Hefei City Maternal and Child Health & Family Planning Service Center, Hefei, China.
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
BMC Pediatr. 2021 Dec 4;21(1):549. doi: 10.1186/s12887-021-02995-4.
The association of low socioeconomic status (SES) with childhood and adolescent obesity has been reported. It is unknown whether low SES affects body mass index (BMI) growth trajectory in the first 12 mo of life. Moreover, accelerated growth as a compensatory mechanism for low birth weight (LBW) during infancy, is an important predictor of later obesity. The aim of the present study was to examine the association of low SES with infancy BMI growth rate and trajectory for LBW and normal birth weight (NBW) infants.
From September 2012 to October 2014, a total of 387 infants in this longitudinal study was subjected to repeated measures of weight and length from birth to 12 mo in Hefei. Generalized growth mixture modeling was used to classify the infancy BMI growth trajectories. Differences in infancy BMI z score (zBMI) and BMI growth rate between low SES and high SES were estimated based on linear regression after adjusting for several confounders including maternal age, pregnancy BMI, physical activity during pregnancy, paternal BMI as well as alcohol use, paternal smoking status, breastfeeding duration and delivery mode.
Infancy BMI trajectories in this study were classified into three categories: rapid growth (class 1), normal growth (class 2) and slow growth (class 3). Low SES infants had the higher zBMI than high SES infants for LBW group at age 6 mo [zBMI difference with 95% CI at 6 mo: 0.28(0.03, 0.53); at 12 mo: 0.21(0.01, 0.43)]. Low SES infants had more rapid zBMI growth rate than those with high SES for low birth weight between 0 and 6 months. Controlling for the confounders, these associations remained robust. We found the lower SES in the rapid growth group.
These findings highlighted the impact of low SES on increasing BMI and accelerated growth during early infancy. Health care and relatively optimal family environment in the first 12 mo of life, especially for LBW infants, are benefit to shape the better infancy growth trajectory.
低社会经济地位(SES)与儿童和青少年肥胖有关。目前尚不清楚低 SES 是否会影响生命最初 12 个月的体重指数(BMI)增长轨迹。此外,婴儿期作为低出生体重(LBW)补偿机制的加速生长是以后肥胖的一个重要预测因素。本研究的目的是检验低 SES 与 LBW 和正常出生体重(NBW)婴儿的婴儿期 BMI 增长率和轨迹的关系。
本纵向研究于 2012 年 9 月至 2014 年 10 月,共纳入 387 名婴儿,在合肥进行了从出生到 12 个月的体重和身长重复测量。使用广义生长混合模型对婴儿 BMI 生长轨迹进行分类。在调整了母亲年龄、妊娠 BMI、妊娠期间的体力活动、父亲 BMI 以及饮酒、父亲吸烟状况、母乳喂养时间和分娩方式等多个混杂因素后,根据线性回归估计低 SES 和高 SES 之间的婴儿期 BMIz 评分(zBMI)和 BMI 增长率之间的差异。
本研究中婴儿 BMI 轨迹分为三类:快速增长(第 1 类)、正常增长(第 2 类)和缓慢增长(第 3 类)。在 LBW 组中,SES 较低的婴儿在 6 个月时的 zBMI 高于 SES 较高的婴儿[6 个月时的 zBMI 差异(95%CI):0.28(0.03,0.53);12 个月时:0.21(0.01,0.43)]。SES 较低的婴儿在 0 至 6 个月的 LBW 期间的 zBMI 增长速度快于 SES 较高的婴儿。控制混杂因素后,这些关联仍然具有很强的稳健性。我们发现快速增长组的 SES 较低。
这些发现强调了低 SES 对婴儿早期 BMI 增加和加速生长的影响。在生命最初的 12 个月内提供医疗保健和相对最佳的家庭环境,特别是对于 LBW 婴儿,有利于形成更好的婴儿生长轨迹。