Childhood obesity is a growing epidemic with long-term sequelae including diabetes. Obesity is challenging to reverse, highlighting an urgent need to target upstream in utero risk factors. We examined associations of prenatal neighborhood deprivation index (NDI) with risk of childhood obesity from 2-10 years and the role of gestational diabetes (GDM) in modifying this association.
In a racially diverse cohort of livebirths (n=258,060) from 2011-2017 in Kaiser Permanente Northern California, we assessed risk of childhood obesity (sex-specific BMI-for-age ≥95th percentile using CDC growth charts) by quartiles (Q) of prenatal NDI (a validated census-based socioeconomic status measure) using modified Poisson regression.
Obesity affected 15.4%, 16.0%, and 21.7% of children aged 2-4, 5-7, and 8-10 years; respectively (Figure). Obesity risk at all ages increased with increasing prenatal NDI Q (P-for-trend <.0001). Specifically, the adjusted relative risk (95% CI) of obesity in children exposed prenatally to more (Q4) compared to less (Q1) deprived neighborhoods was 1.36 (1.31-1.42) at 2-4 years, 1.46 (1.39-1.53) at 5-7 years, and 1.47 (1.37-1.58) at 8-10 years. Similar yet stronger associations were observed in children of individuals with vs. without GDM.
The prenatal neighborhood environment may inform early risk stratification and targeted interventions to prevent childhood obesity.
R.F. Chehab: None. A. Ferrara: None. M. Greenberg: None. C. Lee: None. A. Ngo: None. Y. Zhu: None.
Diabetes Research for Equity through Advanced Multilevel Science Center for Diabetes Translation Research (DREAMS-CDTR) pilot and feasibility program supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [P30-DK092924]; Kaiser Permanente Northern California, Central Research Committee, Community Health project [RNG212200]; National Heart, Lung, and Blood Institute R01 grant [R01HL157666]
