Aubert Adrien M, Lecorguillé Marion, Schipper Mireille C, Douglass Alexander, Kelleher Cecily C, Lioret Sandrine, Heude Barbara, Gaillard Romy, Phillips Catherine M
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
Pediatrics. 2025 Feb 1;155(2). doi: 10.1542/peds.2024-066406.
Investigate associations of different family healthy lifestyle scores (HLS) during the first 1000 days with childhood overweight and obesity (OWOB).
Cohort-specific analyses were conducted on participants (n = 25 006) from 4 European birth cohorts (The study on the pre- and early postnatal determinants of child health and development [EDEN], Elfe, France; Generation R, the Netherlands; and Lifeways, Ireland). Three composite HLSs were calculated: a maternal pregnancy HLS based on prepregnancy body mass index (BMI) and diet quality, physical activity, smoking status, and alcohol consumption during pregnancy; a parental pregnancy HLS additionally considering paternal BMI and smoking status; and an infancy HLS based on breastfeeding duration, age of solid food introduction, and exposure to passive smoking. Associations with child BMI (primary outcome) and waist-to-height ratio (WHtR, available in 2 cohorts) in early (5-5.5 years), middle (7-8 years), and late childhood (9-12 years) were assessed using linear (BMI and WHtR z-scores) and robust Poisson (International Obesity Task Force [IOTF] categories) regression analyses adjusted for sociodemographic confounders.
Only a small proportion of families had favorable lifestyle factors during pregnancy and early infancy, with 3.4% to 10.0%, 1.9% to 3.7%, and 12.2% to 23.6% scoring maximum for maternal, parental, and infancy HLS, respectively. Associations between higher HLSs and a lower risk of OWOB when measured by BMI z-scores or IOTF categories were found for maternal HLS and early (3/4 cohorts with available data), middle (1/2), and late childhood (2/4); parental HLS and early (3/4), middle (2/2), and late childhood (4/4). Associations between infancy HLS and childhood OWOB were less consistent and did not remain significant after additional adjustment for parental HLS. Associations with WHtR were solely significant in EDEN at 5.5 years.
Greater maternal and parental adherence to healthy lifestyle behaviors during pregnancy was associated with a lower risk of offspring OWOB throughout childhood, illustrating the importance of promoting healthy lifestyle behaviors at the family level during pregnancy.
研究出生后1000天内不同家庭健康生活方式评分（HLS）与儿童超重和肥胖（OWOB）之间的关联。
对来自4个欧洲出生队列（法国儿童健康与发育的产前和产后早期决定因素研究[EDEN]、法国的Elfe、荷兰的Generation R和爱尔兰的Lifeways）的参与者（n = 25006）进行队列特异性分析。计算了三个综合HLS：一个基于孕前体重指数（BMI）、饮食质量、身体活动、孕期吸烟状况和饮酒情况的母亲孕期HLS；一个额外考虑父亲BMI和吸烟状况的父母孕期HLS；以及一个基于母乳喂养持续时间、固体食物引入年龄和被动吸烟暴露情况的婴儿期HLS。使用线性（BMI和腰高比[WHtR] z评分）和稳健泊松（国际肥胖特别工作组[IOTF]类别）回归分析评估了在儿童早期（5 - 5.5岁）、中期（7 - 8岁）和晚期（9 - 12岁）与儿童BMI（主要结局）和腰高比（WHtR，在2个队列中可用）的关联，并对社会人口学混杂因素进行了调整。
只有一小部分家庭在孕期和婴儿早期具有良好的生活方式因素，母亲、父母和婴儿期HLS得分最高的家庭分别为3.4%至10.0%、1.9%至3.7%和12.2%至23.6%。当通过BMI z评分或IOTF类别衡量时，发现较高的HLS与较低的OWOB风险之间存在关联，母亲HLS与儿童早期（4个有数据的队列中有3个）、中期（2个队列中有1个）和晚期（4个队列中有2个）有关；父母HLS与儿童早期（4个队列中有3个）、中期（2个队列中有2个）和晚期（4个队列中有4个）有关。婴儿期HLS与儿童期OWOB之间的关联不太一致，在对父母HLS进行额外调整后不再显著。与WHtR的关联仅在EDEN队列5.5岁时显著。
孕期母亲和父母对健康生活方式行为的更高坚持与整个儿童期后代OWOB风险较低相关，这说明了在孕期促进家庭层面健康生活方式行为的重要性。
