ABSTRACT
OBJECTIVE: To investigate the association between gestational weight gain (GWG) and total adiposity, body fat distribution, blood pressure (BP), and metabolic profile in offspring. DESIGN: Cross-sectional study. METHODS: Body mass index (BMI), waist, subscapular and tricipital skinfolds, and BP were measured and blood samples drawn in 12 775 children (aged 2-9 years) from the IDEFICS cohort. Overweight/obesity was defined by IOTF criteria. Parents filled in a questionnaire investigating child and familiar medical history and lifestyle. A section was dedicated to pregnancy history (including GWG). RESULTS: Anthropometric indices linearly and significantly increased across GWG tertiles (BMI z-score: tertile I =0.08, 0.03-0.13; tertile II =0.16, 0.12-0.21; tertile III =0.34, 0.28-0.40, P<0.01, mean, 95% CI) by analysis of covariance (ANCOVA) adjusted by child sex, age and practice of sport, birth weight, current maternal BMI, parental education, gestational age, age at delivery, alcohol and smoking during pregnancy, maternal diabetes mellitus, gestational hypertension, and breastfeeding duration. After inclusion of BMI z-score among covariates, HbA1c significantly increased across tertiles (P=0.009) while no differences were observed for BP, serum insulin, HOMA index, blood glucose and lipids. The adjusted risk of overweight/obesity significantly increased by 14 and 22% in tertiles II and III respectively, in comparison with tertile I by logistic regression analysis controlling for covariates. CONCLUSION: Maternal GWG is an independent predictor of total adiposity and body fat distribution in offspring during infancy. Exposure to perinatal factors should be taken into account for early prevention of overweight and obesity.
Subject(s)
Adiposity , Blood Pressure , Body Fat Distribution , Metabolome , Obesity, Abdominal/prevention & control , Pregnancy Complications/prevention & control , Weight Gain , Age of Onset , Birth Weight , Body Composition , Body Mass Index , Child , Child, Preschool , Cross-Sectional Studies , Europe , Female , Gestational Age , Glycated Hemoglobin/metabolism , Humans , Male , Mothers , Obesity, Abdominal/epidemiology , Obesity, Abdominal/etiology , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/etiology , Prenatal Exposure Delayed Effects , Retrospective Studies , Risk Factors , Skinfold Thickness , Surveys and QuestionnairesABSTRACT
BACKGROUND AND AIM: Infants of mothers with an immigrant background experience poorer health outcomes than infants in Germany as a whole. The aim of this study was to investigate whether differences exist in diagnoses leading to long-term nursing care among infants of Turkish vs. non-Turkish background. METHODS: We analysed records of the medical service of the statutory health insurance of the region Westphalia-Lippe, 2004-2008. We used a name algorithm to identify cases with Turkish migrant background. RESULTS: There were 1 107 applications for long-term nursing care, 141 of which concerned infants of Turkish origin. "Inborn malformations, deformities and chromosomal abnormities" was more often the reason for application among non-Turkish infants, "Certain conditions which have their origin in the perinatal period" were twice as common among Turkish as compared to non-Turkish infants. CONCLUSIONS: Our results do not support the -assumption that mothers of Turkish origin more often apply for long-term nursing care due to malformations of their infant than other mothers.
Subject(s)
Emigrants and Immigrants/statistics & numerical data , Mothers/statistics & numerical data , Needs Assessment , Nursing Care/statistics & numerical data , Registries , Transients and Migrants/statistics & numerical data , Adolescent , Adult , Child, Preschool , Female , Germany/epidemiology , Humans , Infant , Infant, Newborn , Turkey/epidemiology , Young AdultABSTRACT
Background: Gestational diabetes increases the risk of maternal and infant complications and long-term health effects. A study of differences in the incidence of gestational diabetes between women of Turkish and German origin can identify high risk groups and may indicate the need for culturally sensitive diabetes information and treatment during pregnancy. Method: We analysed all pregnancy related health insurance data from the AOK Berlin (a statutory health insurance in Berlin) based on data from 2005 to 2007, using a name algorithm to identify cases with Turkish migrant background. A group of German women insured with the AOK Berlin served as a comparison group. Results: After exclusion of miscarriages and multiple births the data set comprised 3338 pregnancies in total. The incidence of gestational diabetes was significantly higher in women of Turkish origin with 183 per 1000 pregnancies than in German women (138 per 1000 pregnancies). Regression analyses showed that women of Turkish origin with obesity were at the highest risk of gestational diabetes (OR = 2.67; 95â% confidence interval 1.97-3.60). Conclusion: Obesity is an important factor in explaining the higher incidence of gestational diabetes in women of Turkish origin, especially among young Turkish women. These findings should stimulate discussion as to whether or not information about risk factors such as diabetes within the scope of prenatal care adequately addresses the needs of migrant women. Further research is needed to identify potential differences in undetected and primarily in insufficiently treated gestational diabetes between Turkish and German women.
ABSTRACT
Socioeconomic inequalities in obesity have been reported in a variety of studies. Social determinants and processes affecting the development of obesity need to be investigated to better explain these socioeconomic differences. In this context, a life-course perspective on health inequalities particularly in critical or sensitive periods of obesity development is conducive. Socioeconomic-sensitive primary prevention of obesity might allow obesity risks to be influenced by adequate, target group-specific and setting-based interventions in specific critical time periods from pregnancy to adolescence. Future research is necessary to gain a deeper understanding of the mechanisms of health inequalities and obesity risks, resulting in prevention programs which aim at a sustainable and long-term reduction of obesity risk and include obesity-relevant social factors during the life-course.
