Medical Faculty, LIFE Child (Leipzig Research Centre for Civilization Diseases), Leipzig University, Leipzig, Germany.
Department of Women and Child Health, Hospital for Children and Adolescents and Centre for Paediatric Research (CPL), Medical Faculty, Leipzig University, Leipzig, Germany.
PLoS One. 2022 Jul 19;17(7):e0271676. doi: 10.1371/journal.pone.0271676. eCollection 2022.
Birth order and having at least one sibling are known to be associated with an increased risk for development of overweight. However, there are no studies assessing pre- and postnatal factors for developing overweight within families. Therefore, the present study aimed to analyse the association of the mother's weight gain during pregnancy, prepregnancy BMI, mother's age at birth, breastfeeding, age gap between siblings, and physical activity together with sibling-related characteristics on the development of overweight in children and adolescents.
Data were obtained from the longitudinal LIFE Child cohort. The study sample included n = 1932 children, stratified into first-born (n = 578), second-born (n = 608), third-or-later-born single-born siblings (n = 162), only children (n = 526), and twin children (n = 58). Children with chronic or syndromic diseases, born prematurely or from mothers with gestational diabetes were excluded. Data were adjusted for multiple children per family using mixed models. Pregnancy weight gain, prepregnancy BMI and mother's age were considered prenatal co-variates. Postnatal factors included the duration of breastfeeding and the children's physical activity level.
Particularly until the onset of puberty, the BMI-SDS differed between single-born siblings, only children and twins, and increased with birth order. Compared to children with siblings, only children exhibited a strong increase in BMI-SDS starting at age nine. A higher age gap between siblings was associated with a higher BMI-SDS in second- and third-or-later-born children. Single-born siblings had the highest rate and duration of breastfeeding. Physical activity was highest in twins and third-or-later-born children and lowest in only children. In a multivariate model, being an only child showed a highly significant association with BMI-SDS.
The present study demonstrated that siblings had a lower BMI-SDS than only children did. For single-born siblings, the association between birth order and increased BMI-SDS seemed to persist only up to 11 years of age.
已知出生顺序和至少有一个兄弟姐妹与超重风险增加有关。然而，目前还没有研究评估家庭内超重发展的产前和产后因素。因此，本研究旨在分析母亲怀孕期间体重增加、孕前 BMI、母亲出生年龄、母乳喂养、兄弟姐妹年龄差距和体力活动与兄弟姐妹相关特征一起对儿童和青少年超重发展的关联。
数据来自纵向 LIFE 儿童队列。研究样本包括 n = 1932 名儿童，分为第一胎（n = 578）、第二胎（n = 608）、第三胎或以上单胎兄弟姐妹（n = 162）、独生子（n = 526）和双胞胎（n = 58）。患有慢性或综合征疾病、早产或母亲患有妊娠糖尿病的儿童被排除在外。使用混合模型对每个家庭的多个儿童进行了数据调整。孕期体重增加、孕前 BMI 和母亲年龄被视为产前协变量。产后因素包括母乳喂养持续时间和儿童的体力活动水平。
特别是在青春期前，单胎兄弟姐妹、独生子和双胞胎的 BMI-SDS 存在差异，且随着出生顺序的增加而增加。与有兄弟姐妹的儿童相比，独生子从 9 岁开始 BMI-SDS 显著增加。兄弟姐妹之间的年龄差距越大，第二胎和第三胎或以上的儿童 BMI-SDS 越高。单胎兄弟姐妹的母乳喂养率和持续时间最高。双胞胎和第三胎或以上的儿童体力活动最高，独生子最低。在多变量模型中，独生子与 BMI-SDS 呈高度显著相关。
本研究表明，兄弟姐妹的 BMI-SDS 低于独生子。对于单胎兄弟姐妹，出生顺序与 BMI-SDS 增加之间的关联似乎仅持续到 11 岁。
