Impact Of Maternal Parenting Stress On Offspring’s BMI Z Scores In Early Childhood

Objective: A prospective longitudinal cohort study was designed to examine the impact of maternal parenting stress on children’s BMI＿Z in the current year and after 2-4 years,and the impact of maternal persistent parenting stress on the BMI＿Z in early childhood.Methods: The participants of this study are children under one year old and their parents randomly recruited from five central urban areas of Wuhan from 2010 to 2013.The baseline survey was conducted at children aged 1 year old.And families were followed up at the children’s 3 and 5 years old with questionnaire information and anthropometric measurements collected.The questionnaires included the general demographic questionnaires(e.g.,children’s basic characteristics,parents’ basic characteristics and families’ basic characteristics)and the parenting stress questionnaire.Anthropometric measurements include the parental and children’s weight,body length/height.In order to examine the impact of maternal persistent parenting stress on children’s BMI＿Z,this families were divided into higher and lower maternal persistent parenting stress group according to the 75 th percentile of the average score of parenting stress during the five-year follow-up period.The chi-square test was used for the categorical variables,the variance analysis was used for the continuous variables conforming to the normal distribution or approximate normal distribution,and the kruskal-wallis test was used for the continuous variables with skewed distribution.After controlling relevant confounders(e.g.,children’s sex,parental BMI,parental education,family income,and family structure),multiple linear regression was used to analyze the influence of maternal parenting stress on BMI＿Z of children in the current year and the next 2-4 years.The effect of maternal persistent parenting stress on children aged 1,3 and 5 years was analyzed by using linear mixing model.Results:(1)Basic situation: a total of 299 families were included in this study,and 191 families were followed up,with a follow-up rate of 63.88%.Among them,143cases(74.87%)were in the lower maternal persistent parenting stress group,and 48 cases(25.13%)were in the higher maternal persistent parenting stress group.No significant difference between the baseline data and the follow-up population(p>0.05).(2)The total score of parenting stress at children aged 1 and 3 years old was significantly higher than that at children aged 5 years old(p<0.05);There was a significant difference in the total score of maternal parenting stress between family structure.And the difference was only found in the 3-year follow-up data.The total score of maternal parenting stress in the direct family was significantly lower than that in the nuclear family(p<0.05).In the follow-up of children at 1,3 and 5 years old,it was found that the total score of maternal parenting stress was significantly different according to the family income level.The total score of maternal parenting stress in families with monthly income of less than 5,000 yuan and families with monthly income of 5001-10,000 yuan was significantly higher than that of families with monthly income of more than 10,000 yuan(p<0.05).(3)There were differences in BMI and BMI＿Z between children in the higher maternal persistent parenting stress group and those in the lower maternal persistent parenting stress group.The weight,BMI and BMI＿Z of 1-year-old boys in the higher maternal persistent parenting stress group were higher than those in the lower maternal persistent parenting stress group(p<0.05).(4)After controlling relevant confounders,the results of multivariate linear analysis showed that the maternal parenting stress at children aged 1 years old had a significant effect on the children’s BMI＿Z at 3 years old(β=0.011,p<0.05).The results of linear mixing effect model analysis showed that,when other conditions were unchanged,the BMI＿Z value of children at 1,3 and 5 years old in the higher maternal persistent parenting stress group was higher than that in the lower maternal persistent parenting stress group(β=0.239,p<0.05)..Conclusions: Maternal parenting stress at children aged 1 years old has a significant effect on children’s BMI＿Z at 3 years old.Children in the higher maternal persistent parenting stress group have higher BMI＿Z values between 1-5 years of age.Early childhood obesity interventions need to consider the impact of maternal parenting stress.