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Hong Kong's Children of 1997 Birth Cohort

L. L. Hui, MPhil; C. Mary Schooling, PhD; Shirley Sze Lee Leung, MBBS; Kwok Hang Mak, MBBS; Lai Ming Ho, PhD; Tai Hing Lam, MD; Gabriel M. Leung, MD

Arch Pediatr Adolesc Med. 2008;162(3):212-218.

Objective  To investigate the association between birth weight, infant growth rate, and childhood adiposity as a proxy for adult metabolic or cardiovascular risk in a Chinese population with a history of recent and rapid economic development.

Design  Prospective study in a population-representative birth cohort.

Setting  Hong Kong Chinese population.

Participants  Six thousand seventy-five term births (77.5% successful follow-up).

Main Exposures  Birth weight and growth rate (change in the weight z score) at ages 0 to 3 and 3 to 12 months.

Main Outcome Measure  Body mass index (BMI) (calculated as the weight in kilograms divided by the height in meters squared) z score at about age 7 years.

Results  Each unit increase in the weight z score at ages 0 to 3 and 3 to 12 months increased the BMI z score by 0.52 and 0.33, respectively. Children in the highest birth weight and growth rate tertiles had the highest BMI z scores. In the lowest birth weight tertile, increases in the weight z score at ages 0 to 3 months had a larger effect on the BMI z score in boys (mean difference, 0.88; 95% confidence interval 0.69-1.07) than in girls (mean difference, 0.52; 95% confidence interval, 0.33-0.71); these differences by birth weight, growth rate at ages 0 to 3 months, and sex were significant (P = .007).

Conclusions  Faster prenatal and postnatal growth were associated with higher childhood BMI in a population with a recent history of rapid economic growth and relatively low birth weight, suggesting that maximal growth may not be optimal for metabolic risk. However, there may be a developmental trade-off between metabolic risk and other outcomes.

Author Affiliations: Department of Community Medicine and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong (Ms Hui and Drs Schooling, Ho, Lam, and G. M. Leung), and Department of Health, Government of the Hong Kong SAR (Drs S. S. L. Leung and Mak), Hong Kong, China.

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