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父母肥胖与儿童早期发育

Parental Obesity and Early Childhood Development.

作者信息

Yeung Edwina H, Sundaram Rajeshwari, Ghassabian Akhgar, Xie Yunlong, Buck Louis Germaine

机构信息

Epidemiology Branch,

Biostatistics and Bioinformatics Branch.

出版信息

Pediatrics. 2017 Feb;139(2). doi: 10.1542/peds.2016-1459. Epub 2017 Jan 2.

Abstract

BACKGROUND

Previous studies identified associations between maternal obesity and childhood neurodevelopment, but few examined paternal obesity despite potentially distinct genetic/epigenetic effects related to developmental programming.

METHODS

Upstate KIDS (2008-2010) recruited mothers from New York State (excluding New York City) at ∼4 months postpartum. Parents completed the Ages and Stages Questionnaire (ASQ) when their children were 4, 8, 12, 18, 24, 30, and 36 months of age corrected for gestation. The ASQ is validated to screen for delays in 5 developmental domains (ie, fine motor, gross motor, communication, personal-social functioning, and problem-solving ability). Analyses included 3759 singletons and 1062 nonrelated twins with ≥1 ASQs returned. Adjusted odds ratios (aORs) and 95% confidence intervals were estimated by using generalized linear mixed models accounting for maternal covariates (ie, age, race, education, insurance, marital status, parity, and pregnancy smoking).

RESULTS

Compared with normal/underweight mothers (BMI <25), children of obese mothers (26% with BMI ≥30) had increased odds of failing the fine motor domain (aOR 1.67; confidence interval 1.12-2.47). The association remained after additional adjustment for paternal BMI (1.67; 1.11-2.52). Paternal obesity (29%) was associated with increased risk of failing the personal-social domain (1.75; 1.13-2.71), albeit attenuated after adjustment for maternal obesity (aOR 1.71; 1.08-2.70). Children whose parents both had BMI ≥35 were likely to additionally fail the problem-solving domain (2.93; 1.09-7.85).

CONCLUSIONS

Findings suggest that maternal and paternal obesity are each associated with specific delays in early childhood development, emphasizing the importance of family information when screening child development.

摘要

背景

先前的研究确定了母亲肥胖与儿童神经发育之间的关联,但尽管与发育编程相关的遗传/表观遗传效应可能不同,却很少有研究考察父亲肥胖的影响。

方法

上州儿童研究(2008 - 2010年)在产后约4个月时从纽约州(不包括纽约市)招募母亲。当孩子矫正胎龄4、8、12、18、24、30和36个月大时,父母完成年龄与发育进程问卷(ASQ)。ASQ经过验证,可用于筛查5个发育领域(即精细运动、大运动、沟通、个人 - 社会功能和解决问题能力)的发育迟缓情况。分析纳入了3759名单胎和1062名非亲属双胞胎,他们至少返回了1份ASQ。使用广义线性混合模型估计调整后的优势比(aOR)和95%置信区间,并考虑了母亲的协变量(即年龄、种族、教育程度、保险、婚姻状况、产次和孕期吸烟情况)。

结果

与体重正常/体重不足的母亲(BMI <25)相比,肥胖母亲(26%的BMI≥30)的孩子在精细运动领域筛查未通过的几率增加(aOR 1.67;置信区间1.12 - 2.47)。在进一步调整父亲BMI后,该关联仍然存在(1.67;1.11 - 2.52)。父亲肥胖(29%)与个人 - 社会领域筛查未通过的风险增加相关(1.75;1.13 - 2.71),不过在调整母亲肥胖情况后有所减弱(aOR 1.71;1.08 - 2.70)。父母BMI均≥35的孩子在解决问题领域筛查未通过的可能性更高(2.93;1.09 - 7.85)。

结论

研究结果表明,母亲和父亲肥胖均与幼儿发育的特定迟缓相关,强调了在筛查儿童发育情况时家庭信息的重要性。

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