Analysis on determinants of infants overweight and obesity based on generalized estimation equation / 上海预防医学

ABSTRACT

Objective To explore the determinants of infants overweight and obesity using generalized estimation equation (GEE). Methods Data were extracted from 26 624 2-year old infants who completed required health examination from January 2017 to December 2019 in Minhang District of Shanghai.The weight for height at 6, 12, 18 and 24 months of age was calculated to evaluate nutrition status of infants.Ordinal multinomial GEE was fitted with malnutrition, normality, overweight and obesity as responding variables to explore the determinants of infants overweight and obesity. Results Incidence rate of overweight and obesity in infants of 6 to 24 months of age had a tendency of decline, and proportion of normality showed as increasing tendency along with the increase of months of age(P < 0.001).GEE showed that the following factors were more likely involved in infant overweight and obesity male(OR=1.182), lower education level of mother (OR=1.399 for primary school, OR=1.124 for junior high school, and OR＝1.083 for senior high school, respectively), higher body weight of father(OR=1.003), higher pre-pregnant body weight of mother(OR=1.003), longer gestational age(OR=1.058), longer sleeping time at 6 month of age(OR=1.032), lower month of age (OR=2.911 for 6 months, OR=1.952 for 12 months, and OR=1.232 for 18 months, respectively).Those with low birth weight (OR=0.205 for < 2 500 g, and OR=0.410 for 2 500~3 999 g, respectively)and exclusive breastfeeding at 6 months of age(OR=0.946)had low likelihood of overweight and obesity. Conclusion Comprehensive measures should be taken to control infants overweight and obesity, including encouraging expectant parents to maintain normal body weight before pregnancy, strengthening the education of scientific feeding knowledge, and extending exclusive breastfeeding.