Relative effects of postnatal rapid growth and maternal factors on early childhood growth trajectories

Abstract

Background A range of postnatal and maternal factors influences childhood obesity, but their relative importance remains unclear. This study aimed to assess the relative impact of postnatal rapid growth and maternal factors on early childhood growth trajectories. Subjects Secondary longitudinal analysis of pooled data from the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program and the InFANT Extend Program (n = 977) was performed. Children's height and weight were collected at birth, 3, 9, 18, and 36/42 months. Body mass index‐for‐age and height‐for‐age z‐scores (BAZ, HAZ) were computed using WHO growth standards. Mixed‐effect polynomial regression models were fitted to examine BAZ and HAZ trajectories and their determinants. Results Rapid growth from birth to 3 months, maternal country of birth, and pre‐pregnancy BMI were each independently associated with BAZ from 3 to 42 months. Children with rapid growth, those whose mothers were Australian‐born, and those whose mothers were overweight/obese pre‐pregnancy had higher BAZ from 3 to 42 months. Children with rapid growth had an increase in HAZ growth, but their average HAZ from 3 to 42 months was smaller than children without rapid growth. Children of tall mothers (above average height) had higher HAZ than those of short mothers (below average height). Average HAZ from 3 to 42 months did not differ by maternal country of birth. Conclusion Children who experienced rapid growth from birth to 3 months, whose mothers were Australian‐born or whose mothers were overweight/obese pre‐pregnancy demonstrated less favourable growth trajectories across early childhood, potentially predispose them for development of future obesity.

The association between maternal body mass index and child obesity: A systematic review and meta-analysis

“…The searches identified 41,301 studies, of which 100 studies met the inclusion criteria (Fig 1; S3 Table). Following exclusion of 21 studies that reported duplicate data (S4 Table), 79 studies remained [20–98], with sample sizes ranging from 70 to 100,612 (S5 Table); 67 studies were identified in the original searches [20,33–98], and a further 12 studies were identified in the updated searches that reported unique data not already included in the review or meta-analysis [21–32] (Fig 1; S5 Table). Of these studies, 56 were prospective, 21 reported national-level data, and the majority ( n = 63) were published since 2010.…”

“…Additional data were available for associations between categorical maternal BMI and continuous child BMI or z -score for children aged 1 to 9 years, but were not included in the meta-analysis [28,32,33,61,76,82,84,87–91] (S12 Table), and for associations between continuous maternal BMI and continuous child BMI or z -score for children aged 1 to 18 years [24,36,60,61,71,75,80,85,86,88,92–97] (S13 Table). All except 1 showed a significant association between increasing maternal BMI and increasing child BMI or z -score.…”

Longitudinal analysis of growth trajectories in young children of Chinese-born immigrant mothers compared with Australian-born mothers living in Victoria, Australia

“…49 The current study has highlighted early accelerated growth in Chinese-born mothers in this sample population. Rapid growth is a significant risk factor for later obesity, 9 therefore, a deeper understanding of the factors influencing growth patterns in these ethnic groups in order to intervene early is required. Longitudinal studies into later childhood and adulthood to track zBMI and related health outcomes long term is also recommended.…”

Rapid Weight Gain, Infant Feeding Practices, and Subsequent Body Mass Index Trajectories: The CALINA Study

“…An important aspect of the present study is that z-scores have been used to assess growth in children, which is widely recognized as the best system for analysis and presentation of anthropometric data because of its advantages compared to other methods. Furthermore, given that they are sex-independent, their use permits the evaluation of children’s growth status by combining sex and age groups [ 25 ] and has been widely used in recent studies with similar aims [ 26 , 27 , 28 ].…”