Factors affecting the growth of children till the age of three years with overweight whose mothers have diabetes mellitus: A population-based cohort study

Association between environmental composite quality index score and obesity in children and their family: A cross-sectional study in northeast China

BACKGROUND

Childhood obesity has emerged as a severe public health problem worldwide. Most studies focused on the association between single environmental risk factors and obesity. Thus, we investigate the association between environmental composite quality index (ECQI) score and obesity in children and their families.

METHOD

The cross-sectional study was conducted among 2354 children and 1761 mothers in Fuxin City, Liaoning Province, in 2015. The information was collected by questionnaires, including environmental factors, heights, weights, and sociodemographic data. We quantitated thirteen indoor and outdoor risk factors and constructed the ECQI. There were 4 household environmental factors in the household air quality index (HAQI) and 9 variables to evaluate the outdoor environmental quality index (OEQI). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using the binary logistic regression model after adjusting the most common obesity risk factors.

RESULTS

A higher ECQI score was correlated with a higher risk of childhood obesity and family obesity. Comparing the ECQI score 0-2 to the ECQI score ≥5, ORs with childhood obesity was 1.73 (95%CI, 1.25-2.39, P for trend = 0.001), and 1.53 for family obesity (95%CI, 1.09-2.15; P for trend = 0.003) after adjusted confounding factors. Similarly, a significantly positive association was found between OEQI score, HAQI score, and childhood obesity, family obesity.

CONCLUSION

A higher ECQI score was associated with an increased risk of obesity in children and their families. Both HAQI score and OEQI score were associated to childhood obesity and family obesity. Further studies should elucidate the underlying mechanisms.

Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: a narrative review

The global prevalence of overweight and obesity in pregnancy is rising and this represents a significant challenge for the management of pregnancy and delivery. Women who have a pre‐pregnancy body mass index greater than 25 kg m^–2 are more likely than those with a body mass index in the ideal range (20–24.99 kg m^–2) to have problems conceiving a child and are at greater risk of miscarriage and stillbirth. All pregnancy complications are more likely with overweight, obesity and excessive gestational weight gain, including those that pose a significant threat to the lives of mothers and babies. Labour complications arise more often when pregnancies are complicated by overweight and obesity. Pregnancy is a stage of life when women have greater openness to messages about their lifestyle and health. It is also a time when they come into greater contact with health professionals. Currently management of pregnancy weight gain and the impact of overweight tends to be poor, although a number of research studies have demonstrated that appropriate interventions based around dietary change can be effective in controlling weight gain and reducing the risk of pregnancy complications. The development of individualised and flexible plans for avoiding adverse outcomes of obesity in pregnancy will require investment in training of health professionals and better integration into normal antenatal care.

Overweight and obesity before pregnancy and excessive gestational weight gain are major determinants of risk for pregnancy loss, gestational diabetes, hypertensive conditions, labour complications and maternal death.

Pregnancy is regarded as a teachable moment when women are at their most receptive to messages about their health. However, unclear guidance on diet and physical activity, weight stigma from health professionals, inexperience and reluctance among professionals about raising issues about weight, and stretched resources put the health of women and babies at risk.

Excessive weight gain in pregnancy and post‐partum weight retention compromise future fertility and increase risk for future pregnancies.

Large randomised controlled trials have had little success in addressing excessive gestational weight gain or antenatal complications. Individualised, culturally sensitive and responsive interventions appear to have greater success.