Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstraße 22, 89081, Ulm, Germany.
Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany.
BMC Pediatr. 2023 Apr 15;23(1):175. doi: 10.1186/s12887-023-03991-6.
Child overweight remains a prevalent public health concern, but the impact of maternal psychosocial stress and related constructs, the timing, and possible trajectories on child body mass index (BMI) is controversial. We aimed to investigate the association of maternal stress, depression and anxiety symptoms, and maternal hair cortisol concentrations (HCC) at delivery, 6, and 12 months postpartum with child BMI and age- and sex-standardized BMI (BMI-SDS) at age 3 years.
Data were derived from the Ulm SPATZ Health Study with a baseline examination between 04/2012 and 05/2013 at the University Medical Centre Ulm, Germany, the only maternity clinic in Ulm, with a good representation of the source population. Adjusted regression analyses based on BMI/BMI-SDS (dependent) and trajectories of stress, depression, and anxiety (independent variables) were investigated in 596 mothers and children. Multiple imputation of missing covariates was performed.
Various trajectories in independent variables were identified, trajectories of maternal anxiety symptom differed between child sexes. We did not find an association between trajectories of maternal chronic stress, depression symptoms, or HCC and child BMI/BMI-SDS. However, trajectories of low-increasing maternal anxiety symptoms were linked to higher child BMI compared to a low-stable trajectory group (b = 0.58 kg/m, 95% Confidence Interval: 0.11; 1.04) in girls.
Trajectories of maternal anxiety symptoms were associated with the child's BMI/BMI-SDS in girls at age 3 years. However, further large scale studies should include variables to determine the causal pathway and enlighten sex-specific differences.
儿童超重仍然是一个普遍存在的公共卫生问题，但母体的心理社会压力及其相关结构、时间以及可能的轨迹对儿童体重指数（BMI）的影响仍存在争议。我们旨在研究产妇压力、抑郁和焦虑症状以及分娩时、产后 6 个月和 12 个月的母体头发皮质醇浓度（HCC）与儿童 BMI 以及 3 岁时年龄和性别标准化 BMI（BMI-SDS）之间的关联。
数据来自德国乌尔姆 SPATZ 健康研究，基线检查时间为 2012 年 4 月至 5 月，在乌尔姆大学医学中心进行，该中心是乌尔姆唯一的妇产诊所，很好地代表了原始人群。在 596 名母亲和儿童中，根据 BMI/BMI-SDS（因变量）和压力、抑郁和焦虑轨迹（自变量）的轨迹进行了调整后的回归分析。对缺失协变量进行了多重插补。
在独立变量中确定了各种轨迹，儿童性别之间的母体焦虑症状轨迹存在差异。我们没有发现母体慢性压力、抑郁症状或 HCC 轨迹与儿童 BMI/BMI-SDS 之间存在关联。然而，与低稳定轨迹组相比，母体低升高焦虑症状轨迹与女孩的儿童 BMI 更高相关（b=0.58kg/m，95%置信区间：0.11；1.04）。
母体焦虑症状的轨迹与女孩 3 岁时的儿童 BMI/BMI-SDS 相关。然而，进一步的大规模研究应包括确定因果途径和阐明性别差异的变量。
