Abstract
Background. The risk of obesity is determined by a complex interaction of prenatal, lifestyle, genetic, and environmental factors. Objective. To investigate the differential impact of prenatal, child, and family factors on body weight status in childhood. Methods. The current study links population-based survey data of Grade 5 students who participated in the 2003 Children's Lifestyle and School Performance Study in Nova Scotia, Canada, with a provincial perinatal registry. Multilevel logistic regression was used to investigate the association between prenatal, lifestyle, and socioeconomic factors and childhood overweight. Results. Of the 4 298 participating children, 3 426 (80%) could be linked with information in the perinatal registry. Small-for-gestational age infants appeared to be less likely to be overweight at age 10 or 11 years (odds ratio [OR]=0.68) whereas those born large-for-gestational age were more likely to be overweight (OR=1.23). Maternal pre-pregnancy weight was associated with childhood overweight (OR=4.42 for >80 kg vs. <60 kg) as were the child's physical activity (OR=0.65 for >7x/week vs. ≤2x/week) and screen time (OR=1.82 for >6 h/day vs. ≤1h/day). Smoking during pregnancy increased the child's odds for being overweight (OR=1.42 for >0.5 packs/day vs. none). Children living in neighborhoods with higher housing values were less likely to be overweight (OR=0.68 for highest vs. lowest tertile). Conclusions. Overweight young women should be advised on the importance of healthy eating, active living and maintaining a healthy weight in the pre-pregnancy years to reduce the risk of overweight in their offspring.