Leonard Stephanie A, Petito Lucia C, Rehkopf David H, Ritchie Lorrene D, Abrams Barbara
1 Division of Epidemiology, University of California , Berkeley, CA.
2 Division of Biostatistics, University of California , Berkeley, CA.
Child Obes. 2017 Aug;13(4):259-266. doi: 10.1089/chi.2017.0019. Epub 2017 Apr 25.
Women's experience of childhood adversity may contribute to their children's risk of obesity. Possible causal pathways include higher maternal weight and gestational weight gain, which have been associated with both maternal childhood adversity and obesity in offspring.
This study included 6718 mother-child pairs from the National Longitudinal Survey of Youth 1979 in the United States (1979-2012). We applied multiple log-binomial regression models to estimate associations between three markers of childhood adversity (physical abuse, household alcoholism, and household mental illness) and offspring obesity in childhood. We estimated natural direct effects to evaluate mediation by prepregnancy BMI and gestational weight gain.
Among every 100 mothers who reported physical abuse in childhood, there were 3.7 (95% confidence interval: -0.1 to 7.5) excess cases of obesity in 2- to 5-year olds compared with mothers who did not report physical abuse. Differences in prepregnancy BMI, but not gestational weight gain, accounted for 25.7% of these excess cases. There was no evidence of a similar relationship for household alcoholism or mental illness or for obesity in older children.
In this national, prospective cohort study, prepregnancy BMI partially explained an association between maternal physical abuse in childhood and obesity in preschool-age children. These findings underscore the importance of life-course exposures in the etiology of child obesity and the potential multi-generational consequences of child abuse. Research is needed to determine whether screening for childhood abuse and treatment of its sequelae could strengthen efforts to prevent obesity in mothers and their children.
女性童年时期的逆境经历可能会增加其子女患肥胖症的风险。可能的因果途径包括母亲体重较高和孕期体重增加，这两者都与母亲童年时期的逆境以及后代肥胖有关。
本研究纳入了来自美国1979年全国青年纵向调查（1979 - 2012年）的6718对母婴。我们应用多重对数二项回归模型来估计童年逆境的三个指标（身体虐待、家庭酗酒和家庭精神疾病）与儿童期后代肥胖之间的关联。我们估计自然直接效应以评估孕前体重指数和孕期体重增加的中介作用。
在每100名报告童年时期遭受身体虐待的母亲中，与未报告身体虐待的母亲相比，2至5岁儿童中肥胖病例多出3.7例（95%置信区间：-0.1至7.5）。孕前体重指数的差异而非孕期体重增加解释了这些额外病例的25.7%。没有证据表明家庭酗酒或精神疾病与大龄儿童肥胖之间存在类似关系。
在这项全国性前瞻性队列研究中，孕前体重指数部分解释了母亲童年时期身体虐待与学龄前儿童肥胖之间的关联。这些发现强调了生命历程暴露在儿童肥胖病因学中的重要性以及虐待儿童可能产生的多代后果。需要开展研究以确定筛查童年虐待及其后遗症是否能够加强预防母亲及其子女肥胖的努力。
