title: Singaporean Mothers' Perception of Their Three-year-old Child's Weight Status: A Cross-Sectional Study.
abstract: OBJECTIVE
  Inaccurate parental perception of their child's weight status is commonly reported in Western countries. It is unclear whether similar misperception exists in Asian populations. This study aimed to evaluate the ability of Singaporean mothers to accurately describe their three-year-old child's weight status verbally and visually.
  
  
  METHODS
  At three years post-delivery, weight and height of the children were measured. Body mass index (BMI) was calculated and converted into actual weight status using International Obesity Task Force criteria. The mothers were blinded to their child's measurements and asked to verbally and visually describe what they perceived was their child's actual weight status. Agreement between actual and described weight status was assessed using Cohen's Kappa statistic (κ).
  
  
  RESULTS
  Of 1237 recruited participants, 66.4% (n = 821) with complete data on mothers' verbal and visual perceptions and children's anthropometric measurements were analysed. Nearly thirty percent of the mothers were unable to describe their child's weight status accurately. In verbal description, 17.9% under-estimated and 11.8% over-estimated their child's weight status. In visual description, 10.4% under-estimated and 19.6% over-estimated their child's weight status. Many mothers of underweight children over-estimated (verbal 51.6%; visual 88.8%), and many mothers of overweight and obese children under-estimated (verbal 82.6%; visual 73.9%), their child's weight status. In contrast, significantly fewer mothers of normal-weight children were inaccurate (verbal 16.8%; visual 8.8%). Birth order (p<0.001), maternal (p = 0.004) and child's weight status (p<0.001) were associated with consistently inaccurate verbal and visual descriptions.
  
  
  CONCLUSIONS
  Singaporean mothers, especially those of underweight and overweight children, may not be able to perceive their young child's weight status accurately. To facilitate prevention of childhood obesity, educating parents and caregivers about their child's weight status is needed.
authors.affiliation: Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore.
authors.forename: Tuck Seng
authors.initials: TS
authors.lastname: Cheng
authors.affiliation: KK Research Centre, KK Women's and Children's Hospital, Singapore, Singapore.
authors.forename: See Ling
authors.initials: SL
authors.lastname: Loy
authors.affiliation: Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.|Department of International Health, University of Tampere, Tampere, Finland.
authors.forename: Yin Bun
authors.initials: YB
authors.lastname: Cheung
authors.affiliation: KK Research Centre, KK Women's and Children's Hospital, Singapore, Singapore.|Duke-NUS Medical School, Singapore, Singapore.|Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore.
authors.forename: Jerry Kok Yen
authors.initials: JK
authors.lastname: Chan
authors.affiliation: Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health Systems, Singapore, Singapore.
authors.forename: Mya Thway
authors.initials: MT
authors.lastname: Tint
authors.affiliation: MRC Life-course Epidemiology Unit, University of Southampton, Southampton, United Kingdom.|NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.|Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, (A*STAR), Singapore, Singapore.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gluckman
authors.affiliation: Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kwek
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
authors.forename: Seang Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health Systems, Singapore, Singapore.|Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, (A*STAR), Singapore, Singapore.
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, (A*STAR), Singapore, Singapore.|Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health Systems, Singapore, Singapore.
authors.forename: Yung Seng
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore.|Duke-NUS Medical School, Singapore, Singapore.
authors.forename: Fabian
authors.initials: F
authors.lastname: Yap
authors.affiliation: Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore.|Duke-NUS Medical School, Singapore, Singapore.
authors.forename: Ngee
authors.initials: N
authors.lastname: Lek
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004192:Discrimination, Psychological; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers; D063766:Pediatric Obesity / Q000453:epidemiology / Q000523:psychology*; D012846:Singapore / Q000453:epidemiology; D013851:Thinness / Q000453:epidemiology / Q000523:psychology*
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