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Assessment of selection bias in a health survey of children and families -- the IDEFICS Sweden-study.

Artikel i vetenskaplig tidskrift
Författare Susann Regber
Masuma Novak
Gabriele Eiben
Lauren Lissner
Sabrina Hense
Tatiana Zverkova Sandström
Wolfgang Ahrens
Staffan Mårild
Publicerad i BMC public health
Volym 13
Nummer/häfte 1
Sidor 418
ISSN 1471-2458
Publiceringsår 2013
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Institutionen för kliniska vetenskaper, Avdelningen för pediatrik
Institutionen för medicin, avdelningen för molekylär och klinisk medicin
Sidor 418
Språk en
Länkar dx.doi.org/10.1186/1471-2458-13-418
Ämnesord Selection bias, Children, Obesity, Health survey, Registers
Ämneskategorier Hälsovetenskaper


BACKGROUND: A health survey was performed in 2007--2008 in the IDEFICS/Sweden study (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) in children aged 2--9 years. We hypothesized that families with disadvantageous socioeconomic and -demographic backgrounds and children with overweight and obesity were underrepresented. METHODS: In a cross-sectional study, we compared Swedish IDEFICS participants (N=1,825) with referent children (N=1,825) using data from Statistics Sweden population registers. IDEFICS participants were matched for age and gender with a referent child living in the same municipality. Longitudinal weight and height data from birth to 8 years was collected for both populations (n=3,650) from the children's local health services. Outcome measures included the family's socioeconomic and demographic characteristics, maternal body mass index (BMI) and smoking habits before pregnancy, the children's BMI standard deviation score (SDS) at the age of inclusion in the IDEFICS study (BMISDS-index), and the children's BMI-categories during the age-span. Comparisons between groups were done and a multiple logistic regression analysis for the study of determinants of participation in the IDEFICS study was performed. RESULTS: Compared with IDEFICS participants, referent families were more likely to have lower education and income, foreign backgrounds, be single parents, and have mothers who smoked before pregnancy. Maternal BMI before pregnancy and child's BMISDS-index did not differ between groups. Comparing the longitudinal data-set, the prevalence of obesity was significantly different at age 8 years n= 45 (4.5%) versus n= 31 (2.9%) in the referent and IDEFICS populations, respectively. In the multivariable adjusted model, the strongest significant association with IDEFICS study participation was parental Swedish background (odds ratio (OR) = 1.91, 95% confidence interval (CI) (1.48--2.47) followed by parents having high education OR 1.80, 95% CI (1.02-3.16) and being married or co-habiting OR 1.75 95% CI (1.38-2.23). CONCLUSION: Families with single parenthood, foreign background, low education and income were underrepresented in the IDEFICS Sweden study. BMI at inclusion had no selection effect, but developing obesity was significantly greater among referents.

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