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Meta-analysis

Infant obesity risk factors identified

Researchers hope their risk factors could help develop screening guidelines to identify infants at risk.
Risk factors for infants include high birth rate, rapid weight gain, or an overweight mother pre-birth

Infants stand a greater risk of becoming obese later in childhood if they have a high birth weight, rapid weight gain, or an overweight mother who smoked during pregnancy, according to a new systematic review of childhood risk factors.

The study, undertaken by PhD student Stephen Weng at the University of Nottingham, UK, also found that children who were breastfed and were introduced to solid food later were slightly less likely to become overweight.

The study authors hope that the findings could be used to develop screening guidelines or checklists for healthcare professionals for identifying infants at the greatest risk of becoming obese.

Dr Sarah Redsell, who led a team supporting Weng’s work, said: "The results of this study effectively identify the most significant risk factors by analysing data from a large number of other studies that have previously been conducted.

“This will offer a robust starting point for further research that will identify the most appropriate ways in which this information could be useful in healthcare practice."

Weng’s analysis found seven studies that identified high birth weight as a potential risk factor for high childhood BMI; out of these, six found a significant and strong positive association.

The studies found that heavier infants were between 2.3 times and 2.17 times more likely to display later overweight than normal weight infants.

Another study found that for every one-unit standard deviation increase in birthweight, the odds of being overweight at three years of age increased by 1.36.

Three studies found a significant association between a mother’s pre-pregnancy overweight and the child’s later overweight. One found that children of mothers who were obese before pregancy were 4.25 times more likely to be overweight at 7 years than children of non-obese mothers. Another found that the children of mothers who were overweight before pregnancy were 1.37 times more likely to be overweight at three years than children of normal weight parents.

Six studies found that babies who demonstrated rapid weight gain in their first year of life were likely to develop childhood overweird. One study found that babies in the top 20% of monthly weight gain were 3.9 times more likely to be overweight at 4.5 years.

A random effects meta-analysis of seven studies investigating the impact of maternal smoking during pregnancy on childhood overweight found that children with mothers who had smoked regularly during pregnancy were 47% more likely to be overweight, compared with non-smoking mothers.

Out of ten studies identified which compared breastfeeding with other types of feeding during the first year of life, five studies found that breastfeeding had a significant effect on later overweight, while five did not. A random effects meta-analysis of the studies found that overall, children who were ever breastfed in their first year of life were 15% less likely to be overweight than children who were never breastfed.

Four studies investigated the relationship between early introduction of solid foods and childhood overweight, finding some evidence of it being a risk factor.

No association was found in the studies analysed between childhood overweight and maternal age at birth, maternal education, maternal antenatal or postnatal depression, or infant ethnicity.

The study was funded by NHS Nottinghamshire County Primary Care Trust.

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