Prenatal, perinatal, early life, and sociodemographic factors underlying racial differences in the likelihood of high body mass index in early childhood

Am J Public Health. 2012 Nov;102(11):2057-67. doi: 10.2105/AJPH.2012.300686. Epub 2012 Sep 20.

Abstract

Objectives: We investigated early childhood disparities in high body mass index (BMI) between Black and White US children.

Methods: We compared differences in Black and White children's prevalence of sociodemographic, prenatal, perinatal, and early life risk and protective factors; fit logistic regression models predicting high BMI (≥ 95th percentile) at age 4 to 5 years to 2 nationally representative samples followed from birth; and performed separate and pooled-survey estimations of these models.

Results: After adjustment for sample design-related variables, models predicting high BMI in the 2 samples were statistically indistinguishable. In the pooled-survey models, Black children's odds of high BMI were 59% higher than White children's (odds ratio [OR] = 1.59; 95% confidence interval [CI]= 1.32, 1.92). Sociodemographic predictors reduced the racial disparity to 46% (OR = 1.46; 95% CI = 1.17, 1.81). Prenatal, perinatal, and early life predictors reduced the disparity to nonsignificance (OR = 1.18; 95% CI = 0.93, 1.49). Maternal prepregnancy obesity and short-duration or no breastfeeding were among predictors for which racial differences in children's exposures most disadvantaged Black children.

Conclusions: Racial disparities in early childhood high BMI were largely explained by potentially modifiable risk and protective factors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • African Continental Ancestry Group / statistics & numerical data*
  • Age Factors
  • Body Mass Index
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Health Status Disparities*
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Longitudinal Studies
  • Models, Statistical
  • Obesity / epidemiology*
  • Obesity / etiology
  • Odds Ratio
  • Pregnancy
  • Prenatal Exposure Delayed Effects / epidemiology
  • Prevalence
  • Risk Factors
  • Socioeconomic Factors
  • United States / epidemiology
  • Young Adult