BMI Trajectories During the First 2 Years, and Their Associations With Infant Overweight/Obesity: A Registered Based Cohort Study in Taizhou, China

Tian Zhang,Yanjie Jin,Linghua Tao,Haoyue Teng,Danhong Zhou,Yue Zhang,Jianan Lu,Jieyun Yin,Ying Song

doi:10.3389/fped.2021.665655

Abstract

Objective: The purpose of this study was to identify trajectories of body mass index (BMI) in toddlers from birth to 2 years old and examine their association with infantile overweight/obesity.Methods: Data were collected from 19,054 children born in any hospital or community healthcare center in Taizhou, China from 2018 to 2019 with at least three BMI measurements after birth. The Latent Class Growth Mixture Model was used to identify distinct BMI trajectories during the first 2 years of infants. Multiple logistic regression models were conducted to explore the associated factors of different BMI trajectories, and log-binomial regression was performed to assess the association between the trajectories and overweight/obesity.Results: Three heterogeneous BMI trajectories were identified and labeled as “lower” (36.21%, n = 6,899), “middle” (53.15%, n = 10,128) and “upper” (10.64%, n = 2,027), respectively. Several characteristics of infants and their corresponding mothers were found to be correlated with infant BMI trajectories, including infant sex, mode of delivery and weight at birth, as well as maternal parity, early pregnancy BMI and status of gestational diabetes mellitus. Furthermore, compared with those in the lower trajectory, infants in the middle [prevalence ratio (PR) = 2.63, 95% confidence interval (95%CI) = 2.17–2.63] or upper (PR = 2.98, 95%CI = 1.51–2.98) trajectory groups were prone to be overweight/obesity at their final observation.Conclusion: Heterogeneous BMI trajectories were observed in our study. Characteristics of both infants and their corresponding mothers could be potential determinants of infant growth. Moreover, infants in the middle and upper trajectory groups were more likely to suffer overweight/obesity.

Highlights

Overweight and Obesity, defined by the World Health Organization (WHO) as an abnormal or excessive fat accumulation, present an alarming risk to health [1]
The middle trajectory started with a mid-level Body mass index (BMI) (13.75 kg/m2), while the upper one showed a higher level of BMI (14.44 kg/m2) at beginning
Both of them reached the climax at 7 months (“middle” = 18.47 kg/m2, “upper” = 20.58 kg/m2) and the lowest point at 17 months after birth, which were parallel to the process of the lower one

Summary

Introduction

Overweight and Obesity, defined by the World Health Organization (WHO) as an abnormal or excessive fat accumulation, present an alarming risk to health [1]. Childhood overweight and obesity have become a major public health concern [2]. In China, a national survey reported that the prevalence of overweight and obesity in children aged 7–17 years had increased rapidly from 3.8% and 0.6% in 1995 to 14.3% and 4.1% in 2014, respectively [3]. Excessive weight gain in early life is likely to lead to lifelong overweight and obesity [4]. Childhood overweight/obesity is associated with greater risk and earlier onset of chronic disorders, such as heart disease, asthma, type 2 diabetes, and psychosocial disorders [5,6,7]. The early identification and intervention of overweight/obesity in infants is critical to their long-term health conditions

Methods

Results

Conclusion