Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio, USA.
Pediatrics. 2012 Jan;129(1):132-40. doi: 10.1542/peds.2011-0972. Epub 2011 Dec 26.
The goal of this study was to determine whether obesity in adolescence is related to the quality of the early maternal-child relationship.
We analyzed data from 977 of 1364 participants in the Study of Early Child Care and Youth Development. Child attachment security and maternal sensitivity were assessed by observing mother-child interaction at 15, 24, and 36 months of age. A maternal-child relationship quality score was constructed as the number of times across the 3 ages that the child was either insecurely attached or experienced low maternal sensitivity. Adolescent obesity was defined as a measured BMI ≥95th percentile at age 15 years.
Poor-quality maternal-child relationships (score: ≥3) were experienced by 24.7% of children compared with 22.0% who, at all 3 ages, were neither insecurely attached nor exposed to low maternal sensitivity (score: 0). The prevalence of adolescent obesity was 26.1%, 15.5%, 12.1%, and 13.0% for those with risk scores of ≥3, 2, 1, and 0, respectively. After adjustment for gender and birth weight, the odds (95% confidence interval) of adolescent obesity was 2.45 (1.49-4.04) times higher in those with the poorest quality early maternal-child relationships (score: ≥3) compared with those with the highest quality (score: 0). Low maternal sensitivity was more strongly associated with obesity than insecure attachment.
Poor quality of the early maternal-child relationship was associated with a higher prevalence of adolescent obesity. Interventions aimed at improving the quality of maternal-child interactions should consider assessing effects on children's weight and examining potential mechanisms involving stress response and emotion regulation.
本研究旨在探讨青少年肥胖是否与早期母婴关系质量有关。
我们分析了儿童早期照料和发展研究中 1364 名参与者中的 977 名的数据。通过观察 15、24 和 36 个月时母婴互动，评估儿童依恋安全性和母亲敏感性。构建母婴关系质量评分，即 3 个年龄中儿童不安全依恋或经历低水平母亲敏感性的次数。青少年肥胖定义为 15 岁时测量的 BMI≥第 95 百分位数。
与所有 3 个年龄段既未表现出不安全依恋也未经历低水平母亲敏感性（评分：0）的儿童（22.0%）相比，有 24.7%的儿童经历了不良的母婴关系（评分：≥3）。青少年肥胖的患病率分别为≥3 分者 26.1%、2 分者 15.5%、1 分者 12.1%和 0 分者 13.0%。在调整性别和出生体重后，早期母婴关系质量最差（评分：≥3）的青少年肥胖的比值比（95%置信区间）为 2.45（1.49-4.04），而母婴关系质量最高（评分：0）的青少年肥胖的比值比为 1。与不安全依恋相比，低水平母亲敏感性与肥胖的相关性更强。
早期母婴关系质量差与青少年肥胖的患病率较高有关。旨在改善母婴互动质量的干预措施应考虑评估对儿童体重的影响，并研究涉及应激反应和情绪调节的潜在机制。
