Hindawi Publishing Corporation International Journal of Pediatrics Volume 2012, Article ID 157237, 9 pages doi:10.1155/2012/157237 Clinical Study Perinatal Factors Associated with Cardiovascular Disease Risk among Preschool-Age Children in the United States: An Analysis of 1999–2008 NHANES Data Sarah E. Messiah,1, 2 Kristopher L. Arheart,1, 2, 3 Steven E. Lipshultz,1, 2 Emmalee S. Bandstra,4 and Tracie L. Miller1, 2 1 Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Leonard M. Miller School of Medicine, Batchelor Children’s Research Institute, 580 NW 10th Avenue (D820), Miami, FL 33101, USA 2 Department of Epidemiology and Public Health, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33101, USA 3 Division of Biostatistics, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33101, USA 4 Division of Neonatology, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33101, USA Correspondence should be addressed to Sarah E. Messiah, smessiah@med.miami.edu Received 15 October 2011; Revised 11 January 2012; Accepted 26 January 2012 Academic Editor: Tessa J. Roseboom Copyright © 2012 Sarah E. Messiah et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We examined the relationships between selected perinatal and early infancy factors (maternal smoking during pregnancy, infant low birthweight, breastfeeding, and early introduction of solid foods [<6 months of age] and increased BMI [≥85th, ≥95th percentiles for age, sex]), waist circumference (WC), C-reactive protein (CRP), triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein (HDL) cholesterol, and decreased HDL cholesterol during early childhood. The population-based sample included 3,644 3-to-6-year-old Non-Hispanic White (NHW), Hispanic, and Non- Hispanic Black (NHB) children who participated in the 1999–2008 National Health and Nutrition Examination Surveys. Analysis showed that breastfeeding was signiﬁcantly protective against early childhood obesity (OR 0.43, 95% CI, 0.27–0.69) and the highest quintile for WC (OR 0.58, 95% CI, 0.37–0.32) among NHW, and against the highest quintile of non-HDL cholesterol among NHB (OR 0.56, 95% CI, 0.32–0.98). Additionally, NHW children were signiﬁcantly more likely to be obese (OR 2.22, 95% CI 1.30–3.78) and have higher CRP levels (OR 1.63, 95% CI, 1.05–2.51) if their mothers smoked during pregnancy. These results support the observation that breastfeeding may be protective against early childhood obesity while maternal smoking during pregnancy is a risk factor for obesity and increased CRP levels among NHW young children. 1. Introduction The theory that events in the perinatal period have latent eﬀects throughout the life course has become increasingly accepted [1]. The literature on the fetal-origins hypothesis strongly suggests that while maternal malnutrition and poor maternal health might not cause major malformations in childhood, such exposures can nevertheless have enduring, or latent, eﬀects such as restricted growth, hypertension, cardiovascular events, and altered renal function in adult- hood. [1, 2] These potential maternal environments can be physiological (e.g., maternal metabolic regulation), psy- chobehavioral (e.g., stress, smoking), and/or ecological (e.g., poverty, unstable food supply). The literature is emerging on how these environments aﬀect the long-term growth and health of children as they develop into adulthood. [3–5] A recently published review of 135 studies to evaluate factors in early childhood (≤5 years of age) that are the most signiﬁcant predictors of the development of obesity in adulthood reported that possible early markers of obesity included maternal smoking and maternal weight gain during pregnancy [6]. Probable early