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Birth weight, infant growth, and childhood body mass index: Hong Kong's children of 1997 birth cohort.

Hui LL, Schooling CM, Leung SS, Mak KH, Ho LM, Lam TH, Leung GM

Department of Community Medicine and School of Public Health, The University of Hong Kong, 5/F William M. W. Mong Block, 21 Sassoon Rd, Pokfulam, Hong Kong, China.

OBJECTIVE: To investigate the association between birth weight, infant growth rate, and childhood adiposity as a proxy for adult metabolic or cardiovascular risk in a Chinese population with a history of recent and rapid economic development. DESIGN: Prospective study in a population-representative birth cohort. SETTING: Hong Kong Chinese population. PARTICIPANTS: Six thousand seventy-five term births (77.5% successful follow-up). Main Exposures Birth weight and growth rate (change in the weight z score) at ages 0 to 3 and 3 to 12 months. Main Outcome Measure Body mass index (BMI) (calculated as the weight in kilograms divided by the height in meters squared) z score at about age 7 years. RESULTS: Each unit increase in the weight z score at ages 0 to 3 and 3 to 12 months increased the BMI z score by 0.52 and 0.33, respectively. Children in the highest birth weight and growth rate tertiles had the highest BMI z scores. In the lowest birth weight tertile, increases in the weight z score at ages 0 to 3 months had a larger effect on the BMI z score in boys (mean difference, 0.88; 95% confidence interval 0.69-1.07) than in girls (mean difference, 0.52; 95% confidence interval, 0.33-0.71); these differences by birth weight, growth rate at ages 0 to 3 months, and sex were significant (P = .007). CONCLUSIONS: Faster prenatal and postnatal growth were associated with higher childhood BMI in a population with a recent history of rapid economic growth and relatively low birth weight, suggesting that maximal growth may not be optimal for metabolic risk. However, there may be a developmental trade-off between metabolic risk and other outcomes.

Published 4 March 2008 in Arch Pediatr Adolesc Med, 162(3): 212-8.
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Introductory Biostatistics for the Health Sciences: Modern Applications Including Bootstrap (Wiley Series in Probability and Statistics)

Introductory Biostatistics for the Health Sciences: Modern Applications Including Bootstrap (Wiley Series in Probability and Statistics)