Kjaer Thora Wesenberg, Faurholt-Jepsen Daniel, Medrano Rosalinda, Elwan Deena, Mehta Kala, Christensen Vibeke Brix, Wojcicki Janet M
Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
School of Medicine, University of Copenhagen, Copenhagen, Denmark.
J Immigr Minor Health. 2019 Feb;21(1):89-97. doi: 10.1007/s10903-018-0702-0.
Childhood obesity is increasing especially in Latinos and early intervention is essential to prevent later obesity complications. Latino children (n = 201) recruited at two San Francisco hospitals were assessed at birth including infant anthropometrics and feeding practices and followed to age 9 with annual anthropometric assessments. We evaluated the relationship between perinatal risk factors and obesity at age 9 and chronic obesity (obesity at both 5 and 9 years). Higher birthweight [odds ratio (OR) 2.48, 95% confidence interval (CI) 1.06-5.81] and maternal pre-pregnancy body mass index (BMI) (OR 1.09, 95% CI 1.00-1.18) were associated with increased risk for obesity at 9 years. Higher maternal pre-pregnancy BMI (OR 1.10, 95% CI 1.01-1.20) was associated with chronic obesity. Additionally, prenatal depression symptoms were protective (OR 0.33, 95% CI 0.11-0.94) against chronic obesity. We found no association between maternal age and education, exclusive breastfeeding at 4-6 weeks, rapid infant weight gain, and obesity or chronic obesity. Perinatal risk factors for obesity including higher birthweight and maternal pre-pregnancy BMI persisted until age 9, whereas, other variables significant at age 5 in our cohort and other populations including exclusive breastfeeding and rapid infant weight gain were no longer associated with increased risk.
儿童肥胖现象正在增加,尤其是在拉丁裔群体中,早期干预对于预防后期肥胖并发症至关重要。在旧金山两家医院招募的拉丁裔儿童(n = 201)在出生时接受了评估,包括婴儿人体测量学和喂养方式,并随访至9岁,每年进行人体测量评估。我们评估了围产期危险因素与9岁时肥胖以及慢性肥胖(5岁和9岁时均肥胖)之间的关系。较高的出生体重[比值比(OR)2.48,95%置信区间(CI)1.06 - 5.81]和母亲孕前体重指数(BMI)(OR 1.09,95%CI 1.00 - 1.18)与9岁时肥胖风险增加相关。较高的母亲孕前BMI(OR 1.10,95%CI 1.01 - 1.20)与慢性肥胖相关。此外,产前抑郁症状对慢性肥胖具有保护作用(OR 0.33,95%CI 0.11 - 0.94)。我们发现母亲年龄和教育程度、4 - 6周纯母乳喂养、婴儿体重快速增加与肥胖或慢性肥胖之间无关联。包括较高出生体重和母亲孕前BMI在内的肥胖围产期危险因素一直持续到9岁,而在我们的队列以及其他人群中5岁时显著的其他变量,包括纯母乳喂养和婴儿体重快速增加,不再与风险增加相关。