Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
J Nutr. 2023 Aug;153(8):2421-2431. doi: 10.1016/j.tjnut.2023.06.022. Epub 2023 Jun 24.
Risk factors for problematic child eating behaviors and food preferences are thought to begin during the preconception period. It is unknown if maternal preconception body mass index (BMI) is associated with child nutritional risk factors (eg, poor dietary intake and eating behaviors).
We aimed to determine whether maternal preconception BMI was associated with child nutritional risk.
In this longitudinal cohort study, a secondary data analysis of children ages 18 mo to 5 y were recruited from The Applied Research Group for Kids (TARGet Kids!), a primary care practice-based research network in Canada. The primary exposure was maternal preconception BMI. The primary outcome was parent-reported child nutritional risk score, measured using the Nutrition Screening for Every Preschooler/Toddler (NutriSTEP), an age-appropriate validated questionnaire. Fitted linear mixed effects models analyzed associations between maternal preconception BMI and child nutritional risk after adjusting for covariates.
This study included 4733 children with 8611 repeated NutriSTEP observations obtained between ages 18 mo to 5 y. The mean (standard deviation [SD]) maternal preconception BMI was 23.6 (4.4), where 73.1% of mothers had a BMI ≤24.9 kg/m, and 26.9% had a BMI ≥25 kg/m. The mean (SD) NutriSTEP total score was 13.5 (6.2), with 86.6% at low risk (score <21) and 13.4% at high risk (score ≥21). Each 1 unit increase in maternal preconception BMI was associated with a 0.09 increase in NutriSTEP total score (95% confidence interval [CI]: 0.05, 0.12; P ≤ 0.001). After stratification, each 1 unit increase in maternal BMI was associated with a 0.06 increase in mean NutriSTEP total score (95% CI: 0.007, 0.11; P = 0.025) in toddlers and 0.11 increase in mean NutriSTEP total score (95% CI: 0.07, 0.15; P < 0.001) in preschoolers.
Higher maternal preconception BMI is associated with slightly higher NutriSTEP total scores. This provides evidence that the preconception period may be an important time to focus on for improving childhood nutrition. This study was registered at clinicaltrials.gov as NCT01869530.
人们认为，有问题的儿童饮食行为和食物偏好的风险因素始于受孕前阶段。目前尚不清楚母体受孕前体重指数（BMI）是否与儿童营养风险因素（例如，饮食摄入不良和饮食行为）有关。
我们旨在确定母体受孕前 BMI 是否与儿童营养状况有关。
在这项纵向队列研究中，对加拿大基于初级保健实践的研究网络 The Applied Research Group for Kids（TARGet Kids！）招募的 18 个月至 5 岁儿童的二次数据进行了分析。主要暴露因素是母体受孕前 BMI。主要结局是家长报告的儿童营养风险评分，使用适合年龄的经过验证的问卷“Nutrition Screening for Every Preschooler/Toddler（NutriSTEP）”进行测量。在调整协变量后，使用拟合的线性混合效应模型分析了母体受孕前 BMI 与儿童营养风险之间的关联。
这项研究纳入了 4733 名儿童，在 18 个月至 5 岁之间共进行了 8611 次重复的“NutriSTEP”测量。母亲受孕前 BMI 的平均值（标准差[SD]）为 23.6（4.4），其中 73.1%的母亲 BMI 为≤24.9kg/m，26.9%的母亲 BMI 为≥25kg/m。“NutriSTEP”总评分的平均值（SD）为 13.5（6.2），86.6%的儿童处于低风险（评分<21），13.4%的儿童处于高风险（评分≥21）。母体受孕前 BMI 每增加 1 个单位，“NutriSTEP”总评分就会增加 0.09（95%置信区间[CI]：0.05，0.12；P ≤ 0.001）。分层后，母体 BMI 每增加 1 个单位，在幼儿中，“NutriSTEP”总评分的平均值就会增加 0.06（95%CI：0.007，0.11；P=0.025），在学龄前儿童中，“NutriSTEP”总评分的平均值就会增加 0.11（95%CI：0.07，0.15；P<0.001）。
母体受孕前 BMI 较高与“NutriSTEP”总评分略高有关。这表明受孕前阶段可能是改善儿童营养的重要时期。本研究在 clinicaltrials.gov 上注册为 NCT01869530。
