Kapral N, Miller S E, Scharf R J, Gurka M J, DeBoer M D
Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.
Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, USA.
Pediatr Obes. 2018 Jun;13(6):333-341. doi: 10.1111/ijpo.12227. Epub 2017 Jul 6.
Relationships between birthweight and future obesity risk remain unclear.
To assess associations between birthweight and later obesity in a nationally representative cohort of early school-aged children.
We used linear and logistic regression to evaluate 10 186 term- or preterm children in the Early Childhood Longitudinal Study-Kindergarten Cohort 2011 for relationships between birthweight and later obesity and change in BMI z-score from kindergarten-to-second grade. All analyses were adjusted for sex, race/ethnicity, parental education and household income.
Compared to children born normal birthweight (NBW), high birthweight (HBW) term children and large-for-gestational-age (LGA) preterm children had significantly greater BMI z-scores from kindergarten-to-second grade (p < 0.001). Term children born HBW had higher odds of obesity by kindergarten (adjusted odds ratios [aOR] 1.91, p < 0.0001). Among preterm children, odds of obesity was higher among LGA children starting in first grade (aOR 2.34, p < 0.05) and among small-for-gestational age children in second grade (aOR 2.26, p < 0.05). Compared to NBW children, HBW children had greater change in BMI z-score between kindergarten-first grade (p < 0.01).
High birthweight term and LGA preterm children had increased adjusted odds of obesity in school-age compared to their NBW counterparts. Physicians may provide counselling early in life for families of large infants to help prevent future obesity.
出生体重与未来肥胖风险之间的关系仍不明确。
在一个具有全国代表性的学龄儿童队列中评估出生体重与后期肥胖之间的关联。
我们使用线性回归和逻辑回归,对2011年幼儿纵向研究 - 幼儿园队列中的10186名足月儿或早产儿进行分析,以探讨出生体重与后期肥胖以及从幼儿园到二年级BMI z评分变化之间的关系。所有分析均对性别、种族/民族、父母教育程度和家庭收入进行了校正。
与出生体重正常(NBW)的儿童相比,足月高出生体重(HBW)儿童和大于胎龄(LGA)早产儿从幼儿园到二年级的BMI z评分显著更高(p < 0.001)。足月出生体重高的儿童在幼儿园时肥胖几率更高(校正比值比[aOR] 1.91,p < 0.0001)。在早产儿中,一年级开始时LGA儿童肥胖几率更高(aOR 2.34,p < 0.05),二年级时小于胎龄儿童肥胖几率更高(aOR 2.26,p < 0.05)。与NBW儿童相比,HBW儿童在幼儿园到一年级之间BMI z评分变化更大(p < 0.01)。
与出生体重正常的儿童相比,足月高出生体重和大于胎龄的早产儿在学龄期肥胖的校正几率增加。医生可能需要在早期为巨大儿家庭提供咨询,以帮助预防未来肥胖。