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产前应激与儿童早期体质量指数:路径分析方法

Prenatal Stress and Early Childhood Body Mass Index: A Path Analysis Approach.

机构信息

Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado- Anschutz Medical Campus, 13001 East 17th Place, Building 500, Mail Stop B119, Aurora, CO, 80045, USA.

Department of Anthropology, Evolution, Ecology, Ecosystems & Society Program, Dartmouth College, Hanover, NH, 03755, USA.

出版信息

Matern Child Health J. 2021 Mar;25(3):439-449. doi: 10.1007/s10995-020-03060-9. Epub 2021 Jan 27.

Abstract

OBJECTIVES

Stress experienced by mothers during the prenatal period can have negative impacts on offspring development. Elevated BMI in childhood in response to early stress experience is a particularly critical outcome of interest since high BMI in childhood is associated with diabetes, heart disease and stroke in later life. The primary objective of this study was to analyze pathways between prenatal stress and early childhood BMI at 54-months of age and to begin to explore ethnic variations in these pathways.

METHODS

This study used the Growing Up in New Zealand (GUiNZ) dataset, which is a longitudinal, representative birth cohort study that began with recruiting pregnant women in 2009 and 2010 in Auckland, New Zealand. Path analysis modeling was used to explore risk and protective pathways between prenatal maternal stress and early childhood body mass index (BMI) at 54-months of age and differences by ethnicity (n = 5510).

RESULTS

Prenatal stress was positively associated with early childhood BMI at 54-months and maternal nutrition behaviors and length of exclusive breastfeeding mediated this direct relationship (χ (1) = 0.83, p = 0.36; AIC = 50,496). Mediation and moderation paths varied by ethnicity.

CONCLUSIONS FOR PRACTICE

These findings contribute to the understanding of the intergenerational transmission of stress with respect to early childhood obesity. Reducing early stress exposure and/or addressing mediating and moderating factors linking stress experience with obesity development may prove to be more effective than attempting to alter health behaviors and trajectories in adulthood.

摘要

目的

母亲在孕期所经历的压力会对后代的发育产生负面影响。儿童时期 BMI 升高是对早期压力体验的一种特别关键的反应,因为儿童时期的 BMI 升高与成年后患糖尿病、心脏病和中风有关。本研究的主要目的是分析产前压力与 54 个月龄时儿童早期 BMI 之间的关系,并开始探索这些关系在不同种族中的差异。

方法

本研究使用了新西兰成长研究(Growing Up in New Zealand,Guinz)数据集,这是一项纵向、具有代表性的出生队列研究,始于 2009 年和 2010 年在新西兰奥克兰招募孕妇。路径分析模型用于探索产前母亲压力与 54 个月龄时儿童早期体重指数(BMI)之间的风险和保护途径,并按种族(n=5510)进行差异分析。

结果

产前压力与儿童 54 个月龄时的 BMI 呈正相关,母亲的营养行为和纯母乳喂养时间长短则介导了这种直接关系(χ²(1)=0.83,p=0.36;AIC=50496)。中介和调节途径因种族而异。

结论

这些发现有助于理解压力在代际间传递与儿童早期肥胖的关系。减少早期压力暴露,或解决将压力体验与肥胖发展联系起来的中介和调节因素,可能比试图改变成年后的健康行为和轨迹更为有效。

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