ArticleBMC pediatrics2020
Association of number of siblings, birth order, and thinness in 3- to 12-year-old children: a population-based cross-sectional study in Shanghai, China.
Article in BMC pediatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- The global prevalence of single-child families with emphasis on influential factors: a comprehensive systematic review and meta-analysis.Population health metrics · 2025Pooled it
- Concurrent child undernutrition indicators in Malawi: application of trivariate logistic regression.Frontiers in nutrition · 2026Article
- Exploring the Potential Causal Relationship Between Health Insurance Coverage and Child Nutritional Status in Pakistan: Evidence from PDHS-2018.Healthcare (Basel, Switzerland) · 2025Article
- Inequality of opportunity in child nutrition in Pakistan.PloS one · 2025Article
- Additive interaction between birth asphyxia and febrile seizures on autism spectrum disorder: a population-based study.Molecular autism · 2024Article
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- Modeling the Risk Factors of Undernutrition among Children below Five Years of Age in Uganda Using Generalized Structural Equation Models.Children (Basel, Switzerland) · 2023Article
- Effects of Sibship Size and Birth Order on Sexual and Reproductive Health among Sexually Active Young People in China.Children (Basel, Switzerland) · 2022Article
- Comparing the Perceptions of Gender Norms among Adolescents with Different Sibling Contexts in Shanghai, China.Children (Basel, Switzerland) · 2022Article
- Caries status of first-born child is a predictor for caries experience in younger siblings.Clinical oral investigations · 2022Article
- Underweight and Associated Factors Among Teenage Adolescent Girls in Resource-poor Settings: A Cross-sectional Study.Risk management and healthcare policy · 2021Article
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12 authors at 1 institution in 2 countries.
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Abstract
backgroundSibship size and structure have a significant association with overweight and obesity in children, but the relationship with thinness has not been fully studied and understood, especially in Asia. This study evaluated the associations among number of siblings, birth order, and childhood thinness and investigated the association of number of younger or older siblings with childhood thinness.
methodsIn this study, we performed a population-based cross-sectional study among 84,075 3- to 12-year-old children in Shanghai using multistage stratified cluster random sampling. We defined grades 1, 2, and 3 thinness according to the body mass index cutoff points set by the International Obesity Task Force and used multinomial logistic regression models to estimate the odds ratio (OR) and 95% confidence interval (95% CI).
resultsCompared with only children, for boys, children with two or more siblings were more likely to suffer from grade 2 (OR = 1.29, 95% CI 1.02, 1.64) and grade 3 thinness (OR = 1.60, 95% CI 1.07, 2.40); and the youngest child faced a higher risk of grade 2 (OR = 1.44, 95% CI 1.09, 1.90) and grade 3 thinness (OR = 1.53, 95% CI 1.01, 2.33). For girls, children with one sibling were more likely to suffer from grade 1 thinness (OR = 1.22, 95% CI 1.05, 1.42); the oldest child, middle child, and youngest child faced a higher risk of grade 1 (OR = 1.42, 95% CI 1.09, 1.84), grade 2 (OR = 1.26, 95% CI 1.03, 1.54), and grade 1 thinness (OR = 1.87, 95% CI 1.21, 2.88) respectively. There was no statistically significant relationship, however, between a larger number of younger or older siblings and childhood thinness.
conclusionsRegardless of sex, having either siblings or a higher birth order was positively associated with childhood thinness. The present study has suggested that future interventions to prevent childhood thinness should consider family background as an important factor, especially in multi-child-families.
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