Impact of early life factors on metabolic phenotypes of obesity in preschool children

OBJECTIVE: To investigate the impact of factors in the first 1000 days of life on metabolic phenotypes of obesity in preschool children in a cohort study. 

RESEARCH DESIGN AND METHODS: 3-year-olds were recruited. Early life factors included maternal age at delivery, maternal education, prepregnancy BMI, gestational weight gain, gravidity, history of gestational diabetes mellitus, delivery mode, gestational age, family history of metabolic disorders, paternal education, annual family income, child sex, birthweight, and breastfeeding duration. According to BMI and metabolic status, children were classified as: metabolically healthy with normal weight (MHNW), metabolically unhealthy with normal weight (MUNW, normal weight and with ≥1 metabolic risk factor), metabolically healthy with overweight or obesity (MHO, overweight or obesity and without metabolic risk factors), and metabolically unhealthy with overweight or obesity (MUO). 

RESULTS: 3822 children were recruited, with 3015 analyzed. Accelerated BMI z score growth rate between 6~24 months was associated with MHO (β: 0.022; 95% CI: 0.009, 0.036) and MUO (β: 0.037; 95% CI: 0.018, 0.056). Maternal overweight (OR: 3.16; 95% CI: 1.55, 6.42) and obesity (OR: 8.14; 95% CI: 3.73, 17.76) before pregnancy and macrosomia (OR: 2.47; 95% CI: 1.32, 4.59) were associated with MHO, and maternal obesity before pregnancy (OR: 6.35; 95% CI: 2.17, 18.52) increased risk of MUO.

CONCLUSIONS: Early life factors such as maternal obesity and accelerated BMI growth rate between 6~24 months were not only related to MHO but also to MUO. Children with these early life factors should be given interventions for weight control to prevent metabolic abnormalities.