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      Influence of birthweight and delivery mode on obesity among primary school students in Guangzhou


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          Objective To explore the influence of birthweight and delivery mode on overweight/obesity and abdominal obesity in primary school students, and to provide evidence for childhood obesity prevention.

          Methods After physical examination, questionnaire survey was conducted among 3 361 students and their parents from 3 primary schools in Guangzhou selected through stratified clustering sampling. Information about birthweight and delivery mode was collected. Logistic regression model was used to analyze the association of birthweight and delivery mode with overweight/obesity and abdominal obesity. The multiplicative interaction term and the Delta method was used to explore the potential interaction.

          Results The prevalence rate of overweight and obesity for primary school students was 21.33%, and the rate of abdominal obesity was 12.08%. Multivariate Logistic regression analysis showed that delivery by cesarean section was associated with 44% increased risk of overweight/obesity ( OR = 1.44, 95% CI = 1.16–1.80), as compared to vaginal delivery. Higher birthweight was linked to increased risk of overweight/obesity ( OR = 1. 62, 95% CI = 1.092.42). There was no significant association of birth weight and delivery mode with abdominal obesity in multivariate analysis ( P> 0.05). Additionally, a positive additive interaction was seen between delivery mode and parental obesity for students’ risk of over- weight/obesity ( RERI = 0.33, 95% CI = 0.02–0.65), as well as for the risk of abdominal obesity ( RERI = 0.39, 95% CI=0.12–0.65).

          Conclusion Cesarean section delivery and higher birthweight are linked to increased risk of overweight and obesity in primary school students. The synergistic effect of cesarean section and parental obesity may increase the risk of childhood obesity.


          【摘要】 目的 探讨出生体重及分娩方式对小学生超重肥胖和腹型肥胖的影响, 为预防儿童肥胖提供依据。 方法 依托 广州市中小学生常规体检, 采用分层整群抽样方法, 抽取 3 所小学 3 361 名学生, 对学生及家长进行问卷调查。应用Logistic 回归模型分析分娩方式、出生体重与学生超重肥胖和腹型肥胖的关系。应用相乘交互项和 Delta 法探讨交互作用。 结果 广州市小学生的超重肥胖率为21.33%, 腹型肥胖率为 12.08%。多因素Logistic分析表明, 与顺产的学生相比, 经剖宫 产者的超重肥胖风险增加了 44% ( OR = 1.44,95% CI =1.16~1.80);高出生体重的学生超重肥胖风险较正常体重者增加 62% ( OR =1.62,95% CI =1.09~2.42)。调整多因素后, 未观察到出生体重和出生方式与学生腹型肥胖之间的关联性 ( P 值 均>0.05)。经剖宫产出生与父母肥胖对学生的超重肥胖 ( RERI =0.33,95% CI = 0.02~0.65) 和腹型肥胖 ( RERI =0.39,95% CI = 0.12~0.65) 存在相加交互作用。 结论 剖宫产及高出生体重与小学生超重肥胖风险增高有关联。剖宫产出生方式与父 母肥胖可能协同促进儿童肥胖发生。

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          Author and article information

          Chinese Journal of School Health
          Chinese Journal of School Health (China )
          01 February 2021
          01 February 2021
          : 42
          : 2
          : 277-281
          [1] 1School of Public Health, Guangdong Pharmaceutical University, Guangzhou (510310), China
          Author notes
          *Corresponding author: LIU Li, E-mail: pupuliu919@ 123456163.com
          © 2021 Chinese Journal of School Health

          This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

          Self URI (journal-page): http://www.cjsh.org.cn
          Journal Article

          Ophthalmology & Optometry,Pediatrics,Nutrition & Dietetics,Clinical Psychology & Psychiatry,Public health
          Obesity,Parturition,Birth weight,Students,Regression analysis


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