The association between parental, obstetric, socioeconomic, and lifestyle factors and the development of childhood obesity: A Danish Cohort Study

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Background Childhood obesity is a multifactorial disease with complex etiology. Obstetrical factors are seldom taken into considerations. Objectives To investigate the association between parental, obstetric and lifestyle characteristics, and childhood overweight and obesity. Methods This retrospective cohort study evaluated associations between birthweight, pre-pregnancy BMI, birth mode, paternal BMI, family history of obesity, parental status, and maternal socioeconomic status and the outcome variable childhood overweight and obesity using logistic regression. Data regarding parental and childhood characteristics were collected through self-administered questionnaires, and obstetric information was retrieved from the Danish Medical Birth Registry. Results The incidence of childhood overweight and obesity was 11.3 % at a median (IQR) age of 6.51 years (IQR = 2.84). In obese mothers and children who were macrosomic at birth (birthweight ≥4,500 g), the incidence was 21.6% and 23.4%, respectively. Risk factors for childhood overweight and obesity were macrosomia, (aOR 2.34, 95% CI 1.24-2.19), maternal- and (aOR 2.48, 95% CI 1.78-3.45) paternal overweight and obesity (aOR 2.17, 95% CI 1.44-3.34) and birthweight z-score (aOR 1.13, 95% CI 1.03-1.23). Combining maternal obesity and a macrosomic child gave the highest risk (aOR 7.49, 95% CI 2.05-24.86) Other predictors were divorced-(aOR 2.04, 95% CI 1.13-3.57) and living as a single parents (aOR 3.80, 95% CI 1.31-10.16). Conclusions Macrosomia combined with maternal obesity was the strongest risk factor for childhood overweight and obesity. Other individual risk factors are parental obesity and socioeconomic factors. This supports the role of lifestyle modification, education-based policies and interventions to prevent high birth weight in counteracting childhood obesity.