Risk profiles for overweight/obesity among preschoolers



Risk Profiles for Overweight/obesity among Preschoolers: A Classification Tree AnalysisPanagiota Kitsantas, PhDGeorge Mason UniversityCollege of Health and Human ServicesDepartment of Health Administration and Policy Fairfax, VA, USABackground: Previous research has examined maternal characteristics and childhood overweight/obesity. Few studies, however, have explored the combined effect of maternal and child factors in establishing risk profiles for this escalating public health problem. Study Question: Classification and regression tree (CART) analysis was used to examine the combined effect of maternal and child factors in generating risk profiles for preschooler overweight/obesity.Methods: Preschooler data from the U.S. Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) study were used. CART and logistic regression models were built and compared. Results: Children who were overweight/obese at two years old had an increased risk of being overweight/obesity at four years old. Children born to overweight/obese mothers were more likely to be overweight/obese by age four, even if their BMI at age two was normal. Children with high birth weights (≥ 4000 gm.) were more likely to be overweight/obese at age four if they were born to mothers with a normal pregravid BMI but were of lower SES. Among black and white mothers with high pregravid BMIs, breastfeeding duration and parity played an important role in the risk for preschooler overweight/obesity. The predictive accuracy and findings of the classification tree analyses were similar to that of the logistic regression. Conclusions: CART analysis confirms and extends current knowledge of preschool overweight/obesity by providing preliminary risk profiles structured within the context of pre-and postnatal maternal and child characteristics. The findings support: (1) preconception screening/intervention for overweight/obese women, as maternal pregravid BMI may be crucial to offspring BMI; (2) early pediatric screening/intervention for weight status, as BMI ≥ 85th percentile at age two was found to increase the likelihood of overweight/obesity at age four; and (3) identification of Hispanic overweight/obese women as a high-risk group for having overweight/obese children ................
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