Prenatal, birth, and postnatal mediators of maternal education level and children affected with obesity at five years

IF 2.5 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Obesity research & clinical practice Pub Date : 2024-11-01 DOI:10.1016/j.orcp.2025.01.004

Olivera Djuric , Laura Bonvicini , Serena Broccoli , Marta Ottone , Anna Maria Davoli , Elena Ferrari , Costantino Panza , Maddalena Marchesi , Francesca Bontempo , Paolo Giorgi Rossi

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Abstract

Objective

To establish which prenatal, birth, and postnatal characteristics mediate the association between maternal educational level and having a child with obesity at five years.

Study design

This is a sub analysis of a longitudinal study nested in the BMInForma (Bambini Molto In Forma) program. BMInForma is an ongoing public health multilevel intervention started in 2013 to prevent childhood obesity.

Methods

A cohort of 4835 children born from 1.7.2010 to 31.12.2011 and who received well-health visit at three and five years of age in Reggio Emilia, Italy were included in the study. Maternal and child anthropometric and lifestyle data were linked with routinely collected birth data. A series of simple and multiple mediation analyses were performed.

Results

There were 232 (4.8 %) children with obesity at five year visit. Low maternal educational level was significantly associated with children's obesity at 5 years of age (Odds ratio for the total effect 1.8, 95 %CI 1.4 – 2.5), and with almost all prenatal, birth, postnatal and 3-years-old behaviors. Pre-pregnancy overweight and obesity (OW/OB) and hours in front of TV at three years were two significant mediators that explained 32 % of the total effect of maternal educational level on children with obesity at five years of age (Odds ratio for the indirect effect 1.17, 95 %CI 1.10 – 1.24). Nine percent of this effect was evinced through LGA and gestational diabetes (Odds ratio for the indirect effect 1.07, 95 %CI 1.01 – 1.13).

Conclusions

Pre-pregnancy OW/OB was the most important mediator of the effect of maternal educational level on childhood obesity at five years. Interventions are needed to increase awareness of unhealthy behaviors in early pregnancy.

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产前、分娩和产后母亲教育水平与5岁儿童肥胖的中介关系。

目的：探讨母亲受教育程度与5岁儿童肥胖之间的关系，探讨产前、出生和产后的哪些特征。研究设计：这是嵌套在BMInForma （Bambini Molto in Forma）程序中的纵向研究的子分析。BMInForma是一项持续的公共卫生多层次干预措施，始于2013年，旨在预防儿童肥胖。方法：选取2010年7月1日至2011年12月31日出生的4835名在3岁和5岁时接受健康访问的意大利雷吉欧艾米利亚儿童作为研究对象。母亲和儿童的人体测量和生活方式数据与常规收集的出生数据相关联。进行了一系列简单和多重中介分析。结果：随访5年时有232例（4.8 %）儿童存在肥胖。母亲教育水平低与儿童5岁时的肥胖显著相关（总效应优势比为1.8,95% %CI为1.4 - 2.5），并与几乎所有产前、分娩、产后和3岁时的行为相关。孕前超重和肥胖（OW/OB）和3岁前看电视的时间是两个显著的中介，解释了32 %的母亲教育水平对5岁肥胖儿童的总影响（间接影响的优势比为1.17,95 %CI 1.10 - 1.24）。9%的这种影响通过LGA和妊娠糖尿病得到证实（间接影响的优势比为1.07,95 %CI 1.01 - 1.13）。结论：孕前OW/OB是母亲教育水平对5岁儿童肥胖影响的最重要中介。需要采取干预措施，提高对怀孕早期不健康行为的认识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity research & clinical practice 医学-内分泌学与代谢

CiteScore

7.10

自引率

0.00%

发文量

审稿时长

49 days

期刊介绍： The aim of Obesity Research & Clinical Practice (ORCP) is to publish high quality clinical and basic research relating to the epidemiology, mechanism, complications and treatment of obesity and the complication of obesity. Studies relating to the Asia Oceania region are particularly welcome, given the increasing burden of obesity in Asia Pacific, compounded by specific regional population-based and genetic issues, and the devastating personal and economic consequences. The journal aims to expose health care practitioners, clinical researchers, basic scientists, epidemiologists, and public health officials in the region to all areas of obesity research and practice. In addition to original research the ORCP publishes reviews, patient reports, short communications, and letters to the editor (including comments on published papers). The proceedings and abstracts of the Annual Meeting of the Asia Oceania Association for the Study of Obesity is published as a supplement each year.