Associations between maternal BMI, breastfeeding practices and infant anthropometric status in Colombia; secondary analysis of ENSIN 2010

The socioeconomic gradient in overweight and obesity among Colombian adult and pediatric populations: A scoping review

Background: The imminent increase in overweight and obesity prevalence constitutes a pervasive concern for the adult and pediatric Colombian population. Nonetheless, the unequal distribution across distinct social groups limits the implementation of public health policies targeting these escalating rates. Aim: This study aimed to compile existing evidence regarding the prevalence of overweight and obesity in relation to the socioeconomic status (SES) of the Colombian population. Methods: A scoping review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews parameters in MEDLINE (PubMed), EMBASE, and LILACS databases for inclusion of investigations published up to January 2024. Results: Twenty-two cross-sectional studies were included. A higher prevalence of overweight and obesity was documented in adults with lower SES defined by social stratum and monetary income, while in particular for nonpregnant adult women, the prevalence of excess weight was higher in the medium-low socioeconomic stratum. In the pediatric population, higher SES defined by social stratum was directly related to an increased prevalence and risk of overweight and obesity. The ownership of household assets, however, was positively related to the risk of overweight in both adult and pediatric populations. Conclusion: The findings of this investigation disclose a socioeconomic gradient in overweight and obesity in Colombia that resembles the epidemiological distribution in high-income countries for adults, though similar to low-income countries for the pediatric population. Further intersectoral interventions aimed at the most vulnerable groups are imperative to mitigate the inequalities that condition their predisposition to overweight and obesity.

Barriers to adequate nutrition in pregnant adolescent Colombian females

Pregnant adolescent females face nutritional challenges. The nutritional demands of a growing fetus, when added to the requirements for growing adolescent bodies, are risk factors for undernutrition. An adolescent expectant mother's nutritional status therefore affects both the mother's and the child's future growth, development, and potential development of diseases later in life. In Colombia, the rate of female adolescent pregnancies is higher than neighboring countries and the global average. The most recent data suggest that approximately 21 % of all pregnant adolescent females in Colombia are underweight, 27 % suffer from anemia, 20 % suffer from vitamin D deficiency, and 19 % suffer from vitamin B12 deficiency. Contributing factors to these nutritional deficiencies during pregnancy may be the region in which the female lives, the female's ethnicity, and the female's socioeconomic and educational status. In rural parts of Colombia, limitations regarding access to prenatal care and food choices that include animal source proteins may also contribute to nutritional deficiencies. To help remedy this, recommendations include encouraging nutrient dense food sources with higher protein content, eating one additional meal per day, and taking a prenatal vitamin throughout the pregnancy. Making healthy eating choices can be difficult for adolescent females with limited resources and education; therefore, it is recommended that discussions about nutrition begin at the first prenatal visit for optimum benefits. These factors should be considered for the development of future health policies and interventions in Colombia and other low-income and middle-income countries where pregnant adolescent females may be experiencing similar nutritional deficiencies.

What explains the large disparity in child stunting in the Philippines? A decomposition analysis

OBJECTIVE

About one-third of under-five Filipino children are stunted, with significant socio-economic inequality. This study aims to quantify factors that explain the large gap in stunting between poor and non-poor Filipino children.

DESIGN

Using the 2015 Philippine National Nutrition Survey, we conducted a linear probability model to examine the determinants of child stunting and then an Oaxaca-Blinder decomposition to explain the factors contributing to the gap in stunting between poor and non-poor children.

SETTING

Philippines.

PARTICIPANTS

1881 children aged 6-23 months participated in this study.

RESULTS

The overall stunting prevalence was 38·5 % with a significant gap between poor and non-poor (45·0 % v. 32·0 %). Maternal height, education and maternal nutrition status account for 26 %, 18 % and 17 % of stunting inequality, respectively. These are followed by quality of prenatal care (12 %), dietary diversity (12 %) and iron supplementation in children (5 %).

CONCLUSIONS

Maternal factors account for more than 50 % of the gap in child stunting in the Philippines. This signifies the critical role of maternal biological and socio-economic circumstances in improving the linear growth of children.

Effect of maternal hypertensive disorders during pregnancy on offspring's early childhood body weight: A population-based cohort study

OBJECTIVE

The prevalence of hypertensive disorder during pregnancy (HDP) and childhood obesity is increasing worldwide. HDP or obesity in mothers can increase the risk of overweight/obesity (OWOB) in their children. Few longitudinal studies have examined the associations of maternal body weight with the growth and risk factors for overweight in infants born to mothers with HDP. This study examined the risk factors for childhood OWOB through the age of 66 months in children born to mothers with HDP.

MATERIALS AND METHODS

In total, 24,200 pairs of mothers and their children were selected from the Taiwan Birth Cohort Study. The children's body weights were classified and analyzed to determine infant growth at birth and at the ages of 12, 24, 36, and 66 months. Multiple logistic regression analyses with different model settings were performed to identify the factors affecting growth and childhood OWOB in the children of mothers with HDP.

