DREAMERs), Developmental Impact of NICU Exposures (DINE), Breaking the cycle of intergenerational disadvantage: neurodevelopment among Puerto Rican children., ENVIRONMENTAL INFLUENCES ON NEURODEVELOPMENTAL OUTCOME IN INFANTS BORN VERY PRETERM, RTI CHEAR Exposure Assessment Hub, Utah Children's Project, Common Mechanisms linking Pre- and Post-Natal Exposures for Child Health Outcomes, Early Life Exposure to Endocrine Disrupting Chemicals and Child Growth, Adiposity, and Neurodevelopment, The NYU Children’s Health & Environment Study: an ECHO Cohort, Prenatal Exposures and Child Health Outcomes 2: A Statewide Study of Michigan Families, The Early Growth and Development Study Cohort of the ECHO Program, Atlanta ECHO Pediatric Cohort, Host genetics, early-life microbiome, and childhood asthma: MARC-43 Boston, Continued follow-up of the Vitamin C and Smoking in Pregnancy (VCSIP) cohorts through the ECHO consortium, focus on Echo-wide protocols, respiratory outcomes, airway function, and epigenetic changes, A prospective study of critical environmental exposures in formative early life that impact lifelong health in rural US children: the New Hampshire Birth Cohort Study, Environmental influences on Child Health Outcomes (ECHO) Coordinating Center, ASSESSING THE EVOLVING IMPACT OF EARLY LIFE EXPOSURES ON CHILD PHYSICAL HEALTH AND NEURODEVELOPMENT, The Illinois Kids Development Study ECHO Pregnancy and Pediatric Cohort, Resilience to prenatal stress: Implications for offspring health and neurodevelopment, Human Health Exposure Analysis Resource Core: Untargeted Analysis, Environmental influences on Child Health Outcomes in the Northern Plains PASS-ECHO Cohort, Revisiting ReCHARGE: ECHO Follow up on Middle Childhood and Adolescence, ECHO DAC (Environmental Influences on Child Health Outcomes Data Analysis Center), Wisconsin Infant Study Cohort (WISC) ECHO Pediatric Follow-Up, Human Health Exposure Analysis Resource (HHEAR): Coordinating Center, Mount Sinai HHEAR Network Targeted Lab Hub, Environment, Epigenetics, Neurodevelopment & Health of Extremely Preterm Children, ECHO-PROTECT Cohort Study Site in Puerto Rico, Environmental influences on Child Health Outcomes - The Colorado ECHO Pediatric Cohort, ECHO II: Impact of environmental exposures on children's health and the co-morbidity of asthma and ADHD, Mount Sinai ECHO site for Perinatal Environment and Development Studies, Trajectories and Environments in Autism: a Multi-cohort Study (TEAMS) following autism families in ECHO Phase 2, Human Health Exposure Analysis Resource (HHEAR) Data Center, The ECHO Measurement Core: A Framework and Resource for Assessing Environmental Exposure and Child Health, Understanding Risk Gradients from Environment on Native American Child Health Trajectories: Toxicants, Immunomodulation, Metabolic syndromes, & Metals Exposure
OpenAlex ID: W7212147650