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Zembura M, Lula P, Matusik P. Ten-Year Differences in Nutritional Status and Obesity-Related Risk Factors in Polish Preschool Children. CHILDREN 2023; 10:children10040636. [PMID: 37189885 DOI: 10.3390/children10040636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
The aim of this study was to assess ten-year differences in nutritional statuses and obesity prevalences between populations of preschool children from Katowice, Poland, examined in 2007 and 2017, and to determine factors associated with overweight and obesity in preschool children. A cross-sectional questionnaire was conducted among parents and legal guardians of 276 preschool children in 2007 and 259 preschool children in 2017. Basic anthropometric measurements were performed. Overall, the prevalence of overweight and obesity among our sample of Polish preschool children (median age 5.25 year) was 16.82%, whereas 4.49% of children were obese. No significant differences in the number of overweight and obese children were observed when comparing the years 2017 to 2007. Overall body mass index (BMI) z-score was significantly lower in this group of children from 2017. However, median values of the BMI z-score were higher in two of the weight categories (overweight and obesity) in 2017. The child’s BMI z-score was positively correlated with birth weight (r = 0.1, p < 0.05). The BMI z-score was positively correlated with maternal BMI, paternal BMI, and maternal pregnancy weight gain, r = 0.24 p < 0.01; r = 0.16 p < 0.01; r = 0.12 p < 0.05, respectively. A decrease in overweight and obesity prevalence over the past decade and higher median values of BMI z-scores in the group of children with excessive weight in 2017 were observed. Birth weight, maternal BMI, paternal BMI, and maternal pregnancy weight gain all correlate positively with a child’s BMI z-score.
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Xu H, Wu L, Lu H, Sun Y, Wu D, He Y, Yu L, Peng H, Li H. Relationship between Gestational Weight Gain Rate Trajectory and Overweight in Offspring at Three Years of Age. Child Obes 2022; 18:540-547. [PMID: 35352949 DOI: 10.1089/chi.2021.0288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: The incidence of childhood obesity has increased rapidly, and its relationship with adult diseases is constantly being revealed. Maternal factors have been shown to play an important role in the growth and development of newborns. In this article, we explored the relationship between the gestational weight gain (GWG) rate and overweight/obesity in offspring at 3 years of age. Methods: A total of 5146 pregnant women and their children registered between January 2010 and December 2018 were studied by a retrospective cohort study. The Group-based Trajectory Model was used to distinguish the GWG rate patterns. Overweight/obesity was diagnosed by the weight-for-height Z-score at 3 years of age. Logistic regression was used to analyze the association between GWG rate patterns and outcomes. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated to analyze the association between GWG rate patterns and overweight/obesity in offspring at 3 years of age. Results: Three GWG rate growth patterns were identified in this study. The incidence of offspring overweight/obesity in the low-stable, high-stable, and low-sharp patterns was 8.33%, 3.68%, and 6.03% respectively. After adjusting covariates, compared with the low-stable pattern, the high-stable pattern increased the risk for offspring to be overweight/obesity at 3 years of age, with OR of 2.26 (95% CI, 1.31-3.90). However, the low-sharp pattern was not associated with overweight/obesity in offspring at 3 years of age. Conclusions: The high-stable increasing pattern of the GWG rate is a risk factor for overweight/obesity in offspring at 3 years of age.
