[The Association of Computerized Medical Records Users in Perinatology, Obstetrics and Gynecology Sentinel Network for maternity hospitals. I. Perinatal health indicators in 1994]. / Le "Réseau Sentinelle" de maternités AUDIPOG. I. Paramètres de santé périnatale en 1994.

A first experiment aimed at collecting data from 98 maternity hospitals grouped in the AUDIPOG Sentinel Network addressed 7,837 deliveries in January, 1994. The technique used for recovering the results was adapted from the quota method and aimed at strict respect of marginal distributions of deliveries per regional area and per hospital type, and at the best the joint distribution of deliveries per regional area/hospital type, to obtain estimates of perinatal health indicators. Selection indicators (age, family status, socio-economic conditions, previous history), practising indicators (supervision of the pregnancy, entrance motive, presentation, delivery mode, anaesthetic) and result indicators (prematurity, small for date, transfer, pathology of the new-born) are given.

[Birth weight and obesity at the age of 6. Study from the growth curves of a population of schoolchildren]. / Poids de naissance et obésité à 6 ans. Etude à partir de courbes de croissance d'une population d'enfants scolarisés.

The weight and height data of 9261 children from birth onwards were gathered on their admission to primary school in 1989 in the area of Lyon, and compared to French references. In comparison with the latter data, the weight and height for age were found to be higher, and there was an excess of children with a high weight for height. The weight for height was higher than the mean of the reference distribution plus two standard deviations in 6.2% of the children. Birth hypertrophy increased the risk of obesity at age six. A new criterion of neonatal hypertrophy, taking various constitutional characteristics into account, was found to be associated to a twofold risk of subsequent obesity, and was shown to be more appropriate in predicting subsequent obesity than classical definitions based on the weight or on the weight for gestational age or sex.

Risk factors of obesity in a five year old population. Parental versus environmental factors.

To be more effective, the prevention of obesity in childhood should be focused on the population at risk. The purpose of the present study is firstly to find correlations between certain environmental factors and obesity in childhood, and secondly to measure the influence of the environmental factors after taking the parental history of obesity into account. This case controlled study includes 704 controls vs. 327 cases selected in a population of five year old school children. The anthropometric assessment was completed at school. Obesity was defined as a weight for height > or = 2 s.d. using the French weight charts for French children based on sex and height. Interviews of the parents recorded parental overweight and child birth overweight as 'constitutional' factors and family structure, socio-economic level and daily lifestyle (sleep, TV viewing, after school care, etc.) as 'environmental' factors. The results show that parental overweight and birth overweight are closely related to the child's obesity at five years of age (estimated relative risks 3.1 and 2.4 respectively). The environmental factors which contribute to child obesity are: southern European origin of the mother, snacks, excessive television viewing and, more importantly, short sleep duration (estimated relative risks = 1.9, 1.3, 2.1 and 4.9 respectively). A logistic regression model, after taking parental overweight into account, shows that the relationship between obesity and short sleep duration persists independently of television viewing. The hypotheses raised by these findings are discussed.

[Life style of children and obesity in a population of 5-year-old children]. / Mode de vie de l'enfant et obésité dans une population d'enfants de cinq ans.

The increasing level of childhood obesity has prompted some research into the early risk factors likely to lead to preventive measures. A case-control study was conducted of a five year-old population in the Rhône and Isère administrative "départements" of France during the children's first visit to primary school, with the participation of 327 obese children and 704 controls. Anthropometric data on the children since birth, together with data on their lifestyles, were collected in interviews with parents. "Family obesity" and "obesity at birth" were found to be closely related to the child's obesity at five years old (adjusted OR = 2.7 and 2.1 respectively). Of the environmental factors, the hypothesis tested paid specific attention to television viewing, snacks between meals and lack of sleep. These three variables were all found to be risk factors of obesity at five years old. However after allowing for parental obesity, the only remaining significant risk factor for obesity at five was lack of sleep (adjusted OR = 1.4). The pathogenic assumptions raised by these results are discussed.