Children’s weight changes according to maternal perception of the child’s weight and health: A prospective cohort of Peruvian children

The aim of the study was to estimate the association between maternal perception of their child's health status and (mis)classification of their child's actual weight with future weight change. We present cross-sectional and longitudinal analyses from the Peruvian younger cohort of the Young Lives Study. For cross-sectional analysis, the exposure was maternal perception of child health status (better, same or worse); the outcome was underestimation or overestimation of the child's actual weight. Mothers were asked about their perception of their child's weight (same, lighter or heavier than other children). Actual weight status was defined with IOTF BMI cut-off points. For longitudinal analysis, the exposure was (mis)classification of the child's actual weight; the outcome was the standardized mean difference between follow-up and baseline BMI. A Generalized Linear Model with Poisson family and log-link was used to report the prevalence ratio (PR) and 95% confidence intervals (95% CI) for cross-sectional analyses. A Linear Regression Model was used to report the longitudinal analysis as coefficient estimates (β) and 95% CI. Normal weight children who were perceived as more healthy than other children were more likely to have their weight overestimated (PR = 2.06); conversely, those who were perceived as less healthy than other children were more likely to have their weight underestimated (PR = 2.17). Mean follow-up time was 2.6 (SD: 0.3) years. Overall, underweight children whose weight was overestimated were more likely to gain BMI (β = 0.44); whilst overweight children whose weight was considered to be the same of their peers (β = -0.55), and those considered to be lighter than other children (β = -0.87), lost BMI. Maternal perception of the child's health status seems to influence both overestimation and underestimation of the child's actual weight status. Such weight (mis)perception may influence future BMI.