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Affiliation(s)
- He Xu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Lei Wu
- Department of Maternal and Child Health, Suzhou Industrial Park Center for Disease Control and Prevention, Suzhou, Jiangsu, China
| | - Heng Lu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yexiu Sun
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Di Wu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yan He
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Lugang Yu
- Department of Maternal and Child Health, Suzhou Industrial Park Center for Disease Control and Prevention, Suzhou, Jiangsu, China
| | - Hao Peng
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, Jiangsu, China
| | - Hongmei Li
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, Jiangsu, China
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Haby K, Gyllensten H, Hanas R, Berg M, Premberg Å. A Lifestyle Intervention During Pregnancy and Its Effects on Child Weight 2.5 Years Later. Matern Child Health J 2022; 26:1881-1890. [PMID: 35253077 PMCID: PMC9374787 DOI: 10.1007/s10995-022-03395-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2022] [Indexed: 11/27/2022]
Abstract
Aim The aim of this study was to evaluate if overweight and obesity in the offspring is reduced by a low-intensity antenatal primary care intervention with focus on diet and physical activity for pregnant women with obesity, comparing children to mothers receiving the intervention with children to mothers who did not. Methods This study is a follow-up of children 2.5 years of age after their mothers’ participation in a non-randomised controlled intervention intending to limit gestational weight gain. All study participants received standard antenatal care. The intervention group received lifestyle support via motivational talks with midwife and support from dietician. Data on child weight were collected by medical records, letter and phone. Results There was no significant difference between the groups 2.5 years after intervention (International Obesity Task Force ISO-BMI 25 (child BMI corresponding to adult BMI of 25): 20% vs. 21%; ISO-BMI 30: 4.6% vs. 1.3%). The mother’s BMI at the beginning of pregnancy significantly influenced child BMI at 2.5 years (r = 0.13, p = 0.014, r2 = 0.017). For each unit of increase in maternal BMI at enrollment, the probability of child ISO-BMI ≥ 25 increased by 7.5% (p = 0.021) and of ≥ 30, by 12.9% (p = 0.017). Conclusion The frequency of overweight and obesity of the children at 2.5 years of age was significantly correlated to the mother’s BMI, but not correlated to the mothers’ participation in the antenatal lifestyle intervention. Thus, it seems important to address obesity and lifestyle issues before and between pregnancies. Trial registration The study has been registered at ClinicalTrials.gov, Identifier: NCT03147079. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-022-03395-5.
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Affiliation(s)
- Karin Haby
- Antenatal Health Care, Primary Health Care, Research and Development Unit, Regionhälsan, Gothenburg, Sweden.
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Primary Health Care and Research and Development Unit, Regionhälsan, Gothenburg, Region Västra Götaland, Sweden.
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ragnar Hanas
- Department of Paediatrics, NU Hospital Group, Uddevalla, Sweden
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åsa Premberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Primary Health Care and Research and Development Unit, Regionhälsan, Gothenburg, Region Västra Götaland, Sweden
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Deardorff J, Reeves JW, Hyland C, Tilles S, Rauch S, Kogut K, Greenspan LC, Shirtcliff E, Lustig RH, Eskenazi B, Harley K. Childhood Overweight and Obesity and Pubertal Onset Among Mexican-American Boys and Girls in the CHAMACOS Longitudinal Study. Am J Epidemiol 2022; 191:7-16. [PMID: 33831178 DOI: 10.1093/aje/kwab100] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 12/16/2022] Open
Abstract
Secular trends in earlier initiation of puberty have been observed in recent decades. One risk factor appears to be increases in adiposity, as measured by body mass index. This trend is particularly notable among Latino populations, who have higher rates of overweight/obesity compared with non-Latino White youth. Previous research has focused primarily on White girls, resulting in data gaps regarding male puberty and among potentially high-risk populations. Using data from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, we examined body mass index at age 5 years (2005-2006) and multiple markers of pubertal onset, assessed repeatedly and longitudinally at 7 in-person visits, starting at age 9 and continuing through age 14 (2009-2015), among 336 Mexican Americans in Salinas, California. We observed no associations among boys, but found significantly earlier thelarche in overweight (HR = 1.7, 95% CI: 1.1, 2.7) and obese girls (HR = 1.5, 95% CI: 1.0, 2.4), menarche in overweight girls (HR = 1.6; CI: 1.0, 2.4), and pubarche in obese girls (HR = 1.9; CI: 1.2, 3.0), compared with normal-weight girls. This study examined an understudied population and included key covariates, such as birth weight and early adverse events, which are typically omitted in studies.
