Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Prev Med. 2021 May;146:106451. doi: 10.1016/j.ypmed.2021.106451. Epub 2021 Feb 20.
The associations between socioeconomic status and childhood overweight/obesity are inconsistent, and potential underlying factors are unclear. In China, Hukou status is an important attribute of individual's socioeconomic circumstances, but previously received less consideration as a socioeconomic indicator. This study aimed to investigate the association between comprehensive socioeconomic status and childhood overweight/obesity. Using data from Wuhan Maternal and Child Health Management Information System (2009-2018, N = 209,500), clustering analysis was used to create comprehensive socioeconomic groups with indicator components such as parental education level, occupation, and maternal Hukou. The associations between the determined socioeconomic status and childhood overweight/obesity at age 1 and 2 were examined by log-binomial model. Parallel and serial mediation analyses were performed to test the indirect effects of potential mediators, including maternal pre-pregnancy body mass index, gestational weight gain, and infant birth weight, in the association between socioeconomic status and childhood overweight/obesity. Four clusters, defined as low, low-medium, medium-high, and high socioeconomic groups, were identified through clustering analysis. Hukou, among five socioeconomic components, contributed the most to the development of childhood overweight/obesity. Children in the low-medium socioeconomic group have a greater risk of overweight/obesity than the low socioeconomic group. Indirect effects of maternal pre-pregnancy body mass index, gestational weight gain, and infant birth weight were identified for the association. In conclusion, socioeconomic status may impact childhood obesity through maternal pre-pregnancy body mass index, gestational weight gain, and infant birth weight. Hukou should be considered in the evaluation of socioeconomic status in China.
社会经济地位与儿童超重/肥胖之间的关联并不一致，潜在的影响因素尚不清楚。在中国，户口状况是个人社会经济状况的一个重要属性，但以前作为社会经济指标受到的关注较少。本研究旨在探讨综合社会经济地位与儿童超重/肥胖之间的关系。本研究利用武汉母婴保健管理信息系统（2009-2018 年，N=209500）的数据，采用聚类分析方法，根据父母的受教育程度、职业和母亲户口等指标成分创建综合社会经济群体。采用对数二项式模型检验确定的社会经济地位与 1 岁和 2 岁儿童超重/肥胖之间的关系。并行和序列中介分析用于检验潜在中介因素（包括母亲孕前体重指数、孕期体重增加和婴儿出生体重）在社会经济地位与儿童超重/肥胖之间的间接效应。通过聚类分析确定了四个聚类，定义为低、低中等、中高等和高社会经济群体。在五个社会经济成分中，户口对儿童超重/肥胖的影响最大。中低等社会经济群体的儿童超重/肥胖风险大于低等社会经济群体。确定了母亲孕前体重指数、孕期体重增加和婴儿出生体重与社会经济地位相关联的间接效应。总之，社会经济地位可能通过母亲孕前体重指数、孕期体重增加和婴儿出生体重影响儿童肥胖。在中国，应该考虑户口因素来评估社会经济地位。
