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      Relationship between birth weight and overweight/obesity among students in Florianópolis, Santa Catarina, Brazil: a retrospective cohort study Translated title: Relação entre peso ao nascer e sobrepeso/obesidade em estudantes de Florianópolis, Santa Catarina, Brasil: estudo de coorte retrospectivo

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          Abstract

          CONTEXT AND OBJECTIVE:

          Being born heavier than 4 kg is associated with current overweight and obesity over the long term. The objective here was to ascertain whether birth weight was related to overweight or obese status, among 7 to 14-year-old schoolchildren, taking into consideration the possible interactions between socioeconomic factors and other biological variables.

          DESIGN AND SETTING:

          Retrospective cohort study on a probabilistic sample of 2,696 children and adolescents living in Florianópolis, Santa Catarina, Brazil.

          METHODS:

          The following data were collected: anthropometric (student's weight, height and age; and parents' weight and height), socioeconomic (family income, number of people in house and parental schooling level), birth weight and gestational age. Overweight and obesity were classified using percentiles of body mass index and triceps and subscapular skinfolds. The outcome variables were overweight and obesity and the main explanatory variables were birth weight and birth weight according to gestational age. The control variables were the parents' nutritional status, their schooling level and the per capita family income. Poisson multivariate regressions were carried out.

          RESULTS:

          Higher prevalence of high birth weight was observed among overweight male adolescents (PR = 1.14; 95% CI = 1.02-1.27; P = 0.03), but this was not observed among obese male adolescents. Low birth weight and being born small for gestational age were also not associated with the outcomes. Among overweight and obese children, birth weight was not significantly different from that of normal-weight children.

          CONCLUSION:

          No significant association between birth weight and obesity was observed. However, there was a weak but significant association between high birth weight and overweight, among male adolescents.

          Translated abstract

          CONTEXTO E OBJETIVO:

          Nascer com peso > 4 kg se associa a sobrepeso e/ou obesidade em longo prazo. O objetivo foi verificar se o peso ao nascer foi um fator relacionado ao estado de sobrepeso ou obesidade atuais, em escolares de 7-14 anos, levando em consideração interações possíveis com fatores socioeconômicos e outras variáveis biológicas.

          TIPO DE ESTUDO E LOCAL:

          Estudo coorte retrospectivo numa amostra probabilística de 2.696 crianças e adolescentes residentes em Florianópolis, Santa Catarina, Brasil.

          MÉTODOS:

          Coletaram-se dados antropométricos (peso, estatura e idade dos escolares, peso e estatura dos pais), socioeconômicos (renda familiar, número de pessoas na casa, escolaridade dos pais) e de peso ao nascer e idade gestacional. Sobrepeso e obesidade foram definidos utilizando-se os percentis de índice de massa corporal e as dobras cutâneas tricipital e subescapular. Sobrepeso e obesidade foram desfechos, e peso ao nascer e peso ao nascer/por idade gestacional foram variáveis explanatórias principais. As variáveis de controle foram: estado nutricional dos pais, seu nível de escolaridade e renda familiar per capita. Foram realizadas regressões de Poisson.

          RESULTADOS:

          Nos adolescentes do sexo masculino com sobrepeso, houve maior prevalência de elevado peso ao nascer (RP = 1,14; 95% IC = 1,02-1,27; P = 0,03). Naqueles com obesidade, não foi observado o mesmo. Baixo peso ao nascer e nascer pequeno para a idade gestacional também não se associaram aos desfechos. Nas crianças com sobrepeso ou obesidade, o peso ao nascer não diferiu daquele entre as eutróficas.

          CONCLUSÃO:

          Não se observou associação significativa entre peso ao nascer e obesidade. Porém, houve associação significativa, ainda que fraca, entre elevado peso ao nascer e sobrepeso, nos adolescentes do sexo masculino.

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          Most cited references66

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          Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee.

          Anthropometry provides the single most portable, universally applicable, inexpensive and non-invasive technique for assessing the size, proportions, and composition of the human body. It reflects both health and nutritional status and predicts performance, health, and survival. As such, it is a valuable, but currently underused, tool for guiding public health policy and clinical decisions. This report presents the conclusions and comprehensive recommendations of a WHO Expert Committee for the present and future uses and interpretation of anthropometry. In a section that sets the technical framework for the report, the significance of anthropometric indicators and indices is explained and the principles of applied biostatistics and epidemiology that underlie their various uses are discussed. Subsequent sections provide detailed guidance on the use and interpretation of anthropometric measurements in pregnant and lactating women, newborn infants, infants and children, adolescents, overweight and thin adults, and adults aged 60 years and over. With a similar format for each section, the report assesses specific applications of anthropometry in individuals and populations for purposes of screening and for targeting and evaluating interventions. Advice on data management and analysis is offered, and methods of taking particular measurements are described. Each section also includes a discussion of the extent, reliability and universal relevance of existing reference data. An extensive series of reference data recommended by the Expert Committee and not widely distributed by WHO hitherto is included in an annex.
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            Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio

