Zhang Wen-Xuan, Strodl Esben, Yang Wei-Kang, Yin Xiao-Na, Wen Guo-Min, Sun Deng-Li, Xian Dan-Xia, Zhao Ya-Fen, Chen Wei-Qing
Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.
Front Pediatr. 2024 Sep 13;12:1423556. doi: 10.3389/fped.2024.1423556. eCollection 2024.
This study aimed to explore the combination effects of prenatal exposure to environment tobacco smoke (ETS) and nutrients supplement during pregnancy on childhood obesity in preschoolers.
A cross-sectional study was conducted with 58,814 child-mother dyads from 235 kindergartens in Longhua District of Shenzhen, China in 2021. A self-administered structured questionnaire was completed by mothers to collect socio-demographic characteristics, prenatal ETS exposure, and nutrients supplement in pregnancy, and preschoolers' heights and weights were measured at the same time. After controlling for potential confounding variables, logistic regression models and cross-analyses were used to examine the independent and combination effects of maternal prenatal ETS exposure and nutrients supplementation during pregnancy on obesity in preschool children.
The results of our study showed that prenatal ETS exposure increased the risk of childhood obesity (AOR = 1.22, 95% CI = 1.11-1.34) in preschoolers. In addition, risk of childhood obesity was significantly higher when mothers didn't take supplements of multivitamins (AOR = 1.12, 95% CI = 1.05-1.20), folic acid (AOR = 1.23, 95% CI = 1.10-1.37) and iron (AOR = 1.11, 95% CI = 1.04-1.19) during pregnancy. The cross-over analysis showed that the combination of prenatal ETS exposure with mothers taking no multivitamins (AOR = 1.40, 95% CI = 1.21-1.62), no folic acid (AOR = 1.55, 95% CI = 1.12-2.14) and no iron (AOR = 1.38, 95% CI = 1.19-1.59) during pregnancy also increased the risk of obesity among Chinese preschoolers. We also discovered additive interactive effects between prenatal ETS exposure and no maternal multivitamin, folic acid and iron supplementation in pregnancy on the risk of obesity in preschoolers.
The combination of prenatal exposure to ETS with no supplementation of these nutrients might jointly increase the risk of childhood obesity. Public health interventions are needed to reduce prenatal exposure to ETS and to encourage mothers to take appropriate multivitamin, folic acid and iron supplements during pregnancy.
本研究旨在探讨孕期暴露于环境烟草烟雾（ETS）与孕期营养补充对学龄前儿童肥胖的联合影响。
2021年，对来自中国深圳龙华区235所幼儿园的58814对母子进行了一项横断面研究。母亲们通过填写一份自填式结构化问卷来收集社会人口学特征、孕期ETS暴露情况以及孕期营养补充情况，同时测量学龄前儿童的身高和体重。在控制了潜在的混杂变量后，使用逻辑回归模型和交叉分析来检验母亲孕期ETS暴露和孕期营养补充对学龄前儿童肥胖的独立影响和联合影响。
我们的研究结果表明，孕期暴露于ETS会增加学龄前儿童患肥胖症的风险（调整后比值比[AOR]=1.22，95%置信区间[CI]=1.11-1.34）。此外，母亲在孕期未补充多种维生素（AOR=1.12，95%CI=1.05-1.20）、叶酸（AOR=1.23，95%CI=1.10-1.37）和铁（AOR=1.11，95%CI=1.04-1.19）时，儿童肥胖的风险显著更高。交叉分析表明，孕期暴露于ETS且母亲未补充多种维生素（AOR=1.40，95%CI=1.21-1.62）、未补充叶酸（AOR=1.55，95%CI=1.12-2.14）和未补充铁（AOR=1.38，95%CI=1.19-1.59），也会增加中国学龄前儿童肥胖的风险。我们还发现孕期暴露于ETS与母亲未补充多种维生素、叶酸和铁在学龄前儿童肥胖风险上存在相加交互作用。
孕期暴露于ETS且未补充这些营养素可能会共同增加儿童肥胖的风险。需要采取公共卫生干预措施，以减少孕期ETS暴露，并鼓励母亲在孕期适当补充多种维生素、叶酸和铁。
