Jiaxing Birth Cohort

Childhood obesity is becoming an emerging public health issue worldwide, owing to its association with a variety of health problems at younger ages in adulthood, including obesity, type 2 diabetes, and cardiovascular diseases. Identification of prenatal and early lifer risk factors is key for curbing the epidemic of the childhood obesity. Previous evidence has found a variety of risk factors for childhood obesity, such as maternal obesity, gestational weight gain, birthweight, weight gain during infancy, and genetic variations. However, most of the evidence comes from results of Western populations, with evidence rather insufficient and limited in Chinese populations.


From 1999, the Jiaxing Birth Cohort was established based on the existing monitoring system in the Jiaxing area previously enrolled in the birth defect surveillance system. Women in the Jiaxing area were registered at the monitoring system when they were pregnant, and were followed up until the birth of their children. The children born to the registered women continued to be followed up regularly until 6-7 years of age before they went to school.


Using the data from the Jiaxing Birth Cohort, we have addressed many important issues related to maternal and child health, including the association between duration of exclusive breastfeeding and childhood overweight, the association of timing and type of complementary feeding with childhood adiposity, and the association of prenatal risk factors with different birth outcomes. Recently, we integrated an interpretable machine learning algorithm to identify early life risk factors of childhood obesity among preterm infants, which was published in BMC Medicine. In this research, we found that the trajectory of BMI Z-score change with the first year of life is the most important predictor for childhood overweight/obesity. Furthermore, introducing solid foods after 6 months of corrected age was found to be a recommended feeding practice for mitigating the risk of being in the unfavored trajectory of BMI Z-score. So far, we have published 10 articles based on the Jiaxing Birth Cohort, and the full list of the publications are listed below.


  1. Fu YQ, Gou WL, Hu WS, et al.  Integration of an interpretable machine learning algorithm to identify early life risk factors of childhood obesity among preterm infants: a prospective birth cohort. BMC Medicine 2020; (In press, doi: 10.1186/s12916-020-01642-6)

  2. Zheng JS, Liu H, Jiang J, et al. Cohort Profile: The Jiaxing Birth Cohort in China. Int J Epidemiol. 2017;46(5):1382‐1382g. doi:10.1093/ije/dyw203

  3. Zheng JS, Liu H, Ong KK, et al. Maternal Blood Pressure Rise During Pregnancy and Offspring Obesity Risk at 4 to 7 Years Old: The Jiaxing Birth Cohort. J Clin Endocrinol Metab. 2017;102(11):4315‐4322. doi:10.1210/jc.2017-01500

  4. Wang F, Liu H, Wan Y, et al. Age of Complementary Foods Introduction and Risk of Anemia in Children Aged 4-6 years: A Prospective Birth Cohort in China. Sci Rep. 2017;7:44726. Published 2017 Mar 23. doi:10.1038/srep44726

  5. Liu H, Zheng JS, Li J, et al. Increased pre-school overweight and obesity prevalence between 2004 and 2013 is associated with appetite, eating frequency and supportive facilities: the Jiaxing Birth Cohort in China. Asia Pac J Clin Nutr. 2017;26(5):881‐887. doi:10.6133/apjcn.072017.05

  6. Wang F, Liu H, Wan Y, et al. Sleep Duration and Overweight/Obesity in Preschool-Aged Children: A Prospective Study of up to 48,922 Children of the Jiaxing Birth Cohort. Sleep. 2016;39(11):2013‐2019. Published 2016 Nov 1. doi:10.5665/sleep.6234

  7. Wang F, Liu H, Wan Y, et al. Prolonged Exclusive Breastfeeding Duration Is Positively Associated with Risk of Anemia in Infants Aged 12 Months. J Nutr. 2016;146(9):1707‐1713. doi:10.3945/jn.116.232967

  8. Zheng JS, Guan Y, Zhao Y, et al. Pre-conceptional intake of folic acid supplements is inversely associated with risk of preterm birth and small-for-gestational-age birth: a prospective cohort study. Br J Nutr. 2016;115(3):509‐516. doi:10.1017/S0007114515004663

  9. Zheng JS, Liu H, Zhao YM, et al. Complementary feeding and childhood adiposity in preschool-aged children in a large Chinese cohort. J Pediatr. 2015;166(2):326‐31.e2. doi:10.1016/j.jpeds.2014.11.010

  10. Zheng JS, Liu H, Li J, et al. Exclusive breastfeeding is inversely associated with risk of childhood overweight in a large Chinese cohort. J Nutr. 2014;144(9):1454‐1459. doi:10.3945/jn.114.193664