CONTENTIS IN BRIEF
YANG Junting, HUANG Aiqun, CHEN Dafang
Chinese Journal of Reproductive Health.
2023, 34(1):
25-34.
Objective The purpose of this study was to examine the trajectories of body mass index-for-age z-score (Z-BMI) in 3-year-old infants and their determining factors. Methods In this prospective cohort study, pregnant women were recruited based on convenience sampling method at the third trimester from 5 counties in China and their offspring were followed up to 3-year old during Sept 2015 to June 2019. Group-based trajectory model was used to identify distinct Z-BMI trajectories. Group lasso regression analysis and multinomial logistic regression were utilized identify prenatal and early life determinants of the identified trajectories. Results Among a total of 2330 individuals (1253 males and 1077 females), we identified four distinct Z-BMI trajectories:"low-stable" (25.4%), "catch-up" (18.8%), "intermediate-stable" (38.4%) and "rising" (17.4%) trajectories. Multinomial logistic regression showed that, paternal underweight (OR=1.80, 95%CI:1.08-3.01), maternal underweight before pregnancy(OR=1.30, 95%CI:1.04-1.63), time for outdoor activity in the third trimester < 1h (OR=1.30, 95%CI:1.04-1.63), no iron supplementation during pregnancy (OR=1.47, 95%CI:1.17-1.85), and time for outdoor activity of 6-month-old infants < 3h (OR=1.36, 95%CI:1.06-1.75) were associated with significantly increased risk of being at the "low-stable" group compared with the “intermediate-stable” group, while infants whose sleep quality at 1-month-old was assessed as high-quality (OR=0.74, 95%CI:0.58-0.94) had decreased risk of being at the "low-stable" group. Maternal obesity (OR=1.69, 95%CI:1.07-2.66), cesarean delivery (OR=1.43, 95%CI:1.12-1.83), the duration of exclusive breastfeeding < 6 months (OR=1.39, 95%CI:1.07-1.7) were associated with significantly increased risk of being at the "rising" group compared with the "intermediate-stable" group. Conclusion Distinct BMI trajectories exist during the infancy period. Paternal underweight, maternal underweight, no iron supplementation during pregnancy, and inadequate outdoor activity in the third trimester for pregnant women and at 6 months of age for infants are associated with increased the risk of "low-stable" growth, while high-quality of sleep at 1 month of age is associated with decreased risk of "low-stable" growth. Maternal obesity, cesarean delivery, shorter duration of exclusive breastfeeding are associated with increased risk of "rising” growth.