Socioecological correlates of parental lifestyle patterns during the prenatal period

BACKGROUND: There is growing evidence that family lifestyle patterns in early life are associated with the risk of child obesity. However, beyond the influence of socio-economic position, scarce are studies on the social determinants of such lifestyle patterns. The aim was therefore to investigate the socio-ecological correlates of parental lifestyle patterns in pregnancy. METHODS: We selected 1,110 families from the EDEN birth cohort, recruited in two maternity hospitals in France between 2003 and 2006. In a previous work, we identified two parental lifestyle patterns characterized by 1) “high parental smoking, low maternal diet quality, and low leisure physical activity 2) “low parental body mass index and high gestational weight gain”. Within the framework of both socio-ecological and hierarchical approaches, we conducted multivariable linear regression analyses, with socio-ecological factors added progressively from the most distal to the most proximal, i.e. urban environment variables (block 1); socio-economics, geographic origin, parents’ age, parity (block 2); and psychological factors or access to health care (block 3). RESULTS: Parents with a higher socio-economic position (education level, household income), first-time or older mothers and those having attended antenatal sessions had lower scores on the first pattern. Multiparous women, with an intermediate level of education, and older fathers had lower scores on the second pattern. No major associations were reported with urban environment or psychological factors. CONCLUSIONS: Beyond the expected socio-economic gradient of family lifestyle patterns, we report novel insights into potential levers specific to the prenatal period, such as the opportunity of parenting preparation to engage in healthy behaviours. Analyses will be replicated in three other European cohorts, if confirmed, these findings will be valuable to increase the effectiveness of future childhood obesity prevention strategies in early life. KEY MESSAGES: • Higher socio-economic conditions and attendance of parenting preparation classes are associated with healthier family lifestyle in pregnancy. • The identification of potential facilitators and barriers for family lifestyle in early life will help for further translation to effective childhood obesity prevention and implementation strategies.