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Badon SE, Quesenberry CP, Xu F, Avalos LA, Hedderson MM. Gestational weight gain, birthweight and early-childhood obesity: between- and within-family comparisons. Int J Epidemiol 2021; 49:1682-1690. [PMID: 32830276 DOI: 10.1093/ije/dyaa110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Associations of excessive gestational weight gain (GWG) with greater birthweight and childhood obesity may be confounded by shared familial environment or genetics. Sibling comparisons can minimize variation in these confounders because siblings grow up in similar environments and share the same genetic predisposition for weight gain. METHODS We identified 96 289 women with live births in 2008-2014 at Kaiser Permanente Northern California. Fifteen percent of women (N = 14 417) had at least two births during the study period for sibling analyses. We assessed associations of GWG according to the Institute of Medicine (IOM) recommendations with birthweight and obesity at age 3 years, using conventional analyses comparing outcomes between mothers and sibling analyses comparing outcomes within mothers, which control for stable within-family unmeasured confounders such as familial environment and genetics. We used generalized estimating-equations and fixed-effects models. RESULTS In conventional analyses, GWG above the IOM recommendations was associated with 88% greater odds of large-for-gestational age birthweight [95% confidence interval (CI): 1.80, 1.97] and 30% greater odds of obesity at 3 years old (95% CI: 1.24, 1.37) compared with GWG within the IOM recommendations. In sibling analyses, GWG above the IOM recommendations was also associated with greater odds of large-for-gestational age [odds ratio (OR): 1.36; 95% CI: 1.20, 1.54], but was not associated with obesity at 3 years old (OR = 0.98; 95% CI: 0.84, 1.15). CONCLUSIONS GWG likely has a direct impact on birthweight; however, shared environmental and lifestyle factors within families may play a larger role in determining early-childhood weight status and obesity risk than GWG.
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Affiliation(s)
- Sylvia E Badon
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | | | - Fei Xu
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Lyndsay A Avalos
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Monique M Hedderson
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
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Baran J, Weres A, Czenczek-Lewandowska E, Leszczak J, Kalandyk-Osinko K, Łuszczki E, Sobek G, Mazur A. Excessive Gestational Weight Gain: Long-Term Consequences for the Child. J Clin Med 2020; 9:jcm9123795. [PMID: 33255248 PMCID: PMC7761026 DOI: 10.3390/jcm9123795] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/11/2020] [Accepted: 11/21/2020] [Indexed: 02/07/2023] Open
Abstract
Background: The aim of the study was to analyse the impact of mothers’ gestational weight gain (GWG) and age at birth on the long-term risk of overweight and obesity in preschool and school-aged children. Methods: The study involved 749 mothers and children at ages between four and 15 years old. Each child was assessed for height and body weight, and then, the body mass category was determined based on the body mass index (BMI) percentile according to the sex and age of the subjects. Information on the perinatal risk factors for overweight and obesity came from the child’s health card or mother’s maternity card. They contained information about the mother’s age at the time of childbirth and the mother’s gestational weight gain during pregnancy. Results: In the group of 7–11-year-olds, the maternal weight gain during pregnancy was higher in obese children than in children with normal weight (18.8 kg vs. 14.3 kg; p = 0.002). This relationship was shown analogously in the group of 7–11-years-olds boys (20.6 kg vs. 15.1 kg; p = 0.005). Positive correlations were also shown between mother’s gestational weight gain and the BMI percentage of the whole group (p = 0.004). In the case of the mother’s age, no statistically significant relationship was found with the child’s weight category. Conclusions: Mothers’ weight gain during pregnancy is a factor that promotes overweightness and obesity in the child. Maternal age at birth does not appear to lead to any propensity toward overweightness and obesity in the later life of a child.
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Affiliation(s)
- Joanna Baran
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
- Correspondence:
| | - Aneta Weres
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Ewelina Czenczek-Lewandowska
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Justyna Leszczak
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Katarzyna Kalandyk-Osinko
- Institute of Medical Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (K.K.-O.); (A.M.)
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Grzegorz Sobek
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (A.W.); (E.C.-L.); (J.L.); (E.Ł.); (G.S.)
| | - Artur Mazur
- Institute of Medical Sciences, Medical College, University of Rzeszów, Al. mjr.W.Kopisto 2 a, 35-310 Rzeszów, Poland; (K.K.-O.); (A.M.)
