title: The relationship between parity and overweight varies with household wealth and national development.
abstract: BACKGROUND
  Recent studies support a positive relationship between parity and overweight among women of developing countries; however, it is unclear whether these effects vary by household wealth and national development. Our objective was to determine whether the association between parity and overweight [body mass index (BMI) > or =25 kg/m(2)] in women living in developing countries varies with levels of national human development and/or household wealth.
  
  
  METHODS
  We used data from 28 nationally representative, cross-sectional surveys conducted between 1996 and 2003 (n = 275 704 women, 15-49 years). The relationship between parity and overweight was modelled using logistic regression, controlling for several biological and sociodemographic factors and national development, as reflected by the United Nations' Human Development Index. We also modelled the interaction between parity and national development, and the three-way interaction between parity, household wealth and national development.
  
  
  RESULTS
  Parity had a weak, positive association with overweight, which varied by household wealth and national development. Among the poorest women and women in the second tertile of household wealth, parity was positively related to overweight only in the most developed countries. Among the wealthiest women, parity was positively related to overweight regardless of the level of national development.
  
  
  CONCLUSIONS
  As development increases, the burden of parity-related overweight shifts to include poor as well as wealthy women. In the least-developed countries, programmes to prevent parity-related overweight should target wealthy women, whereas such programmes should be provided to all women in more developed countries.
authors.affiliation: Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA 30322, USA.
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Kim
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Yount
authors.forename: Usha
authors.initials: U
authors.lastname: Ramakrishnan
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Martorell
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D008017:Life Expectancy; D008875:Middle Aged; D015233:Models, Statistical; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D010298:Parity; D011159:Population Surveillance; D011203:Poverty; D011247:Pregnancy; D012959:Socioeconomic Factors; D014507:Urbanization