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. 2020 Apr;8(7):474.
doi: 10.21037/atm.2020.03.128.

Interaction between delivery mode and maternal age in predicting overweight and obesity in 1,123 Chinese preschool children

Shufang Liu  1   2 , Jieping Lei  3   4 , Jia Ma  1   2 , Yanyan Ma  5 , Shunan Wang  1   2 , Yuan Yuan  1   2 , Yu Shang  5 , Zhixin Zhang  2   6 , Wenquan Niu  3
Affiliations

Interaction between delivery mode and maternal age in predicting overweight and obesity in 1,123 Chinese preschool children

Shufang Liu et al. Ann Transl Med. 2020 Apr.

Abstract

Background: Pediatric overweight/obesity has escalated to epidemic proportions worldwide. In this study, we aimed to assess the association of delivery mode and maternal age, both individually and interactively, with the risk of being overweight or obese among Chinese preschool children.

Methods: We cross-sectionally recruited 1,123 preschool children from five kindergartens in Beijing. Data were collected by a pre-validated self-developed questionnaire. Overweight and obesity are defined according to the World Health Organization (WHO), International Obesity Task Force (IOTF), and China criteria, respectively.

Results: Cesarean delivery was significantly associated with pediatric overweight/obesity under the WHO [adjusted odds ratio (aOR), 95% confidence interval (CI): 1.60, 1.12-2.29], IOTF (1.77, 1.23-2.53), and China (1.43, 1.06-1.94) criteria, respectively. Maternal age <28 years reached statistical significance under both WHO (1.69, 1.09-2.61) and IOTF (1.69, 1.09-2.61) criteria in predicting pediatric overweight/obesity. The interaction between cesarean delivery and maternal age <28 years was remarkably significant under the WHO (2.26, 1.10-4.67), IOTF (2.92, 1.43-5.96), and China (2.36, 1.24-4.50) criteria.

Conclusions: Our findings indicate that the interaction between cesarean delivery and maternal age <28 years can remarkably increase the risk of overweight/obesity among Chinese preschool children.

Keywords: Delivery mode; maternal age; obesity; overweight; preschool children.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm.2020.03.128). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The prevalence of overweight and obesity in preschool children based on age and gender by WHO, IOTF, and China criteria, respectively. WHO, World Health Organization; IOTF, International Obesity Task Force.
Figure 2
Figure 2
Association between maternal age and overweight/obesity risk among preschool children under the WHO (A), IOTF (B), and China criteria (C), respectively. In panels, navy line was plotted for maternal age, and red line for reference. Dotted lines represent 95% confidence intervals. WHO, World Health Organization; IOTF, International Obesity Task Force.
Figure 3
Figure 3
Three-dimension interactive surface of maternal and birthweight in predicting pediatric overweight and obesity under the WHO (A), IOTF (B), China criteria (C), respectively. The grey horizontal grid denotes the reference surface. WHO, World Health Organization; IOTF, International Obesity Task Force.
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