Journal
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE
Volume 165, Issue 10, Pages 906-912Publisher
AMER MEDICAL ASSOC
DOI: 10.1001/archpediatrics.2011.153
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Funding
- Fonds pour la Recherche en Sante du Quebec
- St Justine Hospital's Research Center
- Canadian Institute for Health Research
- Quebec Ministry of Health and Social Services
- Quebec Ministry of Families and Seniors
- Lucie and Andre Chagnon Foundation
- Social Science and Humanities Research Council of Canada
- Quebec Fund for Research on Society and Culture
- Canada Research Chair Program
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Objectives: To identify groups of children with distinct developmental trajectories of body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, between the ages of 5 months and 8 years and identify early-life risk factors that distinguish children in an atypically elevated BMI trajectory group. Design: Prospective cohort study. Setting: Families with a child born between October 1997 and July 1998 in the province of Quebec, Canada. Participants: A representative sample of children (N = 2120) selected through birth registries for the Quebec Longitudinal Study of Child Development. Children for whom BMI data were available for at least 5 time points were retained in the present study (n = 1957). Main Exposures: Early-life factors putatively associated with BMI, assessed by maternal report. Outcome Measure: Group-based trajectories of children's BMI, identified with a semiparametric modeling method from raw BMI values at each age. Results: Three trajectories of BMI were identified: low-stable (54.5% of children), moderate (41.0%), and high-rising (4.5%). The high-rising group was characterized by an increasing average BMI, which exceeded international cutoff values for obesity by age 8 years. Two maternal risk factors were associated with the high-rising group as compared with the low-stable and moderate groups combined: maternal BMI (odds ratio, 2.38; 95% confidence interval, 1.38-4.54 for maternal overweight and 6.33; 3.82-11.85 for maternal obesity) and maternal smoking during pregnancy (2.28; 1.49-4.04). Conclusions: Children continuing on an elevated BMI trajectory leading to obesity in middle childhood can be distinguished from children on a normative BMI trajectory as early as age 3.5 years. Important and preventable risk factors for childhood obesity are in place before birth.
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