Socioeconomic disparities in preterm birth and birth weight in a non-Western developed setting: evidence from Hong Kong's ‘Children of 1997’ birth cohort

Leung, June Yue Yan; Leung, Gabriel M.; Schooling, CM

doi:10.1136/jech-2015-206668

Cited by 16 publications

(15 citation statements)

References 33 publications

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“…Sleep was inversely associated with BMI z score in children cross‐sectionally and using MR. The observational study has the advantage of being conducted in a population with little social patterning of adiposity , making the estimates less open to confounding like the MR estimates. However, MR gives more of an estimate of lifetime exposure, which might explain any differences in magnitude.…”

Section: Discussionmentioning

confidence: 99%

“…To clarify the role of sleep duration in adiposity for children and adults, we considered the question in two complementary ways. First, in the population‐representative Hong Kong birth cohort “Children of 1997,” in which sleep duration tends to be short and adiposity is not clearly associated with socioeconomic position , we assessed the adjusted cross‐sectional associations of sleep duration with BMI z score and obesity and overweight at ~11 years of age. Given that observational studies may be open to reverse causation, we also examined longitudinal associations of sleep duration with subsequent BMI z score and obesity and overweight from about 11 to 16 years of age.…”

Section: Introductionmentioning

confidence: 99%

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Sleep Duration and Adiposity in Children and Adults: Observational and Mendelian Randomization Studies

Wang

Lam

et al. 2019

Obesity

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Objective: This study used two complementary designs, an observational and a Mendelian randomization (MR) study, to assess whether sleep duration causes adiposity in children and adults. Methods: In Hong Kong's "Children of 1997" birth cohort, the adjusted cross-sectional associations of sleep duration with BMI z score and obesity and overweight were assessed at ~11 years of age. Generalized estimating equations were also used to examine longitudinal associations of sleep duration at ~11 years with annual BMI z score and obesity and overweight at about 11 to 16 years of age. Using MR, this study assessed the association of genetically predicted sleep duration based on 54 singlenucleotide polymorphisms, applied to genetic studies of adiposity in children (n = 35,668), men (n = 152,893), and women (n = 171,977). Results: Longer sleep was cross-sectionally associated with lower BMI z score at ~11 years of age (−0.13 per category, 95% CI: −0.22 to −0.04) and at about 11 to 16 years of age longitudinally in girls (−0.39, 95% CI: −0.66 to −0.13). Using MR, sleep duration was inversely associated with BMI in children (−0.29 SD per hour, 95% CI: −0.54 to −0.04), but was not clearly associated with BMI in adults, particularly for women. Conclusions: A small beneficial effect of sleep on BMI in children cannot be ruled out.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sleep Duration and Adiposity in Children and Adults: Observational and Mendelian Randomization Studies

Wang

Lam

et al. 2019

Obesity

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“…Moreover, in the Hong Kong population, researchers demonstrated parental education, housing, income and occupation were not clearly linearly associated with SGA. 14 As the economy of Hong Kong is more developed than that of China mainland, it makes great sense to explore the association between SES and SGA infants in mainland China.…”

Section: Introductionmentioning

confidence: 99%

Pathways linking socioeconomic status to small-for-gestational-age (SGA) infants among primiparae: a birth cohort study in China

Luo

Liu

et al. 2018

BMJ Open

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ObjectivesEvidence about the relationship between socioeconomic status (SES) and small-for-gestational-age (SGA) infants was insufficient among Chinese primiparae. In addition, factors that may mediate this relationship are poorly understood. The purpose of this study was to investigate the risk of and mediators between SES and SGA.DesignRetrospective cohort study.SettingWuhan, Hubei, China.MethodParticipants were recruited from patients who gave birth in the maternity care hospital of Wuhan between September 2012 and October 2014. Logistic regression models were used to estimate the association between SES and SGA. Pathway analysis was performed to examine the contribution of maternal lifestyles and pregnancy-induced hypertension syndrome (PIH) to the relationship between SES and SGA. Total effect, direct effect and indirect effect of SES on SGA were measured. Effect sizes were evaluated by unstandardised estimates (B) and standardised estimates (ß).ResultsAmong 8737 primiparae, 927 (10.61%) pregnant women had babies with SGA. High SES was inversely associated with risk of SGA (OR 0.856; 95% CI 0.737 to 0.995) after adjustment for potential confounders. Maternal obstetric characteristics, lifestyles and PIH completely mediated SES and SGA (indirect effect: B=−0.067, 95% CI −0.108 to –0.026). The indirect effect of SES was strengthened by PIH (B=−0.029), a multivitamin supplement (B=−0.021), prepregnancy body mass index (BMI) ≥18.50 (B=−0.009) and prepregnancy BMI ≥18.50 to gestational weight gain (GWG) not below the Institute of Medicine (IOM) recommendations (B=−0.003).ConclusionsWomen from high SES predicted lower risk of PIH, more chances to take a multivitamin supplement during early pregnancy, keeping prepregnancy BMI ≥18.50 kg/cm2 and gaining adequate gestational weight which was not below IOM recommendations. Furthermore, lower risk of PIH, more chances to take a multivitamin supplement, prepregnancy BMI ≥18.50 kg/cm2 and GWG not below IOM recommendations were associated with a lower risk of SGA infants.

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“…Growth phases for infancy, childhood, and puberty were defined as birth to 2 years, 2 to 8 years, and 8 to 14 years, respectively. 36 Within the constraints of the data availability (ie, weight at birth, 1,3,9,12,18,24, and 36 months and annually from 6 to 15 years old, length/height at 3, 9, and 36 months and annually from 6 to 15 years old), growth changes were considered as: WAZ in infancy (birth to 2 years) and childhood To provide more understanding on the role of early growth, in the further analysis, growth in infancy was considered as growth in early (WAZ from birth to 1 year; LAZ and BAZ from 3 to 9 months) and late (WAZ from 1 to 2 years; LAZ and BAZ from 9 months to 3 years) infancy.…”

Section: Growth Changesmentioning

confidence: 99%

“…In the present study, we examined the associations of weight, length/height, and BMI growth at different phases from birth to puberty with fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) at ~17.5 years in Hong Kong, which has little social patterning of birth weight and growth . We hypothesized that faster weight, length/height, and BMI growth would be associated with poorer glycemic control given the associations of rapid growth with obesity and of growth hormone with diabetes .…”

Section: Introductionmentioning

confidence: 99%

Associations of growth from birth to puberty with glycemic indicators at ~17.5 years: Evidence from Hong Kong's “Children of 1997” birth cohort

et al. 2019

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Background From an evolutionary biology perspective, where growth and reproduction trade‐off against longevity, we assessed the associations of growth from birth to puberty by phase with later glycemic indicators and any differences by sex. Methods In the population‐representative Hong Kong Chinese “Children of 1997” birth cohort (n = 8327), the relation of initial size (weight‐for‐age z score (WAZ) at birth, length/height‐for‐age z score (LAZ) at 3 months or body‐mass‐index‐for‐age z score (BAZ) at 3 months based on the World Health Organization growth standards/references) and growth at different phases (WAZ gains from 0 to 2 and 2 to 8 years, LAZ or BAZ gains from 3 months to 3 years, 3 to 8 years and 8 to 14 years) with fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) at ~17.5 years, was assessed using adjusted partial least squares regression. Additional analyses further considered growth in late and early infancy. Results This study included 3276 of the cohort participants. Higher WAZ gain from 2 to 8 years, LAZ and BAZ gains from 3 to 8 years were consistently associated with higher FPG, adjusted for maternal and infant characteristics, family history of diabetes and household income. Also, higher BAZ gain from 3 to 8 years was associated with higher HbA1c. These associations did not differ by sex. Conclusions Our findings suggest different mechanisms could underlie the pathogenesis of glucose intolerance. Factors that drive specific growth at different phases need to be evaluated to better inform child growth management for long‐term health outcomes.

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Socioeconomic disparities in preterm birth and birth weight in a non-Western developed setting: evidence from Hong Kong's ‘Children of 1997’ birth cohort

Abstract: PTB, birth weight and SGA may be less clearly socially patterned in Hong Kong than other developed settings, highlighting the need for setting-specific interventions to prevent adverse birth outcomes.

Cited by 16 publications

References 33 publications

Sleep Duration and Adiposity in Children and Adults: Observational and Mendelian Randomization Studies

Sleep Duration and Adiposity in Children and Adults: Observational and Mendelian Randomization Studies

Pathways linking socioeconomic status to small-for-gestational-age (SGA) infants among primiparae: a birth cohort study in China

Associations of growth from birth to puberty with glycemic indicators at ~17.5 years: Evidence from Hong Kong's “Children of 1997” birth cohort

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