Mosli Rana H, Kaciroti Niko, Corwyn Robert F, Bradley Robert H, Lumeng Julie C
Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA; Department of Nutritional Sciences, School of Public Health,
Center for Human Growth and Development, and.
Pediatrics. 2016 Apr;137(4). doi: 10.1542/peds.2015-2456. Epub 2016 Mar 11.
This study examined the longitudinal association between birth of a sibling and changes in body mass index z-score (BMIz) trajectory during the first 6 years of life.
Children (n = 697) were recruited across 10 sites in the United States at the time of birth. Sibship composition was assessed every 3 months. Anthropometry was completed when the child was age 15 months, 24 months, 36 months, 54 months, and in first grade. Children were classified based on the timing of their sibling's birth. A piecewise quadratic regression model adjusted for potential confounders examined the association of the birth of a sibling with subsequent BMIz trajectory.
Children whose sibling was born when they were 24 to 36 months or 36 to 54 months old, compared with children who did not experience the birth of a sibling by first grade, had a lower subsequent BMIz trajectory and a significantly lower BMIz at first grade (0.27 vs 0.51, P value = 0.04 and 0.26 vs 0.51, P value = 0.03, respectively). Children who did not experience the birth of a sibling by the time they were in first grade had 2.94 greater odds of obesity (P value = 0.046) at first grade compared with children who experienced the birth of a sibling when they were between 36 to 54 months old.
A birth of a sibling when the child is 24 to 54 months old is associated with a healthier BMIz trajectory. Identifying the underlying mechanism of association can help inform intervention programs.
本研究探讨了兄弟姐妹出生与儿童出生后头6年体重指数z评分(BMIz)轨迹变化之间的纵向关联。
在美国10个地点招募了697名儿童。每3个月评估一次家庭构成。在儿童15个月、24个月、36个月、54个月大以及一年级时完成人体测量。根据兄弟姐妹出生的时间对儿童进行分类。采用调整了潜在混杂因素的分段二次回归模型,研究兄弟姐妹出生与随后BMIz轨迹之间的关联。
与到一年级时没有兄弟姐妹出生的儿童相比,在24至36个月或36至54个月时有兄弟姐妹出生的儿童,其随后的BMIz轨迹较低,且一年级时的BMIz显著较低(分别为0.27对0.51,P值 = 0.04;0.26对0.51,P值 = 0.03)。与在36至54个月时有兄弟姐妹出生的儿童相比,到一年级时没有兄弟姐妹出生的儿童在一年级时肥胖的几率高2.94倍(P值 = 0.046)。
孩子在24至54个月大时有兄弟姐妹出生,与更健康的BMIz轨迹相关。确定潜在的关联机制有助于为干预项目提供依据。