RESUMO
OBJECTIVE: To study the prospective association between birth weight and attention problems and to explore the role of maternal body mass index (BMI) in this association. STUDY DESIGN: In 6015 children of a population-based cohort (Rotterdam, The Netherlands, 2001-2005), information on birth weight was collected and gestational age-adjusted SDS were calculated. At age 6 years, parents assessed attention problems with the Child Behavior Checklist. We used linear regression to study the association of birth weight with attention problem score and examined the modification of this association by maternal early pregnancy BMI. RESULTS: The observed association between birth weight and attention problem score was curvilinear (adjusted ß per birth weight SDS(2): 0.02, 95% CI 0.00; 0.03, P = .008); the turning point equals 3.6 kg at term. In analyses of the extreme tails of the birth weight distribution, the associations with attention problem score disappeared after adjustment for socioeconomic confounders. Maternal early pregnancy BMI moderated the association of child birth weight with attention problem score (P interaction = .007, with curvilinear term in model). CONCLUSIONS: Higher birth weight was related to less attention problems but from a birth weight of about 3.6 kg or more, a higher birth weight did not reduce the risk of attention problems any further. However, in children of obese mothers (BMI >30 kg/m(2)), high birth weight may increase the risk of attention problems.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Atenção/fisiologia , Peso ao Nascer/fisiologia , Comportamento Infantil/psicologia , Doenças do Recém-Nascido/etiologia , Vigilância da População/métodos , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Seguimentos , Idade Gestacional , Humanos , Incidência , Lactente , Recém-Nascido , Doenças do Recém-Nascido/epidemiologia , Masculino , Mães , Países Baixos/epidemiologia , Gravidez , Estudos ProspectivosRESUMO
OBJECTIVE: To examine bidirectional associations between a child's fussy eating behavior and functional constipation. STUDY DESIGN: Participants were 4823 children enrolled in a prospective cohort study from pregnancy onward. We assessed fussy eating at age 4 years with the Child Eating Behavior Questionnaire, and assessed functional constipation using ROME II and III criteria with parental questionnaires at age 2, 3, 4, and 6 years. RESULTS: Higher food fussiness at age 4 years was associated with a greater risk of functional constipation at both 4 years (OR, 1.30; 95% CI, 1.20-1.42; P < .001 per 1 SD increase) and 6 years (OR, 1.12; 95% CI, 1.03-1.23; P < .05 per 1 SD increase). The converse was also observed; previous constipation predicted a greater risk of being a fussy eater at age 4 years (constipation at 2 years: OR, 2.05; 95% CI 1.43-2.94; P < .001; constipation at 3 years: OR, 1.72; 95% CI, 1.26-2.35, P < .001). Path analyses confirmed that the association between fussy eating and functional constipation was indeed bidirectional, showing that functional constipation at age 3 years predicted fussy eater classification at age 4 years (ß = 0.06; P < .001), which in turn predicted functional constipation at age 6 years (ß = 0.08: P < .001) independent of each other. CONCLUSION: A vicious cycle might develop in which children with functional constipation develop unhealthy eating behavior, which in turn increases the risk of functional gastrointestinal disease.
Assuntos
Comportamento Infantil , Constipação Intestinal/fisiopatologia , Comportamento Alimentar , Preferências Alimentares , Comportamento Infantil/fisiologia , Pré-Escolar , Estudos de Coortes , Comportamento Alimentar/fisiologia , Feminino , Humanos , Masculino , Países Baixos , Estudos Prospectivos , Medição de Risco , Inquéritos e QuestionáriosRESUMO
BACKGROUND: To date few studies have examined how multiple layers of influences shape the emergence of bed-sharing practices in the first 2 years postpartum. In our report, we examined bed-sharing in a large multiethnic sample, exploring the influences of three broad classes of influence on bed-sharing at single time points and across time: (1) sociodemographic and (2) contextual factors such as breastfeeding, maternal mental health and stress, and (3) child temperament and sleep habits. METHODS: Frequencies of bed-sharing were assessed at two time points, 2 and 24 months, in a population-based multiethnic (Dutch, Turkish or Moroccan, and Caribbean) sample of 6309 children born in the Netherlands. RESULTS: In Dutch mothers, the majority of mothers did not share their beds with their child, and bed-sharing rates decreased from 2 to 24 months. Other ethnic groups showed higher bed-sharing rates, typified by both increases in bed-sharing (the Turkish and Moroccan group) and persistence of bed-sharing over time (the Caribbean group). There were few family and child characteristics associated with bed-sharing in the non-Dutch ethnic groups. In contrast, bed-sharing in Dutch mothers was associated with child temperament and sleeping problems, maternal depression, and sociodemographic variables like crowding and maternal education. CONCLUSIONS: Our results suggest that mothers with a Turkish and Moroccan or Caribbean background were more influenced by cultural values, whereas bed-sharing practices were more reactive in the Dutch group.