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加拿大蒙特利尔市移民及社会经济弱势群体中学龄前儿童超重和肥胖的患病率及影响因素

Prevalence and determinants of overweight and obesity among preschool-aged children from migrant and socioeconomically disadvantaged contexts in Montreal, Canada.

作者信息

Woronko Claudia, Merry Lisa, Uckun Sumeyye, Cuerrier Anaële, Li Patricia, Hille Jennifer, Van Hulst Andraea

机构信息

Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, 680 Sherbrooke St, Unit 1800, Montreal, Quebec H3A 2M7, Canada.

Faculté des sciences infirmières, Université de Montréal, Pavillon Marguerite-d'Youville 2375, chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1A8, Canada.

出版信息

Prev Med Rep. 2023 Sep 9;36:102397. doi: 10.1016/j.pmedr.2023.102397. eCollection 2023 Dec.

Abstract

Among migrant and socioeconomically disadvantaged preschool-aged children followed in social perinatal primary care services in Montreal, Canada, we estimated the prevalence of overweight/obesity and identified determinants of body mass index z-score (zBMI) at 4-5 years old. We conducted a retrospective cohort study using electronic medical records of 275 child-mother dyads followed from birth to 4-5 years. Anthropometric measures and established maternal, perinatal and child risk factors for childhood obesity were examined. Age- and sex-specific zBMI at 4-5-years were computed and categorized according to WHO standards. Linear regression with model averaging was used to identify early life factors associated with zBMI. At 4-5 years, children's weight status was classified as underweight (1.5%), normal weight (69.7%), at-risk-of-overweight (19.2%), overweight (6.9%), and obesity (2.7%). Primiparity (0.51, 95% CI 0.24; 0.78), higher birthweight (1.04, 95% CI 0.70; 1.37), accelerated weight gain in the first year of life (0.21, 95% CI 0.13; 0.31), and introduction to solid foods before 6 months (0.89, 95% CI 0.42; 1.36) were associated with a higher zBMI, while less than high school education (-0.50, 95% CI -0.95; -0.05) and higher gestational age (-0.14, 95% CI -0.21; -0.05) were associated with lower zBMI at 4-5 years. Overweight/obesity is prevalent among preschool-aged children from migrant and socioeconomically disadvantaged contexts and is associated with known risk factors. Future research is needed to better understand the role of social perinatal primary care services in promoting optimal weight gain among children living in contexts of vulnerability.

摘要

在加拿大蒙特利尔接受社会围产期初级保健服务的移民及社会经济条件不利的学龄前儿童中,我们估计了超重/肥胖的患病率,并确定了4至5岁儿童体重指数z评分(zBMI)的决定因素。我们进行了一项回顾性队列研究,使用了275对母婴从出生到4至5岁的电子病历。研究考察了人体测量指标以及已确定的儿童肥胖的母亲、围产期和儿童风险因素。计算了4至5岁儿童的年龄和性别特异性zBMI,并根据世界卫生组织标准进行分类。采用模型平均的线性回归来确定与zBMI相关的早期生活因素。在4至5岁时,儿童的体重状况分类为体重过轻(1.5%)、正常体重(69.7%)、超重风险(19.2%)、超重(6.9%)和肥胖(2.7%)。初产(0.51,95%置信区间0.24;0.78)、较高出生体重(1.04,95%置信区间0.70;1.37)、生命第一年体重加速增加(0.21,95%置信区间0.13;0.31)以及6个月前开始添加固体食物(0.89,95%置信区间0.42;1.36)与较高的zBMI相关,而高中以下学历(-0.50,95%置信区间-0.95;-0.05)和较高的孕周(-0.14,95%置信区间-0.21;-0.05)与4至5岁时较低的zBMI相关。超重/肥胖在移民及社会经济条件不利背景的学龄前儿童中普遍存在,且与已知风险因素相关。需要未来的研究来更好地理解社会围产期初级保健服务在促进弱势群体儿童实现最佳体重增加方面的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ad7/10507148/9733ff47a040/gr1.jpg

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