Hohwü Lena, Gissler Mika, Sjöberg Agneta, Biehl Anna M, Kristjansson Alfgeir L, Obel Carsten
Section for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
BMC Public Health. 2014 Nov 25;14:1216. doi: 10.1186/1471-2458-14-1216.
Comparative data of parental separation and childhood overweight has not been available before across the Nordic countries. The aim of this study was to examine the within-country prevalence and association between parental cohabitation and overweight in Nordic children.
A cross-sectional survey of 2-17-year-old children was conducted in 2011, titled: "NordChild". A random sample of 3,200 parents in each of the Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden were invited to participate in the study with parents of 6,609 children accepting to give answers about their children's health and welfare including information on height and weight of each child and parental cohabitation (response rate 41.5%). The group differences in prevalence and adjusted odds ratio (OR) for overweight, with corresponding 95% confidence intervals (CI) were performed in children whose parents lived separately. Additionally, a missing data analysis was performed to determine whether the adjusted estimates might result from confounding or selection bias.
A significant difference was observed in Iceland between children whose parents live separately compared to those who live with both parents (difference: 9.4%, 95% CI: 2.8; 15.9) but no such difference was observed in Denmark, Finland, Norway and Sweden. No significant odds of overweight were observed in children whose parents lived separately compared to children in normal weight at the time of study; Denmark: OR 1.03 (95% CI: 0.42; 2.53), Finland: OR 1.27 (95% CI: 0.74; 2.20), Iceland: OR 1.50 (95% CI: 0.79; 2.84), Norway: OR 1.46 (95% CI: 0.81; 2.62), and Sweden: 1.07 (95% CI: 0.61; 1.86). The missing data analysis indicated that the findings in Norway, Finland and Iceland were partly observed due to selection effects, whereas the adjustment in Denmark was due to confounding. The crude OR for overweight was higher in the 2-9-year-old group than in the 10-17-year-old group whose parents lived separately in Iceland, Norway and Sweden.
No association between parental cohabitation and overweight in Nordic children was found. Our finding of greater prevalence of overweight in Icelandic children whose parents live separately may be an indication that the welfare system in Iceland is separating from the other Nordic countries.
此前北欧国家尚未有关于父母分居与儿童超重的对比数据。本研究旨在调查北欧国家儿童中父母同居情况与超重之间的国内患病率及关联。
2011年对2至17岁儿童进行了一项名为“NordChild”的横断面调查。在北欧各国(丹麦、芬兰、冰岛、挪威和瑞典)随机抽取3200名家长邀请其参与研究,共有6609名儿童的家长接受调查,回答了有关孩子健康和福利的问题,包括每个孩子的身高和体重信息以及父母的同居情况(回复率41.5%)。对父母分居的儿童进行超重患病率及调整后的优势比(OR)的组间差异分析,并给出相应的95%置信区间(CI)。此外,进行了缺失数据分析,以确定调整后的估计值是否可能因混杂或选择偏倚导致。
冰岛父母分居的儿童与父母双方同居的儿童之间存在显著差异(差异:9.4%,95%CI:2.8;15.9),但在丹麦、芬兰、挪威和瑞典未观察到此类差异。与研究时体重正常的儿童相比,父母分居的儿童超重的优势无显著差异;丹麦:OR 1.03(95%CI:0.42;2.53),芬兰:OR 1.27(95%CI:0.74;2.20),冰岛:OR 1.50(95%CI:0.79;2.84),挪威:OR 1.46(95%CI:0.81;2.62),瑞典:1.07(95%CI:0.61;1.86)。缺失数据分析表明,挪威、芬兰和冰岛的研究结果部分是由于选择效应,而丹麦的调整是由于混杂因素。在冰岛、挪威和瑞典,父母分居的2至9岁儿童组超重的粗OR高于10至17岁儿童组。
未发现北欧儿童父母同居情况与超重之间存在关联。我们发现冰岛父母分居的儿童超重患病率更高,这可能表明冰岛的福利体系与其他北欧国家有所不同。