Lumeng J C, Gannon K, Appugliese D, Cabral H J, Zuckerman B
Department of Pediatrics and Communicable Diseases, Center for Human Growth and Development, University of Michigan, Ann Arbor, MI 48109-0406, USA.
Int J Obes (Lond). 2005 Jan;29(1):60-6. doi: 10.1038/sj.ijo.0802848.
To determine if there is a relationship between center-based child care attendance from ages 3 to 5 y and future overweight at ages 6-12 y.
DESIGN/METHODS: Longitudinal, observational study of child experience and future body mass index.
A total of 1244 US children aged 6-12 y included in the 1997 Panel Study of Income Dynamics Child Development Supplement.
Parent-reported child care attendance from ages 3 to 5 y, trichotomized as 'none', 'limited' (>0 but <15 h/week), and 'extensive' (> or =15 h/week). Overweight defined as a body mass index > or =95th percentile for age and gender. Candidate covariates (selected a priori): gender, race, age, poverty status, birth weight, hours of television per day, Behavior Problems Index score >90th percentile, and Home Observation for Measurement of the Environment-Short Form (HOME-SF) cognitive stimulation score.
Of the potential confounding variables, race, HOME-SF cognitive stimulation score, and age significantly altered the relationship between child care attendance and overweight in the multiple logistic regression model. With these covariates in the final model, limited center-based child care attendance from ages 3 to 5 y was independently associated with a decreased risk of overweight at ages 6-12 y (adjusted odds ratio=0.56, 95% confidence interval 0.34, 0.93) relative to no child care attendance. Extensive center-based child care attendance was not associated with future overweight.
Limited center-based child care attendance during the preschool years was independently associated with a decreased risk of future overweight relative to no child care attendance. Additional studies are needed to clarify these findings.
确定3至5岁儿童接受中心式儿童保育与6至12岁时未来超重之间是否存在关联。
设计/方法：对儿童经历和未来体重指数进行纵向观察研究。
1997年收入动态面板研究儿童发展补充调查中纳入的1244名6至12岁美国儿童。
家长报告的3至5岁儿童保育情况，分为“无”、“有限”（>0但<15小时/周）和“广泛”（≥15小时/周）。超重定义为年龄和性别的体重指数≥第95百分位数。候选协变量（预先选定）：性别、种族、年龄、贫困状况、出生体重、每天看电视的时长、行为问题指数得分>第90百分位数，以及家庭环境观察简表（HOME-SF）认知刺激得分。
在多个逻辑回归模型中，种族、HOME-SF认知刺激得分和年龄这些潜在混杂变量显著改变了儿童保育与超重之间的关系。在最终模型纳入这些协变量后，与未接受儿童保育相比，3至5岁儿童接受有限的中心式儿童保育与6至12岁时超重风险降低独立相关（调整后的优势比=0.56，95%置信区间0.34，0.93）。广泛的中心式儿童保育与未来超重无关。
与未接受儿童保育相比，学前阶段接受有限的中心式儿童保育与未来超重风险降低独立相关。需要进一步研究以阐明这些发现。
