背景:儿童肥胖仍然是一个公共健康危机,迫切需要确定肥胖风险的独特产前和早期婴儿期预测因子。
目的:我们测试了生命最初6个月体重快速增加(RWG)的综合生物心理社会模型。
方法:两百九十九名孕妇及其婴儿参加。通过孕妇人体测量学在妊娠晚期评估孕妇产前心理生物学风险(PPBR),血清生物标志物(胰岛素,瘦素,脂联素),和妊娠并发症的产妇报告,物质使用,心理健康和压力。在2个月时测量婴儿的应激反应性(皮质醇输出,休息RSA,观察到的烦躁,负面情绪)。在2个月和6个月时,收集了产妇自我报告的生性喂养方法和在三项任务中观察到的产妇敏感性。根据从出生到6个月的年龄体重z评分的变化对RWG进行分类(>0.67SD)。
结果:肥胖喂养实践预测RWG的可能性更大,β=0.30,p=0.01,独立于其他预测因子和协变量。生性饲喂方法是唯一提出的干预机制,该机制对PPBR对RWG产生了显着的间接影响,b=0.05,S.E.=0.04,95%CI[0.002,0.15],β=0.06。
结论:确定肥胖喂养行为的倾向并提供支持以减少这些行为可能会增强儿童肥胖的预防工作。
BACKGROUND: Childhood obesity remains a public health crisis and identification of unique prenatal and early infancy predictors of obesity risk are critically needed.
OBJECTIVE: We test a comprehensive biopsychosocial model of the predictors of rapid weight gain (RWG) in the first 6 months of life.
METHODS: Two hundred and ninety nine pregnant women and their infants participated. Maternal prenatal psychobiological risk (PPBR) was assessed during the third trimester via maternal anthropometrics, serum biomarkers (insulin, leptin, adiponectin), and maternal report of pregnancy complications, substance use, mental health and stress. Infant stress reactivity was measured at 2 months (cortisol output, resting RSA, observed irritability, negative emotionality). At 2 and 6 months, maternal self-report of obesogenic feeding practices and observed maternal sensitivity during three tasks were collected. RWG was classified based on change in weight-for-age z scores from birth to 6 months (>0.67 SD).
RESULTS: Obesogenic feeding practices predicted greater likelihood of RWG, β = 0.30, p = .0.01, independent of other predictors and covariates. Obesogenic feeding practices was the only proposed intervening mechanism that produced a significant indirect effect of PPBR on RWG, b = 0.05, S.E. = 0.04, 95% CI [0.002, 0.15], β = 0.06.
CONCLUSIONS: Identifying proclivity towards obesogenic feeding practices and providing support to reduce these behaviours may enhance childhood obesity prevention efforts.