Infant Psychosocial Environment Predicts Adolescent Cardiometabolic Risk: A Prospective Study

J Pediatr. 2019 Jun:209:85-91.e1. doi: 10.1016/j.jpeds.2019.01.058. Epub 2019 Mar 12.

Abstract

Objective: To prospectively assess whether the infant psychosocial environment was associated with cardiometabolic risk as early as adolescence.

Study design: Participants were recruited in Santiago, Chile, and have been followed from infancy. Inclusion criteria included healthy infants with birth weight ≥3 kg and a stable caregiver. The psychosocial environment, including depressive symptoms, stressful life events, poor support for child development, father absence, and socioeconomic status, was reported by mothers at 6-12 months. Body mass index (BMI) z score was assessed at 5 and 10 years. BMI z score, waist-to-hip ratio, systolic and diastolic blood pressure, fat mass and body fat percentage, fasting glucose, total and high-density lipoprotein cholesterol, and homeostatic model of insulin resistance were tested in adolescence.

Results: Adolescents ranged from 16 to 18 years of age (n = 588; 48.1% female). A poorer infant psychosocial environment was associated with BMI z score at 10 years (β = 0.10, 95% CI = 0.00-0.19) and in adolescence (β = 0.15, 95% CI = 0.06-0.24) but not at 5 years. A poorer infant psychosocial environment was associated with higher blood pressure (β = 0.15, 95% CI = 0.05-0.24), greater anthropometric risk (β = 0.13, 95% CI = 0.03-0.22), greater biomarker (triglycerides, homeostatic model assessment of insulin resistance, total cholesterol) risk (β = 0.12, 95% CI = 0.02-0.22), and a higher likelihood of metabolic syndrome in adolescence (aOR = 1.50; 95% CI = 1.06-2.12).

Conclusions: These findings demonstrate that a poorer infant psychosocial environment was associated with greater adolescent cardiometabolic risk. The results support screening for infants' psychosocial environments and further research into causality, mechanisms, prevention, and intervention.

Keywords: BMI; adolescence; blood pressure; cardiometabolic risk; infancy; metabolic syndrome; stress.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Anthropometry
  • Birth Weight
  • Body Mass Index*
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / physiopathology
  • Chile
  • Cohort Studies
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology*
  • Obesity / epidemiology*
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Psychology / methods*
  • Risk Assessment
  • Sex Factors
  • Urban Population
  • Waist-Hip Ratio