Exploring the impact of early life factors on inequalities in risk of overweight in UK children: findings from the UK Millennium Cohort Study.
Exploring the impact of early life factors on inequalities in risk of overweight in UK children: findings from the UK Millennium Cohort Study.
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DOI：
10.1136/archdischild-2015-309465
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发表时间：
2016-08
影响因子：
5.2
通讯作者：
Taylor-Robinson D
中科院分区：
文献类型：
--
作者：
Massion S;Wickham S;Pearce A;Barr B;Law C;Taylor-Robinson D
儿童超重和肥胖是一种社会模式，在处境较不利的人群中患病率较高，但尚不清楚早期生活因素在多大程度上缓解了儿童超重/肥胖中发现的社会不平等。我们根据社会经济情况估计了英国千禧年队列研究中11名 764名儿童在11岁时超重(合并肥胖)的相对风险。研究人员探讨了早期生活风险因素，以评估它们是否减弱了秒与超重之间的联系。在11 岁时，28.84%的儿童超重。与学历及以上学历母亲的子女相比，母亲没有学历的子女超重的可能性更大(RR 1.72，95%CI 1.48~2.01)。控制产前、围产期和早期生活特征(特别是孕妇孕前超重和孕期吸烟)，与最高学历组相比，最低学历组超重的RR降至1.44，95%CI为1.23~1.69。我们使用一个有代表性的英国样本，观察了超重11岁儿童的明显社会梯度。此外，我们确定了特定的早期生活风险因素，包括母亲在怀孕期间吸烟和母亲孕前超重，这部分解释了儿童超重中发现的社会不平等。支持母亲在怀孕期间保持健康体重、母乳喂养和戒烟的政策对改善孕产妇和儿童健康结果非常重要，我们的研究提供了一些证据，表明这些政策也可能有助于解决儿童超重不平等现象的持续加剧。
Overweight and obesity in childhood are socially patterned, with higher prevalence in more disadvantaged populations, but it is unclear to what extent early life factors attenuate the social inequalities found in childhood overweight/obesity. We estimated relative risks (RRs) for being overweight (combining with obesity) at age 11 in 11 764 children from the UK Millennium Cohort Study (MCS) according to socio-economic circumstances (SEC). Early life risk factors were explored to assess if they attenuated associations between SECs and overweight. 28.84% of children were overweight at 11 years. Children of mothers with no academic qualifications were more likely to be overweight (RR 1.72, 95% CI 1.48 to 2.01) compared to children of mothers with degrees and higher degrees. Controlling for prenatal, perinatal, and early life characteristics (particularly maternal pre-pregnancy overweight and maternal smoking during pregnancy) reduced the RR for overweight to 1.44, 95% CI 1.23 to 1.69 in the group with the lowest academic qualifications compared to the highest. We observed a clear social gradient in overweight 11-year-old children using a representative UK sample. Moreover, we identified specific early life risk factors, including maternal smoking during pregnancy and maternal pre-pregnancy overweight, that partially account for the social inequalities found in childhood overweight. Policies to support mothers to maintain a healthy weight, breastfeed and abstain from smoking during pregnancy are important to improve maternal and child health outcomes, and our study provides some evidence that they may also help to address the continuing rise in inequalities in childhood overweight.