Barquera S, Peterson K E, Must A, Rogers B L, Flores M, Houser R, Monterrubio E, Rivera-Dommarco J A
Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
Int J Obes (Lond). 2007 Apr;31(4):601-7. doi: 10.1038/sj.ijo.0803529. Epub 2007 Jan 16.
To assess the coexistence of maternal adiposity and child stunting (CS) in Mexico, estimate its national prevalence and identify the associated socio-demographic factors.
A secondary analysis from the Mexican Nutrition Survey 1999, a nationally representative survey, was conducted. Mother and children subsamples were matched and a total of 6225 mother/child pairs were obtained. Stunting was defined as height-for-age z-scores <-2.0. Maternal body mass index (BMI) was classified according to World Health Organization recommended cutoff points. Waist-to-hip ratio (WHR) was calculated by dividing waist by hip circumferences. Logistic regression models were fitted to explore the coexistence of CS and maternal central adiposity (MCA) (WHR> or =0.85) while controlling for biological and socio-demographic factors.
A total of 5974 pairs had complete information. MCA coexisted with CS in 6.2% of the mother/child pairs. The phenomenon was more prevalent in rural locations, in the south region and among indigenous families (14.5, 12.5 and 23.9%). After controlling for child age and maternal BMI, a 78% increase in the likelihood of CS was related to maternal WHR > or =0.85 (odds ratio (OR)=1.78, 95% confidence interval (CI)=1.53, 2.10). After controlling for maternal height, the magnitude of the OR decreased (OR=1.33, 95%CI=1.13, 1.57), but remained significant. Therefore, it is suggested that women with a WHR approximately 1 have had twice the probability of having a stunted child as those with a WHR of 0.65.
Although MCA and CS are two conditions frequently regarded as result of opposite determinants, our observation suggests that this is not necessarily the case, particularly in populations undergoing the nutrition transition. MCA was associated not only to chronic diseases, but also to child stunting.
评估墨西哥孕产妇肥胖与儿童发育迟缓（CS）的共存情况，估计其全国患病率，并确定相关的社会人口学因素。
对具有全国代表性的1999年墨西哥营养调查进行二次分析。对母亲和儿童子样本进行匹配，共获得6225对母婴。发育迟缓定义为年龄别身高z评分＜-2.0。孕产妇体重指数（BMI）根据世界卫生组织推荐的切点进行分类。腰臀比（WHR）通过腰围除以臀围计算得出。在控制生物学和社会人口学因素的同时，采用逻辑回归模型探讨CS与孕产妇中心性肥胖（MCA）（WHR≥0.85）的共存情况。
共有5974对母婴拥有完整信息。在6.2%的母婴对中，MCA与CS共存。这种现象在农村地区、南部地区以及土著家庭中更为普遍（分别为14.5%、12.5%和23.9%）。在控制儿童年龄和孕产妇BMI后，CS发生可能性增加78%与孕产妇WHR≥0.85相关（比值比（OR）=1.78，95%置信区间（CI）=1.53，2.10）。在控制孕产妇身高后，OR值的幅度降低（OR=1.33，95%CI=1.13，1.57），但仍具有统计学意义。因此，建议WHR约为1的女性生育发育迟缓儿童的概率是WHR为0.65的女性的两倍。
尽管MCA和CS通常被认为是由相反决定因素导致的两种情况，但我们的观察表明情况未必如此，尤其是在经历营养转型的人群中。MCA不仅与慢性病有关，还与儿童发育迟缓有关。
