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Developmental Trajectories of Body Mass Index in Early Childhood and Their Risk Factors

Developmental Trajectories of Body Mass Index in Early Childhood and Their Risk Factors

Laura E. Pryor, MSc; Richard E. Tremblay, PhD; Michel Boivin, PhD; Evelyne Touchette, PhD; Lise Dubois, PhD; Christophe Genolini, PhD; Xuecheng Liu, PhD; Bruno Falissard, MD, PhD; Sylvana M. Côté, PhD

Archive of Pediatrics and Adolescent Medicine,
165:10, October 01, 2011

Developmental Trajectories of Body Mass Index in Early Childhood and Their Risk Factors

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.

Prospective cohort study.

Families with a child born between October 1997 and July 1998 in the province of Quebec, Canada.

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.

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).

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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Prepared by: Dr. Houssam Al-Nahhas

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