Published in:
Open Access
01-12-2015 | Research article
Maternal obesity, environmental factors, cesarean delivery and breastfeeding as determinants of overweight and obesity in children: results from a cohort
Authors:
Daniel S Portela, Tatiana O Vieira, Sheila MA Matos, Nelson F de Oliveira, Graciete O Vieira
Published in:
BMC Pregnancy and Childbirth
|
Issue 1/2015
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Abstract
Background
Overweight and obesity are a public health problem with a multifactorial aetiology. The objective of this study was to evaluate risk factors for overweight and obesity in children at 6 years of age, including type of delivery and breastfeeding.
Methods
This study relates to a cohort of 672 mother-baby pairs who have been followed from birth up to 6 years of age. The sample included mothers and infants seen at all ten maternity units in a large Brazilian city. Genetic, socioeconomic, demographic variables and postnatal characteristics were analyzed. The outcome analyzed was overweight and/or obesity defined as a body mass index greater than or equal to +1 z-score. The sample was stratified by breastfeeding duration, and a descriptive analysis was performed using a hierarchical logistic regression. P-values of <0.05 were considered significant.
Results
Prevalence rates (PR) of overweight and obesity among the children were 15.6% and 12.9%, respectively. Among the subset of breastfed children, factors associated with the outcome were maternal overweight and/or obesity (PR 1.92; 95% confidence interval “95% CI” 1.15–3.24) and lower income (PR 0.50; 95% CI 0.29–0.85). Among children who had not been breastfed or had been breastfed for shorter periods (less than 12 months), predictors were mothers with lower levels of education (PR 0.39; 95% CI 0.19–0.78), working mothers (PR 1.83; 95% CI 1.05–3.21), caesarean delivery (PR 1.98; 95% CI 1.14 – 3.50) and maternal obesity (PR 3.05; 95% CI 1.81 – 5.25).
Conclusions
Maternal obesity and caesarean delivery were strongly associated with childhood overweight and/or obesity. Lower family income and lower levels of education were identified as protective factors. Breastfeeding duration appeared to modify the association between overweight/obesity and the other predictors studied.