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7
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Agbota G, Fievet N, Heude B, Accrombessi M, Ahouayito U, Yovo E, Dossa D, Dramane L, Gartner A, Ezinmègnon S, Yugueros Marcos J, Vachot L, Tissières P, Massougbodji A, Martin-Prével Y, Cot M, Briand V. Poor maternal anthropometric status before conception is associated with a deleterious infant growth during the first year of life: a longitudinal preconceptional cohort. Pediatr Obes 2020; 15:e12573. [PMID: 31466135 DOI: 10.1111/ijpo.12573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/12/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND According to the Developmental Origins of Health and Diseases concept, exposures in the preconception period may be critical. For the first time, we evaluated the effect of preconception poor anthropometric status on infant's growth in sub-Saharan Africa. METHODS A mother-child cohort was followed prospectively from preconception to 1 year old in Benin. Maternal anthropometric status was assessed by prepregnancy body mass index (BMI), approximated by BMI at the first antenatal visit before 7 weeks' gestation, and gestational weight gain (GWG). BMI was categorized as underweight, normal, overweight, and obesity according to World Health Organization standards. GWG was categorized as low (<7 kg), mild (7-12 kg), and high (>12 kg). In infant, stunting and wasting were defined as length-for-age and weight-for-length z scores less than -2 SD, respectively. We evaluated the association between BMI/GWG and infant's weight and length at birth and during the first year of life, as well as with stunting and wasting at 12 months using mixed linear and logistic regression models. RESULTS In multivariate, preconceptional underweight was associated with a lower infant's weight at birth and during the first year (-164 g; 95% CI, -307 to -22; and -342 g; 95% CI, -624 to -61, respectively) and with a higher risk of stunting at 12 months (adjusted odds ratio [aOR] = 3.98; 95% CI, 1.01-15.85). Furthermore, preconceptional obesity and a high GWG were associated with a higher weight and length at birth and during the first year. CONCLUSION Underweight and obesity before conception as well as GWG were associated with infant's growth. These results argue for preventive interventions starting as early as the preconception period to support child long-term health.
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Affiliation(s)
- Gino Agbota
- MERIT, IRD, Université Paris 5, Sorbonne Paris Cité, Paris, France.,Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin
| | - Nadine Fievet
- MERIT, IRD, Université Paris 5, Sorbonne Paris Cité, Paris, France
| | - Barbara Heude
- Team "EArly life Research on later Health" (EARoH), INSERM, UMR 1153, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France.,Paris Descartes University, Paris, France
| | - Manfred Accrombessi
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin.,Clinical Research Institute of Benin (IRCB), Abomey-Calavi, Benin
| | - Urbain Ahouayito
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin
| | - Emmanuel Yovo
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin
| | - Djamirou Dossa
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin
| | - Latifou Dramane
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin
| | - Agnès Gartner
- Nutripass, UMR204, IRD, Université de Montpellier, SupAgro, Montpellier, France
| | - Sem Ezinmègnon
- Medical Diagnostic Discovery Department (MD3), bioMérieux, Marcy l'Etoile, France.,UMR 9198, Institut de Biologie Intégrative de la Cellule, Université Paris Saclay, Saint-Aubin, France
| | | | - Laurence Vachot
- Medical Diagnostic Discovery Department (MD3), bioMérieux, Marcy l'Etoile, France
| | - Pierre Tissières
- UMR 9198, Institut de Biologie Intégrative de la Cellule, Université Paris Saclay, Saint-Aubin, France
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin.,Clinical Research Institute of Benin (IRCB), Abomey-Calavi, Benin
| | - Yves Martin-Prével
- Nutripass, UMR204, IRD, Université de Montpellier, SupAgro, Montpellier, France
| | - Michel Cot
- MERIT, IRD, Université Paris 5, Sorbonne Paris Cité, Paris, France
| | - Valérie Briand
- MERIT, IRD, Université Paris 5, Sorbonne Paris Cité, Paris, France
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Larqué E, Labayen I, Flodmark CE, Lissau I, Czernin S, Moreno LA, Pietrobelli A, Widhalm K. From conception to infancy - early risk factors for childhood obesity. Nat Rev Endocrinol 2019; 15:456-478. [PMID: 31270440 DOI: 10.1038/s41574-019-0219-1] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2019] [Indexed: 12/25/2022]
Abstract
Maternal lifestyle during pregnancy, as well as early nutrition and the environment infants are raised in, are considered relevant factors for the prevention of childhood obesity. Several models are available for the prediction of childhood overweight and obesity, yet most have not been externally validated. Moreover, the factors considered in the models differ among studies as the outcomes manifest after birth and depend on maturation processes that vary between individuals. The current Review examines and interprets data on the early determinants of childhood obesity to provide relevant strategies for daily clinical work. We evaluate a selection of prenatal and postnatal factors associated with child adiposity. Actions to be considered for preventing childhood obesity include the promotion of healthy maternal nutrition and weight status at reproductive age and during pregnancy, as well as careful monitoring of infant growth to detect early excessive weight gain. Paediatricians and other health-care professionals should provide scientifically validated, individual nutritional advice to families to counteract excessive adiposity in children. Based on systematic reviews, original papers and scientific reports, we provide information to help with setting up public health strategies to prevent overweight and obesity in childhood.
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Affiliation(s)
- Elvira Larqué
- Department of Physiology, University of Murcia, Murcia, Spain
| | - Idoia Labayen
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD) and Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Carl-Erik Flodmark
- Childhood Obesity Unit, Department of Pediatrics, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences, Faculty of Medicine, University of Lund, Lund, Sweden
| | - Inge Lissau
- Childhood Obesity Unit, Department of Pediatrics, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences, Faculty of Medicine, University of Lund, Lund, Sweden
- Clinical Research Centre, University Hospital Copenhagen, Hvidovre, Denmark
| | - Sarah Czernin
- Deptartment of Pediatrics, Division of Nutrition and Metabolism and Austrian Academic institute for Clinical Nutrition, Vienna, Austria
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, Universidad de Zaragoza, Zaragoza, Spain.
- Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
| | - Angelo Pietrobelli
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Kurt Widhalm
- Deptartment of Pediatrics, Division of Nutrition and Metabolism and Austrian Academic institute for Clinical Nutrition, Vienna, Austria
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9
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Wan N, Cai L, Tan W, Zhang T, Yang J, Chen Y. Associations of gestational weight gain with offspring thinness and obesity: by prepregnancy body mass index. Reprod Health 2018; 15:149. [PMID: 30180902 PMCID: PMC6123984 DOI: 10.1186/s12978-018-0585-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/14/2018] [Indexed: 12/11/2022] Open
Abstract
Background Previous studies indicated that excessive gestational weight gain (GWG) was positively associated with offspring obesity. Nevertheless, little is known about the effect of GWG on offspring thinness. This study aimed to assess the association of GWG with childhood weight status across the full range of weight status by prepregnancy body mass index (BMI). Methods We used data from a retrospective study of 33,828 Chinese children aged 6–18 years and their mothers. Children’s weight and height were objectively measured. Maternal GWG and other information were collected by using self-reported questionnaires. Multivariate linear regressions and logistic regressions were applied. Results Overall, the prevalence of thinness and overweight/obesity in children were 12.9 and 17.3% respectively (p < 0.05). Children’s BMI z-score was on average 0.021 higher for every 1-kg greater GWG. For mothers who were underweight or normal weight before pregnancy, excessive GWG was positively associated with offspring overweight/obesity [OR (95% CI): 1.51 (1.21, 1.90) and 1.30 (1.17, 1.45)], whereas inadequate GWG was associated with increased risk of offspring thinness [OR (95% CI): 1.24 (1.05, 1.46) and 1.17 (1.04, 1.32)]. Similar but non-significant associations were found in prepregnancy overweight mothers. Notably, there was a very high prevalence of child overweight/obesity (30.2%) in prepregnancy overweight subgroup regardless of GWG status. Conclusions Inadequate GWG was associated with an increased risk of offspring thinness, whereas excessive GWG was associated with an increased risk of offspring overweight and obesity among prepregnancy underweight and normal weight mothers only.
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Affiliation(s)
- Nianqing Wan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China
| | - Weiqing Tan
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510000, China
| | - Ting Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China
| | - Jiewen Yang
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510000, China.
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China.
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Denize KM, Acharya N, Prince SA, da Silva DF, Harvey AL, Ferraro ZM, Adamo KB. Addressing cultural, racial and ethnic discrepancies in guideline discordant gestational weight gain: a systematic review and meta-analysis. PeerJ 2018; 6:e5407. [PMID: 30186674 PMCID: PMC6118200 DOI: 10.7717/peerj.5407] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/18/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To systematically review the literature and describe the discrepancies in achieving the 2009 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines across cultures. METHODS Ten databases were searched from inception to April 2018. Observational cohort studies were included that examined adult women; reported on a measure of culture; compared cultural groups, and reported on GWG. Articles were broken down into papers that used the current 2009 IOM GWG guidelines and those that used others. A meta-analysis was conducted for studies using the 2009 guidelines examining the prevalence of discordant GWG across cultural groups. RESULTS The review included 86 studies. Overall, 69% of women experienced discordant GWG irrespective of culture. White women experienced excessive GWG most often, and significantly more than Asian and Hispanic women; Black women had a higher prevalence of excessive GWG than Hispanic and Asian women; however, this difference was not significant. CONCLUSIONS The majority of women experience excessive GWG, with White women experiencing this most often. Culturally diverse GWG guidelines are needed to individualize antenatal care and promote optimal maternal-fetal health outcomes across cultural groups.
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Affiliation(s)
- Kathryn M. Denize
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - Nina Acharya
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - Stephanie A. Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Danilo Fernandes da Silva
- Department of Physical Education, State University of Midwest/Parana (UNICENTRO), Guarapuava, Paraná, Brazil
| | - Alysha L.J. Harvey
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | | | - Kristi B. Adamo
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
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11
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Haby K, Berg M, Gyllensten H, Hanas R, Premberg Å. Mighty Mums - a lifestyle intervention at primary care level reduces gestational weight gain in women with obesity. BMC OBESITY 2018; 5:16. [PMID: 29881627 PMCID: PMC5985595 DOI: 10.1186/s40608-018-0194-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 04/26/2018] [Indexed: 11/10/2022]
Abstract
Background Obesity (BMI ≥30) during pregnancy is becoming an increasing public health issue and is associated with adverse maternal and perinatal outcomes. Excessive gestational weight gain (GWG) further increases the risks of adverse outcomes. However, lifestyle intervention can help pregnant women with obesity to limit their GWG. This study evaluated whether an antenatal lifestyle intervention programme for pregnant women with obesity, with emphasis on nutrition and physical activity, could influence GWG and maternal and perinatal outcomes. Methods The intervention was performed in a city in Sweden 2011–2013. The study population was women with BMI ≥30 in early pregnancy who received standard antenatal care and were followed until postpartum check-up. The intervention group (n = 459) was provided with additional support for a healthier lifestyle, including motivational talks with the midwife, food advice, prescriptions of physical activity, walking poles, pedometers, and dietician consultation. The control group was recruited from the same (n = 105) and from a nearby antenatal organisation (n = 790). Results In the per-protocol population, the intervention group had significantly lower GWG compared with the control group (8.9 ± 6.0 kg vs 11.2 ± 6.9 kg; p = 0.031). The women managed to achieve GWG < 7 kg to a greater extent (37.1% vs. 23.0%; p = 0.036) and also had a significantly lower weight retention at the postpartum check-up (− 0.3 ± 6.0 kg vs. 1.6 ± 6.5 kg; p = 0.019) compared to the first visit. The most commonly used components of the intervention, apart from the extra midwife time, were support from the dietician and retrieval of pedometers. Overall compliance with study procedures, actual numbers of visits with logbook activity, and dietician contact correlated significantly with GWG. There was no statistically significant difference in GWG (10.3 ± 6.1 kg vs. 11.2 ± 6.9 kg) between the intervention and control groups in the intention-to-treat population. Conclusion Pregnant women with obesity who follow a lifestyle intervention programme in primary health care can limit their weight gain during pregnancy and show less weight retention after pregnancy. This modest intervention can easily be implemented in a primary care setting. Trial registration The study has been registered at ClinicalTrials.gov, Identifier: NCT03147079. May 10 2017, retrospectively registered.
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Affiliation(s)
- Karin Haby
- Primary Health Care, Research and Development Unit, Närhälsan, Region Västra Götaland, Gothenburg, Sweden.,2Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marie Berg
- 2Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,3GPCC - University of Gothenburg Centre for Person-centred Care, Gothenburg, Sweden
| | - Hanna Gyllensten
- 2Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,3GPCC - University of Gothenburg Centre for Person-centred Care, Gothenburg, Sweden
| | - Ragnar Hanas
- 4Department of Pediatrics, NU Hospital Group, Region Västra Götaland, Uddevalla, Sweden.,5Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Åsa Premberg
- Primary Health Care, Research and Development Unit, Närhälsan, Region Västra Götaland, Gothenburg, Sweden.,2Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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12
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Spiegel E, Shoham-Vardi I, Sergienko R, Landau D, Sheiner E. The association between birth weight at term and long-term endocrine morbidity of the offspring. J Matern Fetal Neonatal Med 2018; 32:2657-2661. [DOI: 10.1080/14767058.2018.1443440] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- E. Spiegel
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel
| | - I. Shoham-Vardi
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be’er Sheva, Israel
| | - R. Sergienko
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be’er Sheva, Israel
| | - D. Landau
- Department of Pediatrics, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel
| | - E. Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel
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13
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Farpour-Lambert NJ, Ells LJ, Martinez de Tejada B, Scott C. Obesity and Weight Gain in Pregnancy and Postpartum: an Evidence Review of Lifestyle Interventions to Inform Maternal and Child Health Policies. Front Endocrinol (Lausanne) 2018; 9:546. [PMID: 30319539 PMCID: PMC6168639 DOI: 10.3389/fendo.2018.00546] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 08/28/2018] [Indexed: 12/16/2022] Open
Abstract
Background: Maternal obesity, excessive gestational weight gain (GWG) and post-partum weight retention (PPWR) constitute new public health challenges, due to the association with negative short- and long-term maternal and neonatal outcomes. The aim of this evidence review was to identify effective lifestyle interventions to manage weight and improve maternal and infant outcomes during pregnancy and postpartum. Methods: A review of systematic reviews and meta-analyses investigating the effects of lifestyle interventions on GWG or PPWR was conducted (Jan 2009-2018) via electronic searches in the databases Medline, Pubmed, Web of Science and Cochrane Library using all keywords related to obesity/weight gain/loss, pregnancy or postpartum and lifestyle interventions;15 relevant reviews were selected. Results: In healthy women from all BMI classes, diet and physical activity interventions can decrease: GWG (mean difference -1.8 to -0.7 kg, high to moderate-quality evidence); the risks of GWG above the IOM guidelines (risk ratio [RR] 0.72 to 0.80, high to low-quality evidence); pregnancy-induced hypertension (RR 0.30 to 0.66, low to very low-quality evidence); cesarean section (RR 0.91 to 0.95; high to moderate-quality evidence) and neonatal respiratory distress syndrome (RR 0.56, high-quality evidence); without any maternal/fetal/neonatal adverse effects. In women with overweight/obesity, multi-component interventions can decrease: GWG (-0.91 to -0.63 kg, moderate to very low-quality evidence); pregnancy-induced hypertension (RR 0.30 to 0.66, low-quality evidence); macrosomia (RR 0.85, 0.73 to 1.0, moderate-quality evidence) and neonatal respiratory distress syndrome (RR 0.47, 0.26 to 0.85, moderate-quality evidence). Diet is associated with greater reduction of the risks of GDM, pregnancy-induced hypertension and preterm birth, compared with any other intervention. After delivery, combined diet and physical activity interventions reduce PPWR in women of any BMI (-2.57 to -2.3 kg, very low quality evidence) or with overweight/obesity (-3.6 to -1.22, moderate to very low-quality-evidence), but no other effects were reported. Conclusions: Multi-component approaches including a balanced diet with low glycaemic load and light to moderate intensity physical activity, 30-60 min per day 3-5 days per week, should be recommended from the first trimester of pregnancy and maintained during the postpartum period. This evidence review should help inform recommendations for health care professionals and women of child-bearing age.
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Affiliation(s)
- Nathalie J. Farpour-Lambert
- Obesity Prevention and Care Program “Contrepoids,” Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Pediatric Sports Medicine Consultation, Service of General Pediatrics, Department of Child and Adolescent, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- *Correspondence: Nathalie J. Farpour-Lambert
| | - Louisa J. Ells
- School of Health and Social Care, Teesside University, Middlesbrough, United Kingdom
| | - Begoña Martinez de Tejada
- Service of Obstetrics, Department of Gynaecology and Obstetrics, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Courtney Scott
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
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14
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Leonard SA, Rasmussen KM, King JC, Abrams B. Trajectories of maternal weight from before pregnancy through postpartum and associations with childhood obesity. Am J Clin Nutr 2017; 106:1295-1301. [PMID: 28877895 PMCID: PMC5657288 DOI: 10.3945/ajcn.117.158683] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 08/08/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Prepregnancy body mass index [BMI (in kg/m2)], gestational weight gain, and postpartum weight retention may have distinct effects on the development of child obesity, but their combined effect is currently unknown.Objective: We described longitudinal trajectories of maternal weight from before pregnancy through the postpartum period and assessed the relations between maternal weight trajectories and offspring obesity in childhood.Design: We analyzed data from 4436 pairs of mothers and their children in the National Longitudinal Survey of Youth 1979 (1981-2014). We used latent-class growth modeling in addition to national recommendations for prepregnancy BMI, gestational weight gain, and postpartum weight retention to create maternal weight trajectory groups. We used modified Poisson regression models to assess the associations between maternal weight trajectory group and offspring obesity at 3 age periods (2-5, 6-11, and 12-19 y).Results: Our analysis using maternal weight trajectories based on either latent-class results or recommendations showed that the risk of child obesity was lowest in the lowest maternal weight trajectory group. The differences in obesity risk were largest after 5 y of age and persisted into adolescence. In the latent-class analysis, the highest-order maternal weight trajectory group consisted almost entirely of women who were obese before pregnancy and was associated with a >2-fold increase in the risk of offspring obesity at ages 6-11 y (adjusted RR: 2.39; 95% CI: 1.97, 2.89) and 12-19 y (adjusted RR: 2.74; 95% CI: 2.13, 3.52). In the analysis with maternal weight trajectory groups based on recommendations, the risk of child obesity was consistently highest for women who were overweight or obese at the beginning of pregnancy.Conclusion: These findings suggest that high maternal weight across the childbearing period increases the risk of obesity in offspring during childhood, but high prepregnancy BMI has a stronger influence than either gestational weight gain or postpartum weight retention.
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Affiliation(s)
| | | | - Janet C King
- Nutrition and Metabolism Center, Children’s Hospital Oakland Research Institute, Oakland, CA
| | - Barbara Abrams
- Division of Epidemiology, University of California, Berkeley, CA
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15
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Shi J, Tan D, Xie H, Yang B, Liu R, Yu D, Lu Y, Mei B, Wang Z. Unequal Distribution of Overweight Adolescents in Immigrant-Rich Areas: Analysis of Disparities among Public and Private School Students in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E252. [PMID: 28257123 PMCID: PMC5369088 DOI: 10.3390/ijerph14030252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 02/21/2017] [Accepted: 02/23/2017] [Indexed: 12/02/2022]
Abstract
Accelerated urbanization and rising immigration to the big cities in China has resulted in education policies that produce disparate treatment of immigrant and non-immigrant students. The two types of students frequently wind up in different types of junior high schools. However, there is little research on whether disparities exist between students in public and private schools with regard to overweight. This study aims to address this gap through a comparison of the overweight status of junior high school students in public and private schools in Shanghai and explore the possible reasons for the observed differences. Students from two public and two private junior high schools were measured. In order to determine what factors might shape overweight among adolescents. Logistic regression analysis was used to assess associations between overweight and personal characteristics, birth-related factors, levels of physical activity, diet, family socioeconomic status and school environment. Students in private schools proved more likely to be overweight (15.20%, p < 0.05) than public school students (10.18%). Similarly, gender, breastfeeding, parental care and number of classes excluding physical education per day were found to be significant factors. However, private school students were also influenced by gestational age (yes/no: OR = 4.50, p < 0.001), frequency of snacks (sometimes/often: OR = 0.53, p < 0.01) and family income (¥6001-12,000/below ¥6000: OR = 3.27, p < 0.05). Time for lunch was the sole risk factor for public school students in the study (p < 0.05). To reduce the unequal distribution of overweight students between the two types of schools, interventions that consider different multiple risk factors should be implemented.
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Affiliation(s)
- Jianwei Shi
- Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.
- School of Medicine, Tongji University, Shanghai 200092, China.
| | - Duxun Tan
- The Fifth Affiliated Hospital of Southern Medical University, Guangzhou 510900, China.
| | - Huilin Xie
- The Fifth Affiliated Hospital of Southern Medical University, Guangzhou 510900, China.
| | - Beilei Yang
- College of Economic and Management, Tongji University, Shanghai 200092, China.
| | - Rui Liu
- Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
| | - Dehua Yu
- Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.
| | - Yuan Lu
- Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.
| | - Bing Mei
- Department of Emergency, Shanghai Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
| | - Zhaoxin Wang
- Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.
- School of Medicine, Tongji University, Shanghai 200092, China.
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16
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Kawada T. Maternal obesity, gestational weight gain and childhood cardiac outcome at age 6 years. Int J Obes (Lond) 2016; 41:95. [PMID: 27748743 DOI: 10.1038/ijo.2016.181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- T Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
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