Birth weight, life course factors and excess weight among schoolchildren in Niterói, Rio de Janeiro, Brazil in 2010

Noronha, Gisele Almeida de; Kale, Pauline Lorena; Torres, Tania Zdenka Guillén de; Vasconcelos, Jackeline Christiane Pinto Lobato; Kuschnir, Maria Cristina Caetano; Cavalcanti, Maria de Lourdes Tavares; Costa, Antonio José Leal; Szklo, Moyses

doi:10.1016/j.jped.2020.10.012

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ORIGINAL ARTICLE • J. Pediatr. (Rio J.) 97 (05) • Sep-Oct 2021 • https://doi.org/10.1016/j.jped.2020.10.012 copy

Birth weight, life course factors and excess weight among schoolchildren in Niterói, Rio de Janeiro, Brazil in 2010

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To investigate the association between birth weight and excess weight among students aged 6–14 years, adjusted for life course confounding factors.

Methods:

Cross-sectional study with 6–14-year-old schoolchildren in 2010; 795 school children from two public schools. In addition, a sub-sample was selected using a case-cohort study approach. Sociodemographic, breastfeeding, food introduction, previous weight gain, family history, current clinical and behavioral variables as well as maternal variables related to pregnancy, were collected. Multivariable weighted logistic regression was used to evaluate the association between birth weight and overweight. All prevalent cases of overweight (n = 160) were selected to compose the case group and a random sub-sample of all students participating in the study (n = 276 students, of whom 88 were cases) were the control group.

Results:

An unadjusted 6% increase in the excess weight prevalence ratio (p-value = 0.004) was found for each 100 g increase in birth weight. With adjustment for age, sex and behavioral variables (models 1 and 2), the association of birth weight with excess weight was positive and statistically significant, but it was no longer significant in the final model (model 3) when clinical variables were considered.

Conclusions:

Although some of the secondary associations were statistically significant, we could not identify a significant association between birthweight and excess weight in adolescents.

KEYWORDS
Birth weight; Information systems; Fetal development; Weight gain; Pediatric obesity

Variables	Unadjusted PR (CI 95%)		p-value
Birthweight (100 g)	1.06	(1.02–1.10)	0.004
Age (years)	0.92	(0.84–1.00)	0.054
Sex
Female	1.00
Male	1.05	(0.71–1.56)	0.797
Maternal race/color
White	1.00
Black	1.12	(0.54–2.31)	0.748
Brown	0.95	(0.62–1.47)	0.830
Parent/guardian level of schooling at the time of the study
≥8 years	1.00
<8 years	0.75	(0.50–1.13)	0.174
Family size	0.83	(0.70−0.98)	0.029
Mother’s age (years)	1.03	(1.00–1.06)	0.082
Diabetes during pregnancy	2.68	(0.44–16.35)	0.284
Smoking during pregnancy	0.82	(0.50–1.33)	0.424
Passive smoking^a a Passive smoking during pregnancy at home, work, or outside for at least one day/week.
No	1.00
Yes	0.76	(0.51–1.13)	0.173
Length at birth (cm)	1.04	(0.97–1.12)	0.234
Gestational age
Preterm	1.00
Full term	0.70	(0.28–1.74)	0.446
Breastfeeding (months)	1.00	(0.99–1.01)	0.448
Early food introduction^b b Food introduction (meat and/or egg and/or fruit and/or vegetables) before 6 months.	1.20	(0.80–1.79)	0.374
Introduction of unhealthy foods^c c Introduction of unhealthy foods (coffee and/or cookies and/or industrialized drinks and/or sugar) before 12 months.	1.17	(0.74–1.86)	0.502
Weight gain before age 2 years^d d Previous parents’/guardians’ perceptions of excessive weight gain.
No	1.00
Yes	1.20	(0.60–2.39)	0.604
Weight gain between 2 and 6 years of age^d d Previous parents’/guardians’ perceptions of excessive weight gain.
No	1.00
Yes	2.13	(1.09–4.18)	0.027
Weight gain between 7 and 9 years^d,e
No	1.00
Yes	4.13	(1.97–8.64)	0.000
Weight gain between 10 and 14 years^d,e
No	1.00
Yes	3.64	(1.52–8.73)	0.004
Family History
Cardiovascular disease^f	0.70	(0.37–1.32)	0.271
Metabolic diseases^g g Parents or grandparents have/had metabolic disease (diabetes or dyslipidemia or obesity).	1.28	(0.81–2.04)	0.288
Asthma	1.10	(0.71–1.71)	0.673
Unsatisfactory meal consumption pattern	1.10	(0.74–1.64)	0.638
Asthma
No	1.00
Yes	1.64	(0.91–2.96)	0.096
Blood pressure
Systolic (mmHg)	1.02	(1.00–1.04)	0.036
Blood sugar (mg/dL)	1.03	(1.00–1.06)	0.023
Total cholesterol (mg/dL)	1.00	(0.99–1.01)	0.167
HDL (mg/dL)	0.98	(0.96–1.00)	0.059
LDL (mg/dL)	1.00	(0.99–1.00)	0.844
TC/HDL ratio	1.36	(1.11–1.67)	0.003
Triglyceride (mg/dL)	1.01	(1.01–1.02)	0.000
Insulin (µ,IU/mL)
1st quartile	2.48	(1.29–4.76)	0.006
2nd quartile	3.37	(1.77–6.43)	0.000
3rd quartile	4.82	(2.55–9.13)	0.000
CRP
<0.3 mg/dL	1.00
≥0.3 mg/dL	2.07	(1.25–3.42)	0.005

Variables	Model 1^a a Model 1: demographic variables (age, sex, parent/guardian level of schooling at the time of the study, number of people in the family [or family size], mother’s age). PR (CI 95%)		p-value	Model 2^b b Model 2: model 1 + behavioral variable (passive smoking). PR (CI 95%)		p-value	Model 3^c c Model 3: model 2 + clinical variables (previous parents’/guardians’ perceptions of excessive weight gain, asthma, systolic blood pressure, blood sugar, CT/HDL ratio, triglyceride, insulin, CRP). PR (CI 95%)		p-value
Birth weight (in 100 g)	1.05	1.01−1.10	0.010	1.05	1.01−1.10	0.019	1.04	0.99−1.09	0.110
Age (years)	0.92	0.83−1.02	0.121	0.92	0.83−1.02	0.123	0.84	0.73−0.95	0.010
Sex
Female	1.00			1.00			1.00
Male	1.04	0.67−1.59	0.864	1.00	0.65−1.54	0.992	1.43	0.83−2.45	0.199
Parent/guardian level of schooling at the time of the study
≥8 years	1.00			1.00			1.00
<8 years	0.87	0.56−1.36	0.554	0.85	0.54−1.33	0.479	0.78	0.46−1.32	0.361
Family size	0.81	0.67−0.98	0.030	0.80	0.66−0.97	0.025	0.82	0.65−1.02	0.079
Mother’s age (years)	1.02	0.99−1.06	0.167	1.02	0.99−1.05	0.181	1.01	0.97−1.04	0.581
Passive smokingd
No	–			1.00			1.00
Yes	–			0.87	0.55−1.36	0.538	0.74	0.43−1.27	0.281
Weight gain between 2 and 6 years of agee
No	–			–			1.00
Yes	–			–			1.11	0.42−2.91	0.825
Weight gain between 7 and 9 yearse
No	–			–			1.00
Yes	–			–			2.82	1.07−7.45	0.036
Weight gain between 10 and 14 yearse
No	–			–			1.00
Yes	–			–			3.01	0.91−9.98	0.070
Asthma
No	–			–			1.00
Yes	–			–			1.70	0.80−3.63	0.169
Systolic blood pressure (mmHg)	–			–			1.00	0.97−1.03	0.716
Blood sugar (mg/dL)	–			–			1.00	0.97−1.04	0.739
CT/HDL ratio	–			–			1.05	0.81−1.36	0.692
Triglyceride (mg/dL)	–			–			1.01	1.01−1.02	0.042
Insulin (¼IU/mL)
1st quartile	–			–			1.80	0.87−3.76	0.113
2nd quartile	–			–			2.54	1.16−5.54	0.019
3rd quartile	–			–			2.29	0.94−5.54	0.067
CRP
<0.3 mg/dL	–			–			1.00
≥0.3 mg/dL	–			–			1.52	0.78−2.97	0.212

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[1] * Corresponding author. E-mail: giselenoronha@gmail.com (G.A. Noronha).