RESUMO
OBJECTIVE: To investigate the predictive association between preschool childcare arrangements and overweight/obesity in childhood. STUDY DESIGN: Children were enrolled in a prospective birth cohort in Quebec, Canada (n = 1649). Information about childcare obtained via questionnaires to the mothers at ages 1.5, 2.5, 3.5, and 4 years was used to compute a main childcare arrangement exposure variable (center-based/family-based/care by a relative/nanny). Body mass index was derived from measured weights and heights at ages 4, 6, 7, 8, and 10 years and children were classified as overweight/obese versus normal weight. Generalized estimating equations were used to model the effect of main childcare arrangement (center-based/family-based/relative/nanny) (vs parental care) on overweight/obesity adjusting for several potential confounding factors. RESULTS: Compared with parental care, children who attended a center-based childcare (OR: 1.65, 95% CI: 1.13-2.41) or were cared for by a relative (OR: 1.50; 95% CI: 0.95-2.38, although with greater uncertainty) had higher odds of being overweight/obese in childhood (4-10 years). Analyses of number of hours additionally suggested that each increment of 5 hours spent in either center-based or relative childcare increased the odds of overweight/obesity in the first decade of life by 9%. Associations were not explained by a wide range of confounding factors, including socioeconomic position, breastfeeding, maternal employment, and maternal body mass index. CONCLUSION: Overweight/obesity was more frequently observed in children who received non-parental care in center-based settings or care by a relative other than the parent. "Obesogeonic" features of these childcare arrangements should be investigated in future studies.
Assuntos
Cuidado da Criança , Obesidade/diagnóstico , Sobrepeso/diagnóstico , Índice de Massa Corporal , Criança , Creches , Pré-Escolar , Estudos de Coortes , Feminino , Seguimentos , Humanos , Lactente , Masculino , Razão de Chances , Pais , Quebeque , Risco , Classe Social , Fatores SocioeconômicosRESUMO
OBJECTIVE: To establish whether effects of birth weight and socioeconomic position on cognition are explained or modified by home or learning environments. STUDY DESIGN: Prospective birth cohort (n = 13,980) with math tests at 7, 11, and 16 years of age and qualifications by 33 years of age. RESULTS: For 1 kg increase in birth weight, 7-year math Z score increased 0.23 (0.19 adjusted for parental interest in child's progress) and adult qualifications increased 0.22 (on a 5-point scale). Maternal reading benefited math less among lower than higher birth weights (p < .05). The birth weight effect remained unchanged 7 to 16 years of age. For each increment in social class (4 categories; IV&V to I&II), 7-year math increased 0.19 (0.12 adjusted for parental interest). Benefits of mother's reading and father's interest were greatest in classes IV&V (interaction p < .05). The difference in Z scores between classes I&II to IV&V was 0.57 at 7 years; 1.12 at 16 years of age. Estimates were little affected by home and school factors. Adult qualifications increased 0.40 per unit social class (0.33 adjusted for parental interest). Maternal interest reduced the chances of those from unskilled manual origins gaining few qualifications (p < .05). Similarly, interactions were seen for maternal reading and paternal interest. CONCLUSION: Influences in the home partly underlie associations between social background and cognition, but they do little to explain a birth weight/cognition association.