2015 APHA Annual Meeting & Expo

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Online Program

327293
Modeling the Effects of Fetal Growth and Duration of Gestation on Childhood Obesity


Tuesday, November 3, 2015 : 8:48 a.m. - 9:06 a.m.

Hyojun Park, MA, Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI
Maureen Durkin, PhD, DrPH, Population Health Sciences, University of Wisconsin, Madison, WI
Audio (mp3) recording Recorded Presentation (mp4)
Background: The inconclusive evidence for developmental origins of child obesity may be partly explained by the inconsistent use of birthweight (BW), gestational age (GA), and weight for gestational age (WGA) and their use as categorized rather than continuous measures of fetal growth. This study evaluated the interchangeability of BW, GA and WGA as continuous predictors of child growth or obesity using nationally representative longitudinal data.

Methods: Data were from the Early Childhood Longitudinal Study, the 2001 Birth Cohort (n=6,650). Multivariate regression and logistic modeling, accounting for the complex survey design, were used to estimate the impacts of BW, GA and WGA percentiles, singly or in combination, on the BMI percentiles and the risk of obesity in childhood, after adjusting for other covariates.

Results: The model using both WGA (b=0.11, s.e.=0.01, p<0.01) and GA (b=0.03, s.e.=0.01, p=0.03) identified positive and independent effects of fetal growth and of duration of gestation on child growth, while the model using BW alone (b=0.58, s.e.=0.05, p<0.01) captured the net impacts of fetal growth and duration of gestation. A negative effect of GA (GA: b=-0.08, s.e.=0.02, p<0.01) on child growth was found when both BW and GA were used in the same model, which might be due to collinearity between BW and GA.

Conclusion: Use of both WGA and GA as predictors of BMI in childhood allows assessment of the independent effects of fetal growth and duration of gestation. Use of BW alone as an indicator of fetal growth is a reasonable strategy when reliable measures of GA are not available. Use of both BW and GA in the same model is not advised due to their collinearity.

Learning Areas:

Basic medical science applied in public health
Epidemiology
Public health or related research

Learning Objectives:
Describe how birth weight, gestational age and weight for gestational age differently capture fetal growth and duration of gestation. Identify the impact of fetal growth and duration of gestation on child growth and the risk of obesity during early childhood. Consider programmatic and policy implications of our findings.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been studying childhood obesity epidemic as my dissertation topic for last couple of years. Among my scientific interests has been the development of strategies for better understanding childhood obesity.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4032.0: Childhood Obesity in Epidemiological Research