Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
School of Medicine, The Center for Medical Gerontology, Trinity College Dublin, Dublin, Ireland.
J Pediatr. 2018 Nov;202:106-114. doi: 10.1016/j.jpeds.2018.06.049. Epub 2018 Aug 23.
To longitudinally investigate body mass index (BMI) in young children in Ireland and identify factors and critical time points associated with changes in BMI.
Data on 11 134 children were collected in the nationally representative Growing Up in Ireland infant cohort study. Height and weight were measured at 9 months, 3 years, and 5 years of age. Multilevel regression was used to identify risk factors associated with changes in BMI over time (n = 10 377), combining a unique set of covariates collected from the child and the 2 main caregivers (usually the mother and father).
The proportion of children ≥85th percentile of World Health Organization growth criteria was 39% at 9 months, 44% at 3 years, and 30% at 5 years. Children born large for gestational age (13%) and those with rapid infant weight gain (25%) consistently had higher BMI. Low average BMIs were consistently seen in children born small for gestational age (10%) or before 37 weeks (7%). Smaller variations in BMI existed for other factors including ethnicity, household structure, caregiver weight status, breastfeeding, sex, socioeconomic status, sleeping hours, childcare, and region.
In this study, differences at birth and in infancy appear to be most strongly associated with variation in BMI at all ages. Nevertheless, belonging to a number of other high-risk groups cumulatively could lead children to develop critical weight states. Policy-makers should target families with interventions before and during pregnancy when dominant risk factors are still modifiable. Longer-term follow-up of children may be needed to study associations later in childhood.
纵向研究爱尔兰幼儿的体重指数(BMI),并确定与 BMI 变化相关的因素和关键时间点。
在具有全国代表性的爱尔兰婴幼儿队列研究中收集了 11134 名儿童的数据。在 9 个月、3 岁和 5 岁时测量身高和体重。使用多水平回归来确定与 BMI 随时间变化相关的危险因素(n=10377),结合从儿童和 2 位主要照顾者(通常是母亲和父亲)收集的一组独特的协变量。
9 个月时,符合世界卫生组织生长标准第 85 百分位的儿童比例为 39%,3 岁时为 44%,5 岁时为 30%。出生时巨大儿(13%)和快速婴儿体重增加(25%)的儿童BMI 始终较高。出生时体重不足(10%)或不足 37 周(7%)的儿童 BMI 始终较低。其他因素如种族、家庭结构、照顾者体重状况、母乳喂养、性别、社会经济地位、睡眠时间、儿童保育和地区等,BMI 的变化幅度较小。
在这项研究中,出生时和婴儿期的差异似乎与所有年龄段的 BMI 变化最密切相关。然而,属于多个其他高风险群体可能会导致儿童出现临界体重状态。政策制定者应在怀孕前和怀孕期间针对有干预措施的家庭进行干预,因为此时主要风险因素仍然可以改变。可能需要对儿童进行长期随访,以研究后期儿童的关联。