title: Additive interactions of maternal prepregnancy BMI and breast-feeding on childhood overweight.
abstract: OBJECTIVE
  To examine the interactions of maternal prepregnancy BMI and breast-feeding on the risk of overweight among children 2 to 14 years of age.
  
  
  METHODS
  The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI >/=95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI >/=30 kg/m(2). The duration of breast-feeding was measured as the weeks of age from birth when breast-feeding ended.
  
  
  RESULTS
  After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m(2); p < 0.001 for linear trend). Breast-feeding for >/=4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast-feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast-fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1).
  
  
  CONCLUSIONS
  The combination of maternal prepregnancy obesity and lack of breast-feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast-feeding in developing childhood obesity intervention programs.
authors.affiliation: Department of Preventive Medicine and Public Health, Kansas Cancer Institute, University of Kansas School of Medicine, Kansas City, KS, USA. cli2@kumc.edu
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Li
authors.forename: Harsohena
authors.initials: H
authors.lastname: Kaur
authors.forename: Won S
authors.initials: WS
authors.lastname: Choi
authors.forename: Terry T-K
authors.initials: TT
authors.lastname: Huang
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Lee
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
mesh_terms: D000293:Adolescent; D001724:Birth Weight; D044383:Black People; D015992:Body Mass Index; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D009765:Obesity / Q000453:epidemiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D044465:White People