2025-06-26 ワシントン州立大学(WSU)
<関連情報>
- https://news.wsu.edu/press-release/2025/06/26/wsu-led-study-identifies-associations-between-prenatal-factors-and-childhood-obesity/
- https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2834361
ECHOコホートにおける小児の早期生活因子と体格指数の軌跡 Early-Life Factors and Body Mass Index Trajectories Among Children in the ECHO Cohort
Chang Liu, PhD; Sy-Miin Chow, PhD; Izzuddin M. Aris, PhD; et al
Jama Network Open Published:May 22, 2025
DOI:10.1001/jamanetworkopen.2025.11835
Key Points
Question How are early-life factors associated with body mass index (BMI) trajectories in children?
Findings In this cohort study of 9483 children, there were 2 distinct BMI trajectories: a typical trajectory (89% of children) and an atypical trajectory with an earlier BMI increase (11% of children). Prenatal smoking, high maternal prepregnancy BMI, high gestational weight gain, and high birth weight were associated with the atypical trajectory.
Meaning The findings of this study may help identify an atypical BMI trajectory during early childhood and associated risk factors, indicating potential opportunities for preventing childhood obesity.
Abstract
Importance Identifying atypical body mass index (BMI) trajectories in children and understanding associated, modifiable early-life factors may help prevent childhood obesity.
Objective To characterize multiphase BMI trajectories in children and identify associated modifiable early-life factors.
Design, Setting, and Participants This cohort study included longitudinal data obtained from January 1997 to June 2024, from the Environmental influences on Child Health Outcomes (ECHO) cohort, which included children aged 1 to 9 years with 4 or more weight and height assessments. Analyses were conducted from January to June 2024.
Exposures Prenatal exposure to substances and stress (smoking, alcohol, depression, anxiety), maternal characteristics (prepregnancy BMI, gestational weight gain), child characteristics (preterm birth, birth weight, breastfeeding), and demographic covariates.
Main Outcomes and Measures BMI (calculated as weight in kilograms divided by length in meters squared for children aged 1 and 2 years and as weight in kilograms divided by height in meters squared for children older than 2 years) obtained using medical records, staff measurements, caregiver reports, or remote study measures. The analysis was conducted using a multiphase latent growth mixture model.
Results This study included 9483 children (4925 boys [51.9%]). Two distinct 2-phase BMI patterns were identified: typical and atypical. The typical group (n = 8477 [89.4%]) showed linear decreases in BMI (b2, -0.23 [95% CI, -0.24 to -0.22]), with the lowest BMI at age 6 years (95% CI, 5.94-6.11), followed by linear increases from 6 to 9 years (slope difference [b4 – b2], 0.81 [95% CI, 0.76-0.86]; mean BMI at 9 years: 17.33). The atypical group (n = 1006 [10.6%]) showed a stable BMI from ages 1 to 3.5 years (b6, 0.06 [95% CI, -0.04 to 0.15]), followed by rapid linear increases from ages 3.5 to 9 years (slope difference [b8 – b6], 1.44 [95% CI, 1.34-1.55]). At age 9 years, this group reached a mean BMI (26.2) that exceeded the 99th percentile. Prenatal smoking, high prepregnancy BMI, high gestational weight gain, and high birth weight were key risk factors for the atypical trajectory.
Conclusions and Relevance In this cohort study of children in the ECHO cohort, analyses identified children on the path to obesity as early as age 3.5 years. Modifiable factors could be targeted for early prevention and intervention programs aimed at reducing childhood obesity.
