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Growth trajectories in early childhood, their relationship with antenatal and postnatal factors, and development of obesity by age 9 years: results from an Australian birth cohort study

International Journal of Obesity volume 39, pages 1049–1056 (2015)Cite this article

Subjects

Abstract

Background:

In an era where around one in four children in the United Kingdom, the United States, and Australia are overweight or obese, the development of obesity in early life needs to be better understood. We aimed to identify groups of children with distinct trajectories of growth in infancy and early childhood, to examine any association between these trajectories and body size at age 9, and to assess the relative influence of antenatal and postnatal exposures on growth trajectories.

Design:

Prospective Australian birth cohort study.

Subjects and Methods:

In total, 557 children with serial height and weight measurements from birth to 9 years were included in the study. Latent class growth models were used to derive distinct groups of growth trajectories from birth to age 3½ years. Multivariable logistic regression models were used to explore antenatal and postnatal predictors of growth trajectory groups, and multivariable linear and logistic regression models were used to examine the relationships between growth trajectory groups and body size at age 9 years.

Results:

We identified four discrete growth trajectories from birth to age 3½ years, characterised as low, intermediate, high, or accelerating growth. Relative to the intermediate growth group, the low group had reduced z-body mass index (BMI) (−0.75 s.d.; 95% confidence interval (CI) −1.02, −0.47), and the high and accelerating groups were associated with increased body size at age 9 years (high: z-BMI 0.70 s.d.; 95% CI 0.49, 0.62; accelerating: z-BMI 1.64 s.d.; 95% CI 1.16, 2.11). Of the antenatal and postnatal exposures considered, the most important differentiating factor was maternal obesity in early pregnancy, associated with a near quadrupling of risk of membership of the accelerating growth trajectory group compared with the intermediate growth group (odds ratio (OR) 3.72; 95% CI 1.15, 12.05).

Conclusions:

Efforts to prevent childhood obesity may need to be embedded within population-wide strategies that also pay attention to healthy weight for women in their reproductive years.

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Acknowledgements

We gratefully acknowledge the women and children who have participated in the Generation 1 study and the other family members who have supported the study. We thank Emeritus Professor Jeffrey Robinson for his role in cohort establishment, Kendall Smith for study co-ordination, Suzanne Edwards for assistance with aspects of the statistical analyses, and other University of Adelaide staff members involved in interviews, data base construction and data entry. This study was supported by grants from the Faculty of Health Sciences at the University of Adelaide, Dairy Research and Development Corporation, Channel 7 Children's Research Foundation, National Health and Medical Research Council (Grants 465455 and 465437, Career Development Fellowship in Population Health 349548 to MJD and 1022996 to ARR, and Australian Based Public Health Training Fellowship 627033 to LCG) and Australian Research Council (ARC Future Fellowship FT100101018 to MJD). All authors are the guarantors of the manuscript.

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Authors and Affiliations

  1. Discipline of Public Health, School of Population Health, The University of Adelaide, Adelaide,, South Australia, Australia

    L C Giles, M J Whitrow, C E Davies & V M Moore

  2. Robinson Research Institute, The University of Adelaide, Adelaide,, South Australia, Australia

    L C Giles, M J Whitrow, M J Davies, A R Rumbold & V M Moore

  3. Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide,, South Australia, Australia

    A R Rumbold

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Correspondence to V M Moore.

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Giles, L., Whitrow, M., Davies, M. et al. Growth trajectories in early childhood, their relationship with antenatal and postnatal factors, and development of obesity by age 9 years: results from an Australian birth cohort study. Int J Obes 39, 1049–1056 (2015). https://doi.org/10.1038/ijo.2015.42

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