Hohwü Lena, Zhu Jin Liang, Graversen Lise, Li Jiong, Sørensen Thorkild I A, Obel Carsten
Department of Public Health, Aarhus University, Aarhus, Denmark.
Institute of Preventive Medicine, Bispebjerg and Frederiksbjerg Hospitals, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
PLoS One. 2015 Mar 16;10(3):e0119138. doi: 10.1371/journal.pone.0119138. eCollection 2015.
Early parental separation may be a stress factor causing a long-term alteration in the hypothalamic-pituitary-adrenal-axis activity possibly impacting on the susceptibility to develop overweight and obesity in offspring. We aimed to examine the body mass index (BMI) and the risk of overweight and obesity in children whose parents lived separately before the child was born.
A follow-up study was conducted using data from the Aarhus Birth Cohort in Denmark and included 2876 children with measurements of height and weight at 9-11-years-of-age, and self-reported information on parental cohabitation status at child birth and at 9-11-years-of-age. Quantile regression was used to estimate the difference in median BMI between children whose parents lived separately (n = 124) or together (n = 2752) before the birth. We used multiple logistic regression to calculate odds ratio (OR) for overweight and obesity, adjusted for gender, parity, breast feeding status, and maternal pre-pregnancy BMI, weight gain during pregnancy, age and educational level at child birth; with and without possible intermediate factors birth weight and maternal smoking during pregnancy. Due to a limited number of obese children, OR for obesity was adjusted for the a priori confounder maternal pre-pregnancy BMI only.
The difference in median BMI was 0.54 kg/m2 (95% confidence intervals (CI): 0.10; 0.98) between children whose parents lived separately before birth and children whose parents lived together. The risk of overweight and obesity was statistically significantly increased in children whose parents lived separately before the birth of the child; OR 2.29 (95% CI: 1.18; 4.45) and OR 2.81 (95% CI: 1.05; 7.51), respectively. Additional, adjustment for possible intermediate factors did not substantially change the estimates.
Parental separation before child birth was associated with higher BMI, and increased risk of overweight and obesity in 9-11-year-old children; this may suggest a fetal programming effect or unmeasured difference in psychosocial factors between separated and non-separated parents.
早期亲子分离可能是一个压力因素，会导致下丘脑 - 垂体 - 肾上腺轴活动发生长期改变，这可能会影响后代超重和肥胖的易感性。我们旨在研究父母在孩子出生前就分居的儿童的体重指数（BMI）以及超重和肥胖的风险。
利用丹麦奥胡斯出生队列的数据进行了一项随访研究，纳入了2876名儿童，这些儿童在9至11岁时测量了身高和体重，并自我报告了孩子出生时以及9至11岁时父母的同居状况。采用分位数回归来估计出生前父母分居（n = 124）或同居（n = 2752）的儿童之间BMI中位数的差异。我们使用多元逻辑回归来计算超重和肥胖的比值比（OR），并对性别、胎次、母乳喂养状况、母亲孕前BMI、孕期体重增加、孩子出生时的年龄和教育水平进行了调整；同时考虑了是否存在可能的中间因素出生体重和孕期母亲吸烟情况。由于肥胖儿童数量有限，仅对肥胖的OR值根据先验混杂因素母亲孕前BMI进行了调整。
出生前父母分居的儿童与父母同居的儿童相比，BMI中位数差异为0.54 kg/m²（95%置信区间（CI）：0.10；0.98）。在孩子出生前父母分居的儿童中，超重和肥胖的风险在统计学上显著增加；超重的OR值为2.29（95%CI：1.18；4.45），肥胖的OR值为2.81（95%CI：1.05；7.51）。此外，对可能的中间因素进行调整并没有实质性改变估计值。
孩子出生前父母分居与9至11岁儿童较高的BMI以及超重和肥胖风险增加有关；这可能表明存在胎儿编程效应或分居与未分居父母之间心理社会因素的未测量差异。
