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      Crecimiento prenatal y crecimiento posnatal asociados a obesidad en escolares Translated title: Obesity-associated prenatal and postnatal growth in school-aged children

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          Abstract

          Se realizó un estudio observacional, retrospectivo, analítico, de casos y controles en 86 escolares de 6 a 11 años de edad portadores de obesidad y 86 niños con peso corporal normal seleccionados como controles, de la misma zona de residencia, nacidos de madres con similar edad gestacional de 37-42 semanas, homogéneos en edad y sexo y con historia de no afecciones de salud; con el propósito de identificar la posible asociación de los factores posnatales precoces y aquellos relacionados con la vida intraútero en la prevalencia de obesidad en edades ulteriores. Los resultados mostraron una fuerte asociación entre obesidad en esta edad y ganancia de peso elevada en los primeros 4 meses de vida, bajo peso, bajo índice ponderal, reducida longitud supina y circunferencia cefálica al momento del nacimiento y hábito de fumar, insuficiente ganancia de peso y bajo IMC de la madre durante el embarazo. La obesidad en la edad escolar tuvo una fuerte asociación con el crecimiento acelerado de esos escolares durante sus primeros 4 meses y con su crecimiento fetal inadecuado. En los programas de prevención de la obesidad infantil estos factores deben ser considerados. La prevención de la ganancia de peso acelerada en los primeros meses de vida de los niños nacidos con afectación del crecimiento fetal adquiere relevante importancia.

          Translated abstract

          A retrospective observational and analytical case-control study was conducted in 86 obese school children aged 6 to 11 years and in 86 normoweighted children selected as controls, who live in the same area, were born from mother with similar gestational age of 37 to 42 weeks, homogeneous in age and sex and without history of health problems. The objective was to identify the possible association of early postnatal factors and those related to intrauterine life in prevalence of obesity in later life. The results showed a strong association between obesity at this age and weight gain in the first four months of life, low birthweight, low ponderal index, reduced supine length and head circumference at the time of birth and smoking, poor weight gain and low mass body index of the mother during pregnancy. Obesity at school age was heavily associated to accelerated growth of those school children during their first months of life and to inadequate fetal growth. In childhood obesity prevention programs, these factors must be taken into consideration. The prevention of accelerated weight gain during first months of life in children who were born with fetal growth problems acquire special importance.

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          Most cited references93

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          Early life risk factors for obesity in childhood: cohort study.

          To identify risk factors in early life (up to 3 years of age) for obesity in children in the United Kingdom. Prospective cohort study. Avon longitudinal study of parents and children, United Kingdom. 8234 children in cohort aged 7 years and a subsample of 909 children (children in focus) with data on additional early growth related risk factors for obesity. Obesity at age 7 years, defined as a body mass index (3) 95th centile relative to reference data for the UK population in 1990. Eight of 25 putative risk factors were associated with a risk of obesity in the final models: parental obesity (both parents: adjusted odds ratio, 10.44, 95% confidence interval 5.11 to 21.32), very early (by 43 months) body mass index or adiposity rebound (15.00, 5.32 to 42.30), more than eight hours spent watching television per week at age 3 years (1.55, 1.13 to 2.12), catch-up growth (2.60, 1.09 to 6.16), standard deviation score for weight at age 8 months (3.13, 1.43 to 6.85) and 18 months (2.65, 1.25 to 5.59); weight gain in first year (1.06, 1.02 to 1.10 per 100 g increase); birth weight, per 100 g (1.05, 1.03 to 1.07); and short (< 10.5 hours) sleep duration at age 3 years (1.45, 1.10 to 1.89). Eight factors in early life are associated with an increased risk of obesity in childhood.
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            Obesity in young men after famine exposure in utero and early infancy.

            In a historical cohort study of 300,000 19-year-old men exposed to the Dutch famine of 1944-45 and examined at military induction, we tested the hypothesis that prenatal and early postnatal nutrition determines subsequent obesity. Outcomes were opposite depending on the time of exposure. During the last trimester of pregnancy and the first months of life, exposure produced significantly lower obesity rates (P less than 0.005). This result is consistent with the inference that nutritional deprivation affected a critical period of development for adipose-tissue cellularity. During the first half of pregnancy, however, exposure resulted in significantly higher obesity rates (P less than 0.0005). This observation is consistent with the inference that nutritional deprivation affected the differentiation of hypothalamic centers regulating food intake and growth, and that subsequent increased food availability produced an accumulation of excess fat in an organism growing to its predetermined maximum size.
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              Obesity at the age of 50 y in men and women exposed to famine prenatally.

              It was shown that men who were conceived during the Dutch famine of 1944-1945 had higher rates of obesity at age 19 y than those conceived before or after it. Our objective was to study the effects of prenatal exposure to the Dutch famine on obesity in women and men at age 50 y. We measured the body size of 741 people born at term between November 1943 and February 1947 in Amsterdam. We compared people exposed to famine in late, mid, or early gestation (exposed participants) with those born before or conceived after the famine period (nonexposed participants). The body mass index (BMI; in kg/m(2)) of 50-y-old women exposed to famine in early gestation was significantly higher by 7. 4% (95% CI: 0.7%, 14.5%) than that of nonexposed women. BMI did not differ significantly in women exposed in mid gestation (-2.1%; -7.0%, 3.1%) or in late gestation (-1.3%; -6.3%, 3.9%). In 50-y-old men, BMI was not significantly affected by exposure to famine during any stage of gestation: BMI differed by 0.4% (-3.5%, 4.5%) in men exposed to famine in late gestation, by -1.2% (-5.5%, 3.3%) in those exposed in mid gestation, and by 0.5% (-4.6%, 6.0%) in those exposed in early gestation compared with nonexposed men. Maternal malnutrition during early gestation was associated with higher BMI and waist circumference in 50-y-old women but not in men. These findings suggest that pertubations of central endocrine regulatory systems established in early gestation may contribute to the development of abdominal obesity in later life.
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                Author and article information

                Journal
                ibi
                Revista Cubana de Investigaciones Biomédicas
                Rev Cubana Invest Bioméd
                ECIMED (Ciudad de la Habana, , Cuba )
                0864-0300
                1561-3011
                September 2007
                : 26
                : 3
                Affiliations
                [01] La Habana orgnamePoliclínico Universitario Louis Pasteur amacias@ 123456infomed.sld.cu
                Article
                S0864-03002007000300002 S0864-0300(07)02600302
                07fe171e-c11e-4fe6-8718-9ecaf0de6dc1

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 10 May 2007
                : 12 June 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 62, Pages: 0
                Product

                SciELO Cuba

                Categories
                TRABAJOS ORIGINALES

                Obesidad,chromic diseases,accelerated postnatal growth,smoking,weight gain in pregnancy,low birthweight,school children,Obesity,enfermedades crónicas,crecimiento posnatal acelerado,hábito de fumar,ganancia de peso en embarazo,bajo peso al nacer,escolares

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