Child Health Evaluative Sciences and Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Am J Clin Nutr. 2018 Apr 1;107(4):584-592. doi: 10.1093/ajcn/nqx081.
Accelerated postnatal growth is an important predictor for obesity risk. It is unknown whether early-life obesity-related risk factors affect body mass index (BMI) growth rates during distinct growth periods from early infancy through preschool years.
We examined whether breastfeeding duration, maternal BMI, and birth weight are associated with growth trajectories of age- and sex-standardized WHO BMI z scores (zBMIs) in young children.
Children (n = 5905) in The Applied Research Group for Kids (TARGet Kids!) prospective cohort study underwent repeated measures of weight and length or height from birth to 10 y of age. Piecewise linear mixed models were used to determine whether zBMI growth rates differ for each risk factor during periods of growth between birth and 1, 3, 18, 36, and 72 mo of age.
Children who were breastfed <6 mo compared with ≥6 mo showed a higher growth rate between 1-3 and 3-18 mo, resulting in higher standardized BMIs (zBMIs) of +0.24, +0.12, and +0.19 at 18, 36, and 72 mo, respectively. Maternal BMI (in kg/m2) ≥30 compared with <30 resulted in higher growth rates between 1-3 and 36-72 mo and higher zBMIs of +0.22, +0.14, +0.18, and +0.41 at 3, 18, 36, and 72 mo, respectively. Infants weighing <2.5 kg at birth (compared with 2.5-4 kg) experienced higher growth rates between 1-3 and 3-18 mo but had lower zBMIs at all time points (zBMI: -1.45 to -0.21). Infants weighing ≥4 kg at birth (compared with 2.5-4 kg) had significantly lower growth rates in the first 3 mo but higher zBMIs at all time points (zBMI: +1.16 to +0.27).
Differences in zBMI growth rates by breastfeeding duration, maternal BMI, and birth weight are seen in early infancy and contribute to differences in zBMI, which persist into midchildhood. This trial was registered at www.clinicaltrials.gov as NCT01869530.
加速的产后生长是肥胖风险的一个重要预测指标。目前尚不清楚生命早期与肥胖相关的危险因素是否会影响从婴儿早期到学龄前不同生长阶段的体重指数（BMI）增长率。
我们研究了母乳喂养持续时间、母亲 BMI 和出生体重是否与幼儿时期 WHO 年龄和性别标准化 BMI z 评分（zBMI）的生长轨迹有关。
参加应用研究小组对儿童（TARGet Kids！）前瞻性队列研究的儿童（n=5905）从出生到 10 岁时接受了体重和长度或身高的重复测量。分段线性混合模型用于确定在出生后 1、3、18、36 和 72 个月的生长期间，每个危险因素的 zBMI 增长率是否不同。
与母乳喂养≥6 个月的儿童相比，母乳喂养<6 个月的儿童在 1-3 个月和 3-18 个月期间的生长速度较快，导致在 18、36 和 72 个月时的标准化 BMI（zBMI）分别增加了 0.24、0.12 和 0.19。母亲 BMI（kg/m2）≥30 与<30 相比，在 1-3 个月和 36-72 个月期间的生长速度较快，在 3、18、36 和 72 个月时的 zBMI 分别增加了 0.22、0.14、0.18 和 0.41。出生体重<2.5 kg（与 2.5-4 kg 相比）的婴儿在 1-3 个月和 3-18 个月期间的生长速度较快，但在所有时间点的 zBMI 均较低（zBMI：-1.45 至-0.21）。出生体重≥4 kg（与 2.5-4 kg 相比）的婴儿在前 3 个月的生长速度明显较慢，但在所有时间点的 zBMI 均较高（zBMI：+1.16 至+0.27）。
母乳喂养持续时间、母亲 BMI 和出生体重对 zBMI 生长速度的差异在婴儿早期就存在，并导致 zBMI 存在差异，这些差异持续到儿童中期。该试验在 www.clinicaltrials.gov 上注册为 NCT01869530。
