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J Pediatr. 2013 Apr;162(4):753-758.e1. doi: 10.1016/j.jpeds.2012.09.026. Epub 2012 Nov 6.

Childcare and overweight or obesity over 10 years of follow-up.

Author information

  • 1MRC Center of Epidemiology for Child Health, Center for Pediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, London, United Kingdom. m.geoffroy@ich.ucl.ac.uk

Abstract

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.

Copyright © 2013 Mosby, Inc. All rights reserved.

PMID:
23140878
[PubMed - indexed for MEDLINE]
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