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预测出生时的学龄前儿童肥胖：孕早期母亲肥胖的作用。

Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy.

作者信息

Whitaker Robert C

机构信息

Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

出版信息

Pediatrics. 2004 Jul;114(1):e29-36. doi: 10.1542/peds.114.1.e29.

DOI:10.1542/peds.114.1.e29

PMID:15231970

Abstract

OBJECTIVE

Knowing risk factors at birth for the development of childhood obesity could help to identify children who are in need of early obesity prevention efforts. The objective of this study was to determine whether children whose mothers were obese in early pregnancy were more likely to be obese at 2 to 4 years of age.

METHODS

A retrospective cohort study was conducted of 8494 low-income children who were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Ohio and were followed from the first trimester of gestation until 24 to 59 months of age. Measured height and weight data from WIC were linked to birth certificate records for children who were born in the years 1992-1996. Obesity among 2- to 4-year-olds was defined as a body mass index (BMI) > or =95th percentile for age and gender. Mothers were classified as obese (BMI > or =30 kg/m2) or nonobese (BMI <30 kg/m2) on the basis of BMI measured in the first trimester of the child's gestation.

RESULTS

The prevalence of childhood obesity was 9.5%, 12.5%, and 14.8% at 2, 3, and 4 years of age, respectively, and 30.3% of the children had obese mothers. By 4 years of age, 24.1% of children were obese if their mothers had been obese in the first trimester of pregnancy compared with 9.0% of children whose mothers had been of normal weight (BMI 18.5 and <25 kg/m2). After controlling for the birth weight, birth year, and gender of the children plus the mothers' age, race/ethnicity, education level, marital status, parity, weight gain, and smoking during pregnancy, the relative risk of childhood obesity associated with maternal obesity in the first trimester of pregnancy was 2.0 (95% confidence interval [CI]: 1.7-2.3) at 2 years of age, 2.3 (95% CI: 2.0-2.6) at 3 years of age, and 2.3 (95% CI: 2.0-2.6) at 4 years of age.

CONCLUSION

Among low-income children, maternal obesity in early pregnancy more than doubles the risk of obesity at 2 to 4 years of age. In developing strategies to prevent obesity in preschoolers, special attention should be given to newborns with obese mothers.

摘要

目的

了解儿童肥胖发展的出生时风险因素有助于识别需要早期肥胖预防措施的儿童。本研究的目的是确定母亲在妊娠早期肥胖的儿童在2至4岁时肥胖的可能性是否更高。

方法

对8494名低收入儿童进行了一项回顾性队列研究，这些儿童参加了俄亥俄州的妇女、婴儿和儿童特别补充营养计划（WIC），并从妊娠早期一直随访至24至59个月龄。WIC测量的身高和体重数据与1992 - 1996年出生儿童的出生证明记录相关联。2至4岁儿童的肥胖定义为年龄和性别的体重指数（BMI）≥第95百分位数。根据儿童妊娠早期测量的BMI，将母亲分为肥胖（BMI≥30 kg/m²）或非肥胖（BMI<30 kg/m²）。

结果

2岁、3岁和4岁儿童肥胖的患病率分别为9.5%、12.5%和14.8%，30.3%的儿童母亲肥胖。到4岁时，如果母亲在妊娠早期肥胖，24.1%的儿童肥胖，而母亲体重正常（BMI 18.5且<25 kg/m²）的儿童这一比例为9.0%。在控制了儿童的出生体重、出生年份、性别以及母亲的年龄、种族/族裔、教育水平、婚姻状况、产次、孕期体重增加和吸烟情况后，妊娠早期母亲肥胖与儿童肥胖相关的相对风险在2岁时为2.0（95%置信区间[CI]：1.7 - 2.3），3岁时为2.3（95% CI：2.0 - 2.6），4岁时为2.3（95% CI：2.0 - 2.6）。