            Background Cross-sectional studies with binary outcomes analyzed by logistic regression are frequent in the epidemiological literature. However, the odds ratio can importantly overestimate the prevalence ratio, the measure of choice in these studies. Also, controlling for confounding is not equivalent for the two measures. In this paper we explore alternatives for modeling data of such studies with techniques that directly estimate the prevalence ratio. Methods We compared Cox regression with constant time at risk, Poisson regression and log-binomial regression against the standard Mantel-Haenszel estimators. Models with robust variance estimators in Cox and Poisson regressions and variance corrected by the scale parameter in Poisson regression were also evaluated. Results Three outcomes, from a cross-sectional study carried out in Pelotas, Brazil, with different levels of prevalence were explored: weight-for-age deficit (4%), asthma (31%) and mother in a paid job (52%). Unadjusted Cox/Poisson regression and Poisson regression with scale parameter adjusted by deviance performed worst in terms of interval estimates. Poisson regression with scale parameter adjusted by χ2 showed variable performance depending on the outcome prevalence. Cox/Poisson regression with robust variance, and log-binomial regression performed equally well when the model was correctly specified. Conclusions Cox or Poisson regression with robust variance and log-binomial regression provide correct estimates and are a better alternative for the analysis of cross-sectional studies with binary outcomes than logistic regression, since the prevalence ratio is more interpretable and easier to communicate to non-specialists than the odds ratio. However, precautions are needed to avoid estimation problems in specific situations.
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              Early life risk factors for obesity in childhood: cohort study.

              To identify risk factors in early life (up to 3 years of age) for obesity in children in the United Kingdom. Prospective cohort study. Avon longitudinal study of parents and children, United Kingdom. 8234 children in cohort aged 7 years and a subsample of 909 children (children in focus) with data on additional early growth related risk factors for obesity. Obesity at age 7 years, defined as a body mass index (3) 95th centile relative to reference data for the UK population in 1990. Eight of 25 putative risk factors were associated with a risk of obesity in the final models: parental obesity (both parents: adjusted odds ratio, 10.44, 95% confidence interval 5.11 to 21.32), very early (by 43 months) body mass index or adiposity rebound (15.00, 5.32 to 42.30), more than eight hours spent watching television per week at age 3 years (1.55, 1.13 to 2.12), catch-up growth (2.60, 1.09 to 6.16), standard deviation score for weight at age 8 months (3.13, 1.43 to 6.85) and 18 months (2.65, 1.25 to 5.59); weight gain in first year (1.06, 1.02 to 1.10 per 100 g increase); birth weight, per 100 g (1.05, 1.03 to 1.07); and short (< 10.5 hours) sleep duration at age 3 years (1.45, 1.10 to 1.89). Eight factors in early life are associated with an increased risk of obesity in childhood.
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                Author and article information

                Journal
                Sao Paulo Med J
                Sao Paulo Med J
                Sao Paulo Med J
                São Paulo Medical Journal
                Associação Paulista de Medicina - APM
                1516-3180
                1806-9460
                22 July 2014
                2014
                : 132
                : 5
                : 273-281
                Affiliations
                [I ] originalMSc. Assistant Professor, Undergraduate Nutrition Course, Universidade Federal da Fronteira Sul (UFFS), Chapecó, Santa Catarina, Brazil
                [II ] originalPhD. Titular Professor, Undergraduate Nutrition Course, Department of Public Health, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
                Author notes
                Address for correspondence: Camila Elizandra Rossi. Rua Zelindro Périco, 2.191, Caixa Postal 205. Jd. Panorâmico - Loteamento Marchese - Realeza (PR) - Brasil. CEP 85770-000. E-mail: camilarossi@ 123456uffs.edu.br

                Conflict of interest: None

                Article
                10.1590/1516-3180.2014.1325630
                10496754
                25054968
                b4ca5949-4df3-49bf-825b-2cc0739a5250

                This is an open access article distributed under the terms of the Creative Commons license.

                History
                : 20 November 2012
                : 21 September 2013
                : 08 October 2013
                Page count
                Tables: 5, References: 40, Pages: 9
                Categories
                Article

                child,adolescent,birth weight,overweight,obesity,criança,adolescente,peso ao nascer,sobrepeso,obesidade

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