RESULTS

The average birth weight of children was lower in the HDP group than in the non-HDP group. The catch-up phenomenon began at the age of 18 months. The incidence of OWOB was higher in the children in the HDP group than in those in the non-HDP group from the age of 24 months and increased with the children's age. At every age point, maternal overweight before pregnancy was the main risk factor for childhood OWOB, and this effect increased with the children's age (odds ratio [OR]: 1.83 at 66 months). The effect of excessive maternal gestational weight gain on childhood OWOB was significant (OR: 1.26-1.44 for various age points).

CONCLUSION

Maternal overweight is the main risk factor for OWOB in children born to mothers with HDP. After adjusting for related confounders, we determined that HDP did not exert a significant effect on the risk of childhood OWOB.

Human Biomonitoring of Polychlorinated Biphenyls (PCBs) in the Breast Milk of Colombian Mothers

Polychlorinated biphenyls (PCBs) are persistent in the environment, bioaccumulate and biomagnify throughout the food chain, and may have adverse effects on human health and wildlife. PCB indicator (PCB 28, PCB 52, PCB 101, PCB 118, PCB 138, PCB 153, and PCB 180) were monitored in human milk using 68 samples from healthy and primiparous mothers from seven cities in Colombia, and the estimated daily intake (EDI) of infants was calculated. The PCB indicator with the highest concentration was PCB 153 with a value of 7.30 ng g^-1 lipids. The maximum EDI was calculated as 0.257 μg kg^-1 bw^-1 day^-1. In general, the PCB levels found in the 68 samples were low and did not represent a risk to breastfed infants. Additionally, these results could strengthen Colombia's efforts to increase the practice of breastfeeding. Finally, the results establish a general overview of population exposure and can be a scientific tool to improve environmental health policies in the country.

Association of maternal obesity with fetal and neonatal death: Evidence from South and South-East Asian countries

BACKGROUND

Obesity prevalence is increasing in many countries in the world, including Asia. Maternal obesity is highly associated with fetal and neonatal deaths. This study investigated whether maternal obesity is a risk factor of fetal death (measured in terms of miscarriage and stillbirth) and neonatal mortality in South and South-East Asian countries.

METHODS

This cross-sectional study pooled the most recent Demographic and Health Surveys (DHS) from eight South and South-East Asian countries (2014-2018). Multivariate logistic regression was deployed to check the relationships between maternal obesity with fetal and neonatal deaths. Finally, multilevel logistic regression model was employed since the DHS data has a hierarchical structure.

RESULTS

The pooled logistic regression model illustrated that maternal obesity is associated with higher odds of miscarriage (adjusted odds ratio [aOR]: 1.26, 95% CI: 1.20-1.33) and stillbirths (aOR: 1.46, 95% CI: 1.27-1.67) after adjustment of confounders. Children of obese mothers were at 1.18 (aOR: 1.18, 95% CI: 1.08-1.28) times greater risk of dying during the early neonatal period than mothers with a healthy weight. However, whether maternal obesity is statistically a significant risk factor for the offspring's late neonatal deaths was not confirmed. The significant association between maternal obesity with miscarriage, stillbirth and early neonatal mortality was further confirmed by multilevel logistic regression results.

CONCLUSION

Maternal obesity in South and South-East Asian countries is associated with a greater risk of fetal and early neonatal deaths. This finding has substantial public health implications. Strategies to prevent and reduce obesity should be developed before planning pregnancy to reduce the fetal and neonatal death burden. Obese women need to deliver at the institutional facility centre that can offer obstetrics and early neonatal care.

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

Background

The prevalence of diabetes mellitus (DM) during pregnancy and childhood obesity is increasing worldwide. Factors affecting the growth of children with overweight whose mothers had DM are complicated and inconclusive. Few longitudinal studies have focused on the growth of infants with macrosomia born to mothers with DM and the factors influencing their overweight. This study explored risk factors for childhood overweight/obesity (OWOB) among children of mothers with DM. Perinatal, maternal socio-demographic, infant care, and maternal body weight characteristics as well as child growth until age 3 years were analyzed using a longitudinal design.

Methods

In total, 24,200 pairs of mothers and their children from the Taiwan Birth Cohort Study were included. Combined Taiwan Children Growth Curve report classifications were analyzed for infant growth at birth and at 6, 12, 18, 24, and 36 months old (m/o). A multiple logistic regression analysis with different model settings was used to assess factors affecting the growth of high birth weight children of mothers with diabetic mellitus (HODM).

Results

Children in the HODM group had a higher average body weight than did those in the non-DM group at different age stages. Relative to the non-DM group, weight gain in the HODM group was slower before 18 m/o but faster from 18 to 36 m/o, particularly after 24 m/o. Maternal DM was a major risk factor for childhood OWOB (odds ratio [OR]: 3.25–3.95). After adjustment for related confounders, the OR was 2.19–3.17. Maternal overweight or obesity and higher gestational weight gain were greater risk factors for childhood OWOB at 3 years old after adjusted maternal DM and other selected confounders (OR: 1.45 and 1.23, respectively). Breastfeeding until 6 m/o was a protective factor against childhood OWOB (OR: 0.95). The HODM and non-DM groups did not differ significantly in perinatal, maternal socio-demographic, or infant care characteristics.

Conclusions

Maternal DM is a major factor of childhood OWOB. Maternal body weight before and after pregnancy affects childhood OWOB, and this effect increases with the child’s age.