Environmental Effects of Pre-pregnancy, Gestational and Infant Nutrition on Childhood Growth: A Comprehensive Review

Background: The first 1,000 days of life, from conception to two years of age, represent a critical period for growth, metabolic programming, and neurodevelopment. Maternal nutrition before and during pregnancy, along with infant feeding practices, significantly influences childhood growth, obesity risk, and long-term health outcomes. Understanding the impact of maternal and infant nutrition on growth trajectories is essential for optimizing child health. Objective: This review aims to analyze the effects of maternal preconception nutrition, gestational dietary intake, and early-life feeding practices on childhood growth and metabolic health. Specific objectives include evaluating the role of maternal body mass index (BMI), gestational weight gain (GWG), macronutrient and micronutrient intake, breastfeeding, and complementary feeding in shaping growth outcomes. Methods: A systematic evaluation of 50 peer-reviewed studies published between 2000 and 2024 was conducted. The included studies comprised randomized controlled trials (RCTs), observational studies, and meta-analyses assessing the impact of maternal and infant nutrition on childhood growth outcomes. Data were analyzed based on reported growth parameters, obesity risk, and metabolic indicators, with impact percentages derived from pooled odds ratios and standardized mean differences. Results: Prepregnancy Nutrition & BMI: Maternal underweight (BMI <18.5) increased the risk of growth restriction (35%), while obesity (BMI ≥30) led to higher childhood obesity risk (50%). Gestational Weight Gain (GWG): Excessive GWG was associated with macrosomia (40%) and childhood obesity risk (30%), whereas inadequate GWG increased the likelihood of low birth weight (25%). Macronutrient & Micronutrient Intake: Low protein intake increased low birth weight risk (30%), and excessive carbohydrate intake raised macrosomia risk (25%). Deficiencies in iron, folic acid, iodine, and vitamin D contributed to stunted growth (40%). Breastfeeding & Complementary Feeding: Exclusive breastfeeding for six months reduced obesity risk by 40% and stunting risk by 30%. Introducing complementary foods before 4 months increased obesity risk by 35%, while delayed introduction beyond 6 months raised stunting risk (25%). Conclusion & Recommendations: Optimizing maternal nutrition before and during pregnancy is essential for healthy childhood growth trajectories. Public health strategies should prioritize maternal weight management, balanced dietary intake, and prenatal micronutrient supplementation. Exclusive breastfeeding for six months and appropriate complementary feeding practices should be widely promoted to reduce stunting and obesity risks. Future research should focus on longitudinal studies evaluating lifelong metabolic outcomes and the development of personalized nutrition interventions for high-risk populations.