Massion Samuel, Wickham Sophie, Pearce Anna, Barr Ben, Law Catherine, Taylor-Robinson David
Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
Institute of Child Health, University College London, London, UK.
Arch Dis Child. 2016 Aug;101(8):724-30. doi: 10.1136/archdischild-2015-309465. Epub 2016 May 9.
Overweight and obesity in childhood are socially patterned, with higher prevalence in more disadvantaged populations, but it is unclear to what extent early life factors attenuate the social inequalities found in childhood overweight/obesity.
We estimated relative risks (RRs) for being overweight (combining with obesity) at age 11 in 11 764 children from the UK Millennium Cohort Study (MCS) according to socio-economic circumstances (SEC). Early life risk factors were explored to assess if they attenuated associations between SECs and overweight.
28.84% of children were overweight at 11 years. Children of mothers with no academic qualifications were more likely to be overweight (RR 1.72, 95% CI 1.48 to 2.01) compared to children of mothers with degrees and higher degrees. Controlling for prenatal, perinatal, and early life characteristics (particularly maternal pre-pregnancy overweight and maternal smoking during pregnancy) reduced the RR for overweight to 1.44, 95% CI 1.23 to 1.69 in the group with the lowest academic qualifications compared to the highest.
We observed a clear social gradient in overweight 11-year-old children using a representative UK sample. Moreover, we identified specific early life risk factors, including maternal smoking during pregnancy and maternal pre-pregnancy overweight, that partially account for the social inequalities found in childhood overweight. Policies to support mothers to maintain a healthy weight, breastfeed and abstain from smoking during pregnancy are important to improve maternal and child health outcomes, and our study provides some evidence that they may also help to address the continuing rise in inequalities in childhood overweight.
儿童期超重和肥胖存在社会模式差异，在处境更为不利的人群中患病率更高，但尚不清楚早期生活因素在多大程度上会减弱儿童超重/肥胖中发现的社会不平等现象。
我们根据社会经济状况（SEC），对来自英国千禧队列研究（MCS）的11764名儿童在11岁时超重（合并肥胖）的相对风险（RRs）进行了估计。对早期生活风险因素进行了探究，以评估它们是否会减弱社会经济状况与超重之间的关联。
28.84%的儿童在11岁时超重。与母亲拥有学位及更高学历的儿童相比，母亲没有学历的儿童超重的可能性更大（RR 1.72，95%CI 1.48至2.01）。在控制了产前、围产期和早期生活特征（特别是母亲孕前超重和孕期吸烟）后，与学历最高的组相比，学历最低组超重的RR降至1.44，95%CI 1.23至1.69。
我们使用具有代表性的英国样本观察到11岁超重儿童中存在明显的社会梯度。此外，我们确定了特定的早期生活风险因素，包括孕期母亲吸烟和母亲孕前超重，这些因素部分解释了儿童超重中发现的社会不平等现象。支持母亲在孕期保持健康体重、进行母乳喂养并戒烟的政策对于改善母婴健康结局很重要，并且我们的研究提供了一些证据表明，这些政策可能还有助于解决儿童超重不平等现象的持续上升问题。
