The association between maternal body mass index and child obesity: A systematic review and meta-analysis
The association between maternal body mass index and child obesity: A systematic review and meta-analysis
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DOI：
10.1371/journal.pmed.1002817
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发表时间：
2019-06-01
期刊：
影响因子：
15.8
通讯作者：
Rankin, Judith
中科院分区：
文献类型：
--
作者：
Heslehurst, Nicola;Vieira, Rute;Rankin, Judith
背景全球范围内存在肥胖危机，尤其是在女性和弱势群体中。预防儿童肥胖的早期生活干预是公共卫生、全球卫生和临床实践的优先事项。了解儿童肥胖和母亲孕前体重状况之间的联系，将使人们能够通过将资源引导到干预措施来估计子女获得健康的潜力，从而为政策和实践提供信息。这项系统的综述和荟萃分析旨在研究母亲体重指数(BMI)与子代儿童肥胖症之间的剂量反应关系。方法和发现MEDLINE、儿童发展和青少年研究、CINAHL、Embase和SqucINFO的搜索于2017年8月进行，并于2019年3月更新。补充搜索包括手动搜索参考文献列表、执行引文搜索和联系作者。两名研究人员进行了独立的筛选、数据提取和质量评估。其中包括用英语发表的观察性研究，以及连续和/或分类的母婴BMI或z得分之间的关联报告。分类结果是儿童肥胖(>；=第95个百分位数，主要结果)、超重/肥胖(>；=第85个百分位数)和超重(第85到95个百分位数)。使用随机效应模型进行线性和非线性剂量-反应荟萃分析。不能纳入荟萃分析的研究以叙述性的方式进行总结。在确定的41,301项研究中，79项符合纳入标准(n=59个队列)。儿童肥胖的Meta分析包括20项研究(n=88,872)；儿童超重/肥胖，22项研究(n=181,800)；以及超重，10项研究(n=53,238)。儿童肥胖与母亲肥胖(优势比[OR]3.64，95%可信区间2.68-4.95)和母亲超重(优势比1.89，95%可信区间1.62-2.19)显著增加。儿童超重/肥胖(OR 2.69，95%CI 2.10-3.46)和儿童超重(OR 1.80，95%CI 1.25，2.59)合并母亲肥胖的风险显著增加。这项研究的局限性是，纳入的研究并不总是以能够纳入这项复杂的荟萃分析的格式报告数据。结论这项研究发现，当母亲在怀孕前肥胖时，儿童肥胖的几率增加264%。这项研究提供了大量证据，证明有必要制定在受孕前就开始的干预措施，以支持育龄妇女进行体重管理，以遏制代际肥胖。
BackgroundThere is a global obesity crisis, particularly among women and disadvantaged populations. Early-life intervention to prevent childhood obesity is a priority for public health, global health, and clinical practice. Understanding the association between childhood obesity and maternal pre-pregnancy weight status would inform policy and practice by allowing one to estimate the potential for offspring health gain through channelling resources into intervention. This systematic review and meta-analysis aimed to examine the dose-response association between maternal body mass index (BMI) and childhood obesity in the offspring.Methods and findingsSearches in MEDLINE, Child Development & Adolescent Studies, CINAHL, Embase, and PsycInfo were carried out in August 2017 and updated in March 2019. Supplementary searches included hand-searching reference lists, performing citation searching, and contacting authors. Two researchers carried out independent screening, data extraction, and quality assessment. Observational studies published in English and reporting associations between continuous and/or categorical maternal and child BMI or z-score were included. Categorical outcomes were child obesity (>= 95th percentile, primary outcome), overweight/obesity (>= 85th percentile), and overweight (85th to 95th percentile). Linear and nonlinear dose-response meta-analyses were conducted using random effects models. Studies that could not be included in meta-analyses were summarised narratively. Seventy-nine of 41,301 studies identified met the inclusion criteria (n = 59 cohorts). Meta-analyses of child obesity included 20 studies (n = 88,872); child overweight/obesity, 22 studies (n = 181,800); and overweight, 10 studies (n = 53,238). Associations were nonlinear and there were significantly increased odds of child obesity with maternal obesity (odds ratio [OR] 3.64, 95% CI 2.68-4.95) and maternal overweight (OR 1.89, 95% CI 1.62-2.19). Significantly increased odds were observed for child overweight/obesity (OR 2.69, 95% CI 2.10-3.46) and for child overweight (OR 1.80, 95% CI 1.25, 2.59) with maternal obesity. A limitation of this research is that the included studies did not always report the data in a format that enabled inclusion in this complex meta-analysis.ConclusionsThis research has identified a 264% increase in the odds of child obesity when mothers have obesity before conception. This study provides substantial evidence for the need to develop interventions that commence prior to conception, to support women of childbearing age with weight management in order to halt intergenerational obesity.