Overweight in Infancy: Which Pre- and Perinatal Factors Determine Overweight Persistence or Reduction A Birth Cohort Followed for 11 Years

Abstract

Background: A considerable proportion of children with early-life overweight attain a normal weight. To recognize infants at risk of persistent overweight, we compared early-life factors of children with a longitudinal pattern of persistent overweight to children with a pattern of overweight in early but not in later childhood. Methods: In 3,550 children participating in a birth cohort that started in 1996/1997 in the Netherlands, body mass index was repeatedly assessed until age 11 and dichotomized into with/without overweight. Latent class growth modeling was used to distinguish trajectories. Our analysis was focused on the comparison of early-life factors in children in a persistent overweight pattern with those in an overweight reduction pattern using multivariable log-binomial regression analyses. Results: Children (n = 133) in the persistent overweight pattern were more likely to have overweight parents [relative risk (RR)_mother: 1.85, 95% CI: 1.37-2.49: RR_father: 1.75, 95% CI: 1.21-2.55] than children in the overweight reduction pattern (n = 303). Maternal education, child's gender, ethnicity, birth weight, breast-feeding and maternal smoking during pregnancy did not differ between the trajectories. Conclusion: Health care practitioners should focus on high-weight infants with overweight parents, as these children are less likely to resolve their overweight.

Importance of Characterizing Growth Trajectories

“…In this issue, Van Rossem et al studied 3550 children participating in a birth cohort with repeated measures until age 11 years. [27] They used group-based modeling and showed that children in the category of persistent overweight were more likely to have overweight parents than those in the overweight reduction pattern, while birth weight and breastfeeding did not differ between the two groups of children. [27] In this issue, Twisk asks whether it is necessary to classify subjects into different trajectories to answer research questions.…”

“…[27] They used group-based modeling and showed that children in the category of persistent overweight were more likely to have overweight parents than those in the overweight reduction pattern, while birth weight and breastfeeding did not differ between the two groups of children. [27] In this issue, Twisk asks whether it is necessary to classify subjects into different trajectories to answer research questions. [28] Even if classification is useful for description, he questions how useful it can be for analytic purposes.…”

Connecting the Dots in Childhood Obesity Disparities: a Review of Growth Patterns from Birth to Pre-Adolescence

“…Pryor et al did not identify a persistent overweight trajectory among children followed from 6 months, but children from families with low SES were at higher risk of following a “high rising” BMI trajectory, which diverged at around 3 years [60]. Children overweight in infancy were less likely to resolve their overweight status as they aged into pre-adolescents if they were from lower SES or ethnic minority families [61]. Lower SES [57] and black [59] children were more likely to exhibit late onset overweight or increasing overweight severity [56] than stable normal weight trajectories.…”

“…Most studies reported estimates from models simultaneously adjusted for numerous risk factors [26, 27, 30, 31, 43, 44, 46, 50, 51, 56, 59-61, 70], or conducted minimally adjusted analysis [41, 42, 48, 49]. In three studies, the primary study aim did not align with our research question [29, 38, 45], but provided findings that informed our research question of social differences of growth.…”

The association between parental overweight and obesity before pregnancy and the development of offspring overweight and obesity in childhood, adolescence and young adulthood

“…They found that the odds were significantly higher among female offspring compared to males. Recently, researchers using a Netherlands birth cohort found four overweight trajectory groups from birth to 11 years (never overweight, persistent overweight, overweight reduction, and late onset overweight) [136]. They reported that among the persistent overweight group, children were more likely to have overweight parents in childhood compared to the overweight reduction